0000000001095916
AUTHOR
Alana Delaforce
<p>Preoperative Anemia Screening and Treatment Practices in Patients Having Total Joint Replacement Surgery: A Retrospective, Observational Audit</p>
Background: Surgical patients with preoperative anemia are more likely to experience adverse outcomes. Patient blood management (PBM) guidelines recommend screening and treating patients for anemia preoperatively to enable optimisation before surgery. This study investigates compliance with PBM guidelines and reports the association between length of stay and transfusion risk in patients with preoperative anemia. Study Design and Methods: A retrospective, observational, chart audit that included all patients having primary, total hip and knee replacement surgery between July–December 2018 at a tertiary, metropolitan healthcare facility. Results: Six hundred and seven patients patients were …
Preoperative Anemia Screening and Treatment Practices in Patients Having Total Joint Replacement Surgery: A Retrospective, Observational Audit
Alana Delaforce,1,2 Lemya Galeel,2 Edgar Poon,3 Cameron Hurst,4 Jed Duff,1,5 Judy Munday,5,6 Janet Hardy2 1School of Nursing, University of Newcastle, Newcastle, NSW, Australia; 2Mater Research, Mater Health Services, South Brisbane, QLD, Australia; 3School of Pharmacy, University of Queensland, Brisbane, Australia; 4QIMR Berghoffer Medical Research Institute, Brisbane, QLD, Australia; 5School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia; 6School of Nursing, The University of Agder, Kristiansand, NorwayCorrespondence: Alana DelaforceMater Research Mater Health Services, Level 6, Duncombe Building, Raymond Terrace, South Brisbane, QLD 4101, AustraliaTel +61 3163 …
<p>Barriers and enablers to the implementation of perioperative hypothermia prevention practices from the perspectives of the multidisciplinary team: a qualitative study using the Theoretical Domains Framework</p>
Judy Munday,1,2 Alana Delaforce,1,3 Gillian Forbes,4 Samantha Keogh11School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia; 2Department of Health and Nursing Science, University of Agder, Grimstad, Norway; 3Clinical Governance Unit, Mater Health, South Brisbane, QLD 4101, Australia; 4Department of Clinical, Educational and Health Psychology, UCL Centre for Behaviour Change, London WC1E 6BT, UKPurpose: Inadvertent perioperative hypothermia is a significant problem for surgical patients globally, and is associated with many detrimental side-effects. Despite the availability of rigorously developed internatio…
<p>Preoperative Anemia and Iron Deficiency Screening, Evaluation and Management: Barrier Identification and Implementation Strategy Mapping</p>
Introduction and aims: Patients undergoing major surgery risk significant blood loss and transfusion, which increases substantially if they have pre-existing anemia. Preoperative Anemia and Iron Deficiency Screening, Evaluation and Management Pathways (PAIDSEM-P) outline recommended blood tests and treatment to optimize patients before surgery. Documented success using PAIDSEM-P to reduce transfusions and improve patient outcomes exists, but the reporting quality of such studies is suboptimal. It remains unclear what implementation strategies best support the implementation of PAIDSEM-P. Method: Maximum variation, purposive sampling was used to recruit a total of 15 partici-pants, including…
Assessing transfusion practice in elective surgical patients: a baseline audit
Background Externally generated hospital benchmarking data indicated that the blood transfusion rate within elective surgical orthopaedic and gastrointestinal patients at a metropolitan, tertiary healthcare facility was higher than comparable Australian hospitals. An investigation of transfusion practices was undertaken with the aim of understanding the reasons contributing to this higher incidence. Study Methods A chart audit was undertaken of every major, elective, surgical orthopaedic and gastrointestinal patient who received a blood transfusion between July and December 2017. The audit aimed to ascertain whether patients were screened and treated for preoperative anaemia and measure the…
Preoperative Anemia and Iron Deficiency Screening, Evaluation and Management: Barrier Identification and Implementation Strategy Mapping
Alana Delaforce,1,2 Jed Duff,1,3 Judy Munday,3,4 Janet Hardy2 1School of Nursing and Midwifery, The University of Newcastle, Callaghan, NSW, Australia; 2Mater Health Services, South Brisbane, QLD 4101, Australia; 3School of Nursing/Centre for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, QLD, Australia; 4School of Nursing, The University of Agder, Kristiansand, NorwayCorrespondence: Alana Delaforce Email alana.delaforce@mater.org.auIntroduction and aims: Patients undergoing major surgery risk significant blood loss and transfusion, which increases substantially if they have pre-existing anemia. Preoperative Anemia and Iron Deficiency Screening, Evaluation and…
Overcoming barriers to evidence-based patient blood management: a restricted review
Abstract Background Blood transfusions are associated with a range of adverse patient outcomes, including coagulopathy, immunomodulation and haemolysis, which increase the risk of morbidity and mortality. Consideration of these risks and potential benefits are necessary when deciding to transfuse. Patient blood management (PBM) guidelines exist to assist in clinical decision-making, but they are underutilised. Exploration of barriers to the implementation and utilisation of the PBM guidelines is required. This study aimed to identify common barriers and implementation strategies used to implement PBM guidelines, with a comparison against current expert opinion. Methods A restricted review a…