Factors Essential to the Progress of Patient Blood Management

1. Factors Essential to the Progressof Patient Blood Management Sharon Vernon, RN 09/21/2012

2. Definition - Courage COURAGE “The quality of mind or spirit that enables a person to face difficulty, danger, pain, etc., without fear; bravery.” “Have the courage of one's convictions, to act in accordance with one's beliefs, especially in spite of criticism.”

3. Courage

6. Courage

7. Patient Self-Determination Act The right to facilitate their own health care decisions. The right to accept or refuse medical treatment. The right to make an advance health care directive.

8. Courage Physicians’ courage resulted in a wealth of alternatives to transfusions.

9. Nursing Advocacy • Identify patient’s wishes regarding medical care – take role as an advocate. • Medical environment became a Team concept. • Nurses become PBM coordinators.

10. Definition - Commitment COMMMITMENT “A promise, a dedication or an obligation.” “It embodies a pledge, devotion, steadfastness, allegiance and/or loyalty.”

12. Fee-based Assistance Providers to Hospitals Strategic Blood Management™ Consulting Haemonetics - THE Blood Management Company PDC Perfusion Services

13. SABM Goals Research the positive impact of innovative Patient Blood Management Programs. Educate professionals. Educate the public.

15. Date for implementation into the survey process has not been announced. Implementation Guide for The Joint Commission Patient Blood Management Performance Measures 2011

16. The Joint Commission PBM-01 Transfusion Consent PBM-02 RBC Transfusion Indication PBM-03 Plasma Transfusion Indication PBM-04 Platelet Transfusion Indication PBM-05 Blood Administration Documentation PBM-06 Preoperative Anemia Screening PBM-07 Preoperative Blood Type Testing and Antibody Screening

17. American Association of Blood Banks Patient Blood Management: Patient Care and Outcome Strategies Workshop  October 5, 2012 Boston Convention & Exhibition Center - Boston, MA

18. Future Needs • More PBM Programs • More PBM Nurses • Education in Medical Schools • The JC measures implemented in survey process • Additional funding for research • Ongoing commitment

19. The Strategy Win them over….. One at a time….

20. CV Guidelines • 2011 Guideline Update • Manage dual anti-platelet therapy pre-op • Use drugs that augment RBC volume or limit blood • loss • Use of blood derivatives • Changes in management of blood salvage • Use of minimally invasive procedures

21. CV Guidelines • 2011 Guideline Update • Recommendations for blood conservation r/t • extracorporeal membrane oxygenation • cardiopulmonary perfusion • use of topical hemostatic agents • new insights into value of TEAM interventions in blood management

22. AABB Guidelines • Establish National Consensus • Clinical recommendations for Hgb concentration threshold s and other clinical variables that trigger RBC transfusion in hemodynamically stable adults and children

23. AABB Guidelines Establish National Consensus Results: Recommend a restrictive transfusion strategy of 7 to 8 g/dl in hospitalized stable patients and if there is evidence of CV disease a Hgb of 8 g/dl or less.

25. PBM Opportunity • Identify interest • Start with one specialty – ‘to see is to believe’ • Make realistic goals • Don’t settle for ‘status quo’ • Justify your PBM Program

26. JUSTIFY

28. Finish Line

29. The Factors Essential to the Progress of PBM Courage and Commitment Thank You….