Disease transmission by blood transfusion continues to be a major concern because of the continued increase in the prevalence of AIDS and the lack of a specific test for non-A, non-B hepatitis. The health care costs of patients who develop post-transfusion hepatitis are over $150 million per year. The mission of this project is to reduce disease transmission by increasing the appropriate use of the patient's own predonated blood for elective surgery. Traditional medical education in the past 30 years has been ineffective: in January-February 1986, 94% of elective surgery patients who could predonate did not do so. Efficient and well-organized predonation programs are urgently needed. The investigators propose to develop model programs in the east, west and midwest areas of the country.
The specific aims of the study are to determine why predonations are underutilized and to test whether an education program increases (1) the predonation rate and (2) the number of patients who actually benefit. The main target of education are surgeons because they order predonation. Chiefs of Surgery at the study sites believe that such a project is timely and important. Others targets are anesthesiologists, surgery clinic nurses, elective surgery patients and blood bank personnel. The program includes lectures, brochures, slides, tapes, posters, blood order forms and feedback reports. An estimated 9000 patients will be studied over 3 years. Other questions which will be answered included: what proportion of the blood supply can be predonated units, how often freezing blood is necessary for elective surgery patients, and how often clerical errors occur. """"""""Model"""""""" programs are often not """"""""modelled"""""""" at other institutions. A unique aspect of this proposal is the incorporation of a dissemination phase in years 4 and 5, when the program will be tested at 3 community and 15 teaching hospitals in different parts of the country.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL036715-02
Application #
3351900
Study Section
(SRC)
Project Start
1987-04-01
Project End
1992-03-31
Budget Start
1988-04-01
Budget End
1989-03-31
Support Year
2
Fiscal Year
1988
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Type
Schools of Medicine
DUNS #
073133571
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Toy, P T; Kerr, K (1996) Preoperative autologous blood donation. AACN Clin Issues 7:221-8
Ferguson, K J; Strauss, R G; Toy, P T (1994) Physician recommendation as the key factor in patients' decisions to participate in preoperative autologous blood donation programs: Preoperative Autologous Blood Donation Study Group. Am J Surg 168:2-5
Randels, M J; Ferguson, K; Strauss, R G et al. (1994) Preoperative autologous donation: surgery clinic staff knowledge/attitudes. Preoperative Autologous Blood Donation Study Group. J Clin Apher 9:168-70
Toy, P T; Menozzi, D; Strauss, R G et al. (1993) Efficacy of preoperative donation of blood for autologous use in radical prostatectomy. Transfusion 33:721-4
McVay, P A; Hoag, M S; Lee, S J et al. (1992) Factors associated with successful autologous blood donation for elective surgery. Am J Clin Pathol 97:304-8
Toy, P T; McVay, P A; Strauss, R G et al. (1992) Improvement in appropriate autologous donations with local education: 1987 to 1989. Transfusion 32:562-4
Toy, P T; Kaplan, E B; McVay, P A et al. (1992) Blood loss and replacement in total hip arthroplasty: a multicenter study. The Preoperative Autologous Blood Donation Study Group. Transfusion 32:63-7
McVay, P A; Fung, H C; Toy, P T (1991) Return of autologous blood donors as homologous blood donors. Transfusion 31:119-21
McVay, P A; Strauss, R G; Stehling, L C et al. (1991) Probable reasons that autologous blood was not donated by patients having surgery for which crossmatched blood was ordered. Transfusion 31:810-3
Strauss, R G; Ferguson, K J; Stone, G G et al. (1990) Surgeons' knowledge, attitude, and use of preoperative autologous blood donation. Transfusion 30:418-22

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