Patient blood management pre-op screening project aims to improve outcomes

A new project from the University of Florida College of Medicine is aimed at screening patients ahead of scheduled surgeries to improve their recovery time and further limit any side effects by preventing unnecessary blood transfusions.

UF’s patient blood management program is an evidence-based approach to improving outcomes by managing and preserving a patient’s own blood, while promoting patient safety and empowerment. UF Health Shands Hospital is home to Gainesville’s only patient blood management program.

World Health Organization recommendations specify that it’s optimal to use a patient’s own blood supply in surgery, when possible, because of the potential side effects that can result from a blood transfusion, said Thorsten Haas, M.D., the director of patient blood management at the College of Medicine and a professor in the division of multispecialty anesthesiology. Common side effects include nausea, fever and chills, but some patients can experience severe complications and even death.

Haas and the patient blood management team recently received a $24,000 grant from the UF W. Martin Smith Interdisciplinary Patient Safety Awards Program to begin a project in which patients are screened for hemoglobin levels before scheduled surgeries. Research shows that anemia, a deficiency of red blood cells or of hemoglobin in the blood that affects 2.4 billion people globally, is a common factor that can lead to a patient needing a blood transfusion.

Patients will be screened for anemia before going into a surgery at UF Health Shands Hospital, and depending on the time that is left before surgery and the underlying reasons for anemia, the health team will work with the patient to increase their hemoglobin levels and reduce the need for a blood transfusion.

“We think we can do something very special here at UF Health by screening all our patients for anemia, and we hopefully can make sure that a substantial number of these patients will be treated for that before they go into surgery,” Haas said. “When they’re starting with better hemoglobin levels, they are less likely to get transfused, which would improve patient safety because they are less likely to develop any side effects.”

Patients can improve their hemoglobin levels by taking an iron supplement or increasing their consumption of iron-rich foods such as dark, leafy vegetables, red meat, tofu, dried fruit and iron-fortified wheat products. By eliminating the need for blood transfusions, Haas said, patients are likely to recover from surgery and return home from the hospital more quickly. It also frees up the hospital’s blood supply for emergency cases or other situations where anemia is not the primary reason for transfusion.

Under Haas’ direction, UF’s patient blood management program has undergone significant growth in the past several months. The team recently hired a patient blood management quality officer, Imke Casey, D.N.P., CRNA, RN-BC, RHIT, to manage everyday needs for the program. She said the interdisciplinary work across teams at the College of Medicine and the hospital will help to make processes run more smoothly for all health care teams to minimize the need for transfusions.

“It is a very intricate and complex system that we really have to address,” she said. “We know how to provide excellent anesthesia surgical care. But we can notch it up a bit because the recent evidence shows us we should take hemoglobin levels into consideration. Having a clinical background working with many different teams in quality improvement both as a nurse anesthetist and in academia, I think the best improvements come when everyone isn’t siloed but rather working together to progress, as we are with this program.”

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