1238 / Effectiveness of tranexamic acid (TXA) in reducing postoperative bleeding and transfusion risk in first knee replacement surgery

ITALY
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Blood / Blood products
Medication / IV Fluids There is no specified text here
Topic of the reported practice
Quality improvement project
Aim and the benefit of the Patient Safety Practice
 
The aim of this study is to evaluate the efficacy and safety of TXA in reducing bleeding during total knee replacement surgeries and whether the use of this drug can lead to a modification of our protocols for the “good use of blood".
Description of the Patient Safety Practice
 
The study was carried out by comparing two groups of 50 patients with similar characteristics who underwent knee replacement surgery in our hospital. To the “B” group of patients was administered TXA 10 minutes before the release of the tourniquet, a dosage of 15mg/kg and then to 10 mg/kg/h during the first 12 hours after surgery. Group “A” did not receive TXA . We evaluated the number of patients transfused, units of blood transfused, blood loss from the drainage, anemia, complications. Results: The analyzed parameters showed a statistically significant difference in favor of the group treated with TXA ( X 2 12.250a patients receiving a transfusion, transfused blood bags, recovery from drainage, drainage losses in 24 hours, fall in hemoglobin to 24 hours : p < 0.000 ). No complications have been reported in either group.
The study demonstrated an unquestionable effectiveness of TXA in reducing bleeding in knee replacement surgery, without increasing the risk of complications, with obvious clinical benefit and significant savings for the hospital. The hospital committee for the proper use of blood has revised the specific protocol deleting the preoperative pre-deposit and postoperative recovery, with organizational simplification and further cost reduction.
Attachment of relevant written information and/or photos, as appropriate
There is no specified text here
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Unit or ward level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Both/mixed (qualitative and quantitative)
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
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Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Pharmacists
Administrative support (secretary, clerk, receptionist etc.)
Clinical manager
Quality manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
Yes
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
Patient(s)
Point of time in which service user or their reprasentatives' involvement takes place
During the application of the Patient Safety Practice
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
No
Short description of the service users' level of involvement
Collaboration, such as co-designing a Patient Safety Practice or active partnership in implementation
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Yes
List of sources where public information is accessible
http://buonepratiche.agenas.it/questionnaire.aspx?id=4637
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Motivated staff
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
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Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
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Contact information
 
Name: Piera Menosso
Country: ITALY
Organisation: ASS3 ALTO FRIULI
E-mail: piera.menosso@ass3.sanita.fvg.it
Phone: There is no specified text here
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