Improving the Safety and Efficacy of Blood Product Administration in the Pediatric Hematology/Oncology Patient Population

Inaccurate blood product ordering can have a negative impact on patient care by leading to delays in transfusion initiation and inadequate use of hospital resources. The pediatric hematology/oncology patient population is at an increased risk of blood product ordering errors due to the numerous modifications, weight-based dosing, and special processing that are often required to keep transfusions safe. Our SMART Aim was to decrease the percentage of incorrectly ordered blood products at our center by 50% over a 9-month time period. At baseline, we found that there was a 60% median error rate in blood product ordering. The most common error in blood product ordering at our institution was the utilization of cytomegalovirus-negative blood products when it was not required institutionally due to our standardized leukoreduction process. Educating providers on the blood product ordering process, appropriate modifications required for a given clinical scenario, and weight-based dosing was associated with a reduction in the median percentage of incorrectly ordered blood products to 30% over the course of the project. In the future, we plan to implement improvements in blood product ordering across the entirety of the children's hospital at our institution.