ObjectiveTo explore the applications of shorten waiting time for clinical receiving fresh frozen plasma (FFP) in patient blood management (PBM).
MethodsFrom April to November 2017, a total of 4 974 copies of clinical data from patients who receiving FFP infusion treatment in the First Affiliated Hospital of Chongqing Medical Universityin were selected as research subjects. According to the implementation of rectification measures for shorten waiting time for clinical receiving FFP, the research subjects were divided into preliminary rectification stage group (n=2 303, FFP receiving date was from June to August 2017), continuous rectification stage group (n=2 048, FFP receiving date was from September to November 2017), and control group (n=623, not implemented any rectification measures, FFP receiving data was from April to May 2017). By investigating the clinical data of the control group and preliminary rectification stage group, analyzed the problems and their causes existing in clinical receiving FFP, and formulated preliminary and continuous rectification measures to shorten waiting time for clinical receiving FFP. Calculate the average waiting time for clinical receiving FFP in each group, as well as the scrap rate and outbound time of pre-thawed FFP in preliminary rectification stage group and continuous rectification stage group. The overall comparison of the average waiting time for clinical receiving FFP among the three groups, was performed using the Kruskal-WallisHtest. The pairwise comparison between groups was performed using the Mann-WhitneyUtest, and the test level correction of the pairwise comparison was performed using the Bonferroni correction method.The comparison of scrap rate of pre-thawed FFP between preliminary rectification stage group and continuous rectification stage group was performed using Chi-square test.
Results① In this study, the median waiting time for clinical receiving FFP of whole hospital in the continuous rectification stage group, preliminary rectification stage group, and control group were 8.0 min (5.0-14.8 min), 11.0 min (4.0-18.0 min) and 19.0 min (16.0-23.0 min), respectively. And the difference of median waiting time for clinical receiving FFP in whole hospital among three groups was statistically significant (χ2=239.862,P<0 .001), the differences of that compared the continuous rectification stage group and preliminary rectification stage group with control group were statistically significant (Z=-11.651,P<0 .001;Z=-15.986,P<0 .001). the median waiting time for clinical receiving ffp in department of critical patients were 8.0 min (5.0-13.0 min), 11.5 min (4.0-17.0 min), and 20.0 min (17.0-23.0 min), respectively. and the difference of median waiting time for clinical receiving ffp in department of critical patients among three groups was statistically significant (χ2=150.978,P<0 .001), the differences of that compared the continuous rectification stage group and preliminary rectification stage group with control group were statistically significant (Z=-9.225,P<0 .001;Z=-12.602,P<0 .001), and the difference of that compared the preliminary rectification stage group with continuous rectification stage group was statistically significant (Z=-2.176,P=0.030). ② In the preliminary rectification stage group, a total of 6 581 bags of FFP were pre-thawed, of which 7 bags were scrapped, and the scrap rate was 0.11% (7/6 581). In the continuous rectification stage group, a total of 5 853 bags of FFP were pre-thawed, of which 2 bags were scrapped, and the scrap rate was 0.03% (2/5 853). And there was no significant difference in the scrap rates between two groups (χ2=2.232,P=0.135). ③ In the preliminary and continuous rectification stage groups, the un-scrap pre-thawed FFP was 12 425 bags, of which 10 729 bags (86.35%) had a outbound time<12 h, and 1 696 bags (13.65%) had a outbound time with 13-20 h.
ConclusionsThe measures to shorten the waiting time for clinical receiving FFP adopted in this study is worth promoting, which could effectively shorten the waiting time for clinical receiving FFP, reasonably control the scrap rate, and improve the efficiency of PBM. However, the results of this study are limited to a single-center retrospective study. The actual value of shorten the waiting time for clinical receiving FFP in PBM still needs to be further confirmed by a multi-center prospective studies.
