The new platelet transfusion mobile site - a bedside tool to aid decision making
Estcourt L., McSporran W., Dhesi A.
Introduction: NHS Blood and Transplant (NHSBT) has recently seen demand for platelet transfusions (pltTxs) rise. A proportion of this increase will be due to pltTxs being given outside indicated guidelines. The 2010 UK National Comparative Audit of pltTxs in haematology patients found that 34% of prophylactic pltTxs given were outside national guidelines and 10% were double the standard UK dose. The World Health Organization has recognized that ‘‘mobile and wireless technologies . . . (mHealth) has the potential to transform the face of health service delivery across the globe’’. Two recent systematic reviews have shown that clinical decision support systems (CDSS) can improve appropriate prescribing in other healthcare settings compared to written guidelines (included studies using mobile technology). CDSS integrated into hospital computer systems have been shown to be effective at reducing transfusion usage and improving adherence to guidelines. However, these systems (if not already in place) are expensive to install. An alternative would be to promote the use of a ‘mobile site’ that would enable clinicians to access pltTx information at the bedside. A recent Australian study showed that 87% of healthcare professionals who owned a smartphone used it during clinical practice. Aim: To create a ‘mobile site’ for pltTx. Methods: A search of transfusion ‘Apps’ and ‘mobile sites’ quickly established that there was a gap in the market for a tool that could facilitate the decision to transfuse platelets. NHSBT agreed to fund and build an HTML5 website. The mobile site was piloted by transfusion stakeholders and end users and feedback was incorporated. The site now includes information from BCSH pltTx guidelines, including pltTx thresholds, when a pltTx is not required (e.g. prior to bone marrow aspirate/trephine), alternatives to giving a pltTx, risks of pltTxs, as well as a paediatric pltTx dose calculator. Results: The Platelet Transfusion Mobile Site is free to access and download (available from: http://goo.gl/pLGtX), and is currently being promoted to end users. Since its launch in Winter 2012, 1,564 unique visitors have accessed the site with 54% returning to it. Conclusion: The people who manage patients on a daily basis and make the decision to give a pltTx are not transfusion experts.This ‘mobile site’ provides an opportunity to have expert advice when required.