Reducing On-Shelf Wastage of Fresh Frozen Plasma and Cryoprecipitate in a Tertiary Care Hospital Blood Centre: A Clinical Audit Using the Plan-Do-Study-Act (PDSA) Method
摘要
To reduce on-shelf wastage of Fresh frozen plasma (FFP) and Cryoprecipitate units, critical in blood product management given the substantial resources involved and demand-supply disparity in India. This audit aimed to identify and mitigate the causes of breakage in these units. A Prospective clinical audit was conducted at the tertiary care hospital Blood Centre from January to December 2024. The study comprised three stages: Baseline, Intervention, and postintervention using Plan-Do-Study-Act (PDSA) method. Study included all FFP and Cryoprecipitate prepared and stored during this period. Statistical analysis revealed a significant reduction in FFP and Cryoprecipitate breakage proportion from an intervention value of 2.09% to a post-intervention value of (1.03<, p< 0.001), and from a baseline of 2.66% to post-intervention (1.03%, p< 0.001). While the initial decrease from baseline (2.50%) to intervention (2.09%) was not statistically significant (p=0.21), wastage due to all other reasons demonstrated a statistically significant reduction from baseline (4.96%) to intervention (3.68%, p=0.04). Furthermore, the mean wastage of FFP and Cryoprecipitate bags attributable to both breakage and other reasons, showed consistent and statistically significant reductions across the study period (p= 0.012 and p=0.004 respectively for baseline to post-intervention changes, with Post-Hoc Analysis confirming p= 0.01 and p = 0.001). This audit provides a valuable blueprint for other blood centers, achieving a significant reduction in on-shelf FFP and Cryoprecipitate wastage (3.9% to 0.22%) via iterative PDSA. Optimal utilization requires staff training, SOP adherence and monitoring. Future efforts must disseminate these best practices and expand similar Quality improvement (QI) initiatives.