The impact of electronic decision support on transfusion practice: a systematic review

Written by: Stephen P. Hibbs, Nathan D. Nielsen, Susan Brunskill, Carolyn Doree, Mark H. Yazer, Richard M. Kaufman, and Michael F. Murphy

Introduction

The purpose of this paper is to make a systematic review of studies examining the effects of clinical decision support system (CDSS) on the following: 1) prescriber compliance on blood transfusion guidelines, 2) average pre-transfusion blood counts or coagulation parameters as a surrogate of compliance, 3) amount of blood usage, 4) financial outcomes, 5) patient outcomes, 6) educational outcomes, and 7) clinician workflows.

Methods

A search was made through MEDLINE with the following criteria for studies: 1) discuss and investigate use of a decision support system for blood ordering, 2) give recommendations for transfusion of red blood cell (RBC), plasma, platelets, and/or cryoprecipitae, an d 3) report outcomes of interest: 1) prescriber compliance on blood transfusion guidelines, 2) average pre-transfusion blood counts or coagulation parameters as a surrogate of compliance, 3) amount of blood usage, 4) financial outcomes, 5) patient outcomes, 6) educational outcomes, and 7) clinician workflows.