Patient Blood Management Flashcards
1
Q
- Which type of review does not require direct discussion
between the ordering clinician and transfusion service
personnel?
a. Discontinuous prospective
b. Targeted prospective
c. Concurrent
d. Retrospective
e. Prospective
A
d. Retrospective
2
Q
- Which of the following is the most important first step in
developing a comprehensive PBM/BUM program?
a. Identification of a qualified transfusion safety officer
with excellent blood banking bench skills
b. Determination of patient populations within the hospital with the highest blood utilization
c. Creation of a multidisciplinary transfusion committee
to determine the category of blood utilization review
d. Meet with key physician and nursing leadership to
facilitate the creation of a hospital-wide transfusion
guideline
e. Determine the estimated cost savings through the implementation of an anemia clinic for elective surgical
patients
A
d. Meet with key physician and nursing leadership to
facilitate the creation of a hospital-wide transfusion
guideline
3
Q
- Optimal value as it relates to blood utilization is best
obtained by which of the following:
a. Development of standardized cost metric for blood
utilization
b. Reduction in variabilities in transfusion ordering practice from evidence-based standards
c. Consistent reporting of outcome metrics such as
decreased sepsis or emergency room admissions
d. Decreasing peril and waste by encouraging bloodless
surgery and conversion to lower volume phlebotomy
tubes
e. Use of LEAN practices to improve value and prevent
waste by considering the ordering clinician as a customer
A
b. Reduction in variabilities in transfusion ordering practice from evidence-based standards
4
Q
- To receive benefit from a transfusion the patient must
have:
a. A hemoglobin level less than 8 g/dL
b. An invasive procedure planned
c. A pathological lesion or deficiency that can be remedied by functioning stored components
d. A blood order signed by the attending physician
e. Understood the risks, benefits and alternatives, and
given informed consent
A
c. A pathological lesion or deficiency that can be remedied by functioning stored components
5
Q
- Which of the following statements best describes the most
important reason for creating a PBM/BUM program?
a. PBM/BUM decreases blood bank exposure to risk management and litigation by promoting optimal documentation of transfusion indication and expected
outcome within the electronic medical record
b. PBM/BUM reduces patient exposure to transfusion associated acute lung injury (TRALI) through physician
education and by prospectively encouraging mitigation
strategies from the blood supplier
c. PBM/BUM improves patient safety by promoting
evidence-based transfusion, transfusion avoidance
strategies, and prevention of inappropriate transfusion
d. PBM/BUM are laboratory and hospital regulatory requirements that are essential for ensuring a hospital
culture that promotes patient safety through the periodic direct observation and assessment of transfusion
administration by nursing staff
e. PBM/BUM provides significant and substantial direct
and indirect cost savings to both patients and blood
banks by reducing the number of unnecessary or inappropriate transfusions
A
c. PBM/BUM improves patient safety by promoting
evidence-based transfusion, transfusion avoidance
strategies, and prevention of inappropriate transfusion
6
Q
- Which of the following is an example of targeted prospective review as it related to blood utilization?
a. Continuing education on the proactive use of iron to
correct anemia in presurgical patients
b. Viscoelastic testing to assess real-time platelet need for
cardiac surgery patients
c. Hematologist directed erythropoietin clinic for anemic
cancer patients prior to chemotherapy
d. Decision support pop-up restricted to routine orders
for two or more units of RBCs
e. Report of average RBC usage per patient for a targeted
procedure or physician group
A
d. Decision support pop-up restricted to routine orders
for two or more units of RBCs
7
Q
- Which of the following pairs best describes an intervention strategy that is best paired with a utilization review
category?
a. Minimize unnecessary phlebotomy loss, discontinuous
prospective review
b. Periodic physician feedback, retrospective review
c. Annual continuing education for medical residents,
prospective review
d. Predictive modeling, retrospective review
e. Automatic cancellation of surgical blood orders, concurrent review
A
b. Periodic physician feedback, retrospective review
8
Q
- The PBM program planning team should include:
a. Nursing representatives
b. Representatives from the facility’s practicing clinicians
c. The blood bank medical director
d. A laboratorian who is knowledgeable in blood bank
policies and procedures
e. All of the above
A
d. A laboratorian who is knowledgeable in blood bank
policies and procedures
9
Q
- Metrics should be:
a. Chosen to indicate progress during the process of
continuous improvement
b. Tracked and disseminated only to members of the
blood utilization management team
c. The same for all institutions
d. Selected only by the transfusion service leadership
e. Only qualitative in nature, since medical decision
making is a complex process
A
a. Chosen to indicate progress during the process of
continuous improvement
10
Q
- Which statement is most accurate regarding continuous
improvement as it relates to PBM/BUM?
a. Blood utilization metrics should be periodically converted to national standardized metrics
b. An example of an ideal PBM metric is the ratio of the
facility cost of one unit of RBCs divided by the regional red blood cell cost
c. Continuous improvement should be performed by a
different set of players than were used in the planning
process
d. Outcomes during prospective review should be limited to the transfusion committee
e. Feedback loops and appropriate metrics are required
to achieve long-term improvements
A
e. Feedback loops and appropriate metrics are required
to achieve long-term improvements
