Fellow Rush Medical College of Rush University Medical Center Chicago, Illinois, United States
Background: Packed red blood cells (pRBC) are a precious and limited resource that is frequently utilized in the NICU. Unrestricted transfusion practices can lead to increased risk of adverse side effects, healthcare costs and waste of valuable transfusion resources. With that said, studies demonstrate that neonatologists have an estimated 20-30% non-adherence rate with the pRBC transfusion guideline at their given institution. The existing literature does not explain what factors influence a neonatologist’s decision to not adhere to their unit’s transfusion guideline. Objective: The goal of this study is to investigate provider and patient-related factors that may influence a neonatologist's decision to adhere to the pRBC transfusion guideline of a single level III NICU. We hypothesize that the neonatologist's years in practice, a history of prior transfusions, and the patient's clinical status will be significant in influencing the decision to transfuse patients. Design/Methods: With the Epic EMR, query reports will be utilized to identify patients who 1) received a pRBC transfusion off guideline or 2) did not receive a pRBC transfusion when the guideline would have recommended it. These patient charts will be accessed and the pertinent patient data will be collected (e.g. hematocrit level, age, comorbidities, etc.). In order to acquire provider data (e.g. years in practice, prior experience with a guideline, etc.), baseline interviews will be conducted and follow up REDCap surveys will be sent to the neonatologist responsible for the patient's care at the time of the aforementioned events. Interviews will be recorded on a digital audio recorder and will subsequently be coded and themed in a qualitative data analysis using Dedoose software. Data collected from patient charts and REDCap surveys will be quantitatively analyzed using the SPSS (Statistical Package for the Social Sciences) software program. Data collection will be conducted from September to February 2023 and data analysis will be performed in March of 2023. This study was approved by the IRB of Rush University.
