Optimizing Fresh Frozen Plasma Use: A Quality Improvement Initiative in a Community Healthcare Setting

Introduction:

Blood products, including packed red blood cells, fresh frozen plasma (FFP), platelets, and cryoprecipitate, play a critical role in the clinical setting. However, there is a growing concern regarding the overuse of these products in community hospitals, often deviating from established transfusion guidelines. This practice not only increases the risk of transfusion-related reactions but also imposes a financial burden on the healthcare system. This study aims to assess the utilization of FFP and implement interventions to optimize the use of these essential blood products.

Methods:

A retrospective population study was conducted at Landmark Medical Center, Rhode Island. We identified patients who received FFP transfusions between 2021 and 2024 from blood bank records. Data were extracted from the EPIC electronic medical record (EMR) system, including the number of FFP units ordered and administered, pre-transfusion INR values, and the clinical indications recorded in the EMR. A proportional analysis was conducted to evaluate the concordance of FFP use with transfusion guidelines.

Results:

Among the 112 patients analyzed, 67.36% were above 65 years of age. The majority (81.42%) were White non-Hispanic, with a nearly equal gender distribution (57.52% male, 42.48% female). FFP transfusions were administered in accordance with EMR indications in 61.61% of cases, while 38.39% did not meet the documented indications. Notably, of the 69 patients (61.61%) who received FFP transfusions per EMR indications, 44 patients (63.77%) did not adhere to established transfusion criteria, suggesting these cases could have been managed without transfusion.

Conclusion:

This study identifies a significant discrepancy between the use of FFP and transfusion guidelines. Interventions, including provider education, enhanced oversight by the blood bank, and potential modifications to the EMR system, are being considered to improve guideline adherence and optimize the utilization of blood products. These measures are currently under discussion at our community hospital, and further evaluation will be necessary to assess their impact.

No relevant conflicts of interest to declare.