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[null,"Red Blood Cell Clinical Audit Tool"]
[null,"The purpose of the Red Blood Cell Clinical Audit tool is to allow for the standardised collection of information on (or about) current practice, and subsequent comparison to best practice guidelines. This can be undertaken as part of a continuous improvement cycle where a risk is identified through the audit, improvements are implemented, and the audit is re-performed. Where no risk is identified, that is, current practice is demonstrated as compliant with guidelines, ongoing monitoring of practice should be continued as part of a quality cycle. Using the audit tool in this way will support organisations in complying with requirements of NSQHS standards which require the establishment of a regular audit program in line with accepted standards of clinical governance in Australian hospitals.\n \n\nPatient selection \n\nPatient groups for audit should be determined by the relevant governance committee.  Examples of specific groups include those transfused in a specific clinical unit, or specialty, or those transfused in a specific time period.\n\nData collection\n\nRetrospective or concurrent \n\nData analysis\n\nUse Excel or other graphing software\n\nReporting\n\nAn audit report should be provided to the relevant governing committee and the clinician group whom provided the care episodes that were included in the audit. The report should include:\n\n• Graphical representation of the audit results highlighting risks if identified\n• Recommendations or action plan that includes any improvement opportunities addressing the risks identified, or the requirement for further analysis of the risk\n• A timeline for re-audit dependent upon the purpose of the audit as an improvement or assurance tool\n\nThe audit report should not be finalised until all relevant groups have had the opportunity to actively participate in the recommendations or action plan.\n"]

{"sheet":"Instructions","index":1,"n_rows":2,"n_cols":2,"rows_kept":2,"cut":false,"hidden":false,"merged":[[0,1,0,13],[1,1,73,13]]}
[null,"Red Blood Cell Clinical Audit Tool"]
[null,"How to use the RBC Audit Tool\nThe Red Cell Clinical Audit Tool has two parts:\ni. Red Cell Clinical Audit Tool (This file)\nii. Red Cell Clinical Audit Tool Database\n\n1. Do not conduct an audit using the .xls files opened  from an email. Ensure both files are first saved in the same location (i.e. my documents folder or desktop).\n\n2. Only use the Audit tool file when collecting data. Do NOT open the database file when carrying out an audit.\n\n3. Go to the RBC Audit Form tab and fill in all the fields as required. \nPlease be aware of the following restrictions:\nField  Restriction\nDate:    Between 1/01/2014 and 1/01/2099\nDate of Transfusion: before or equal to audit date\nPatient age (years):  between 0 and 120\nPre-transfusion  Hb:  between 0 and 200 (takes decimals)\nPost-Transfusion Hb:  between 0 and 200 (takes decimals)\nNumber of units transfused: between 0 and 200\nDischarge Hb:   between 0 and 200 (takes decimals)\n\n4. Once all the relevant fields are completed press the submit button. If there is any problems with unfilled fields a pop up message will appear. Once the form is correctly filled and submitted you will receive a “Form Uploaded Successfully” pop up message. \n\n5. To clear the form and carry out another audit press “Reset Form”.\n\n\n"]

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[null,"Red Blood Cell\nClinical Audit Tool"]
[]
[null,"Audit Information"]
[]
[null,"Facility Name:",null,null,null,null,null,null,null,"Date of Audit: "]
[]
[null,"Clinical unit/ward transfusion started:",null,null,null,null,null,null,null,"Date of transfusion:"]
[]
[null,"Is this audit retrospective or concurrent:"]
[]
[]
[null,"Patient Demographics"]
[]
[null,"Patient identification/medical record number:",null,null,null,null,null,null,null,"Patient gender:"]
[]
[null,"Consultant/treating specialist:",null,null,null,null,null,null,null,"Patient age (years):"]
[]
[null,"Clinical Speciality:",null,null,null,null,null,null,null,"Urgent/emergency transfusion:"]
[]
[]
[null,"Numerical Outcomes"]
[]
[null,"Pre-transfusion Hb:",null,null,null,null,null,null,null,"Post-transfusion Hb:"]
[null,null,null,null,null,null,"g/L",null,null,null,null,null,null,"g/L"]
[null,"Number of units transfused:",null,null,null,null,null,null,null,"Discharge Hb:"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"g/L"]
[null,"If the patient has been discharged, was this the last transfusion episode prior to discharge:"]
[]
[null,"*Episode is defined as the interval in patient care from the time of the prescription of a defined number of units of a single fresh blood component for a patient and the time of completion of administration of these components to that patient"]
[]
[null,"RBC Audit Details"]
[]
[null,"Appropriateness of Transfusion"]
[null,"1. For this episode was there documentation of: "]
[]
[null,"A clinically significant or recent history of bleeding?"]
[null,"Acute Ischemia?"]
[null,"Evidence of respiratory or haemodynamic decompensation related to anaemia?"]
[null,"None of the above"]
[]
[null,"2. Does the transfusion decision comply with the appropriate PBM guideline? ",null,null,null,null,null,null,null,null,null,"3."]
[null,"3. Does the transfusion dose comply with the appropriate PBM guideline? ",null,null,null,null,null,null,null,null,null,"4."]
[null,"    * Patient Blood Management Guidelines and NSQHS Standard 7.1.1"]
[null,"Administration of Transfusion"]
[null,"4. Is there documentation of the patient having received written information regarding their transfusion? ",null,null,null,null,null,null,null,null,null,"5."]
[null,"5. Is there a valid consent for the blood product administered (according to hospital protocol)? ",null,null,null,null,null,null,null,null,null,"6."]
[null,"6. Is there a valid prescription for the blood product? ",null,null,null,null,null,null,null,null,null,"7."]
[null,"7. Is there documented indication for transfusion?",null,null,null,null,null,null,null,null,null,"8."]
[null,"8. If concurrent audit, does the patient identification band match details on all relevant documentation?",null,null,null,null,null,null,null,null,null,"9."]
[null,"9. Have patient observations been documented appropriately (according to hospital protocol)? ",null,null,null,null,null,null,null,null,null,"10."]
[null,"10. Has the compatibility form/label been completed appropriately during the patient identification process?",null,null,null,null,null,null,null,null,null,"11."]
[null,"      (according to hospital protocol)"]
[null,"11. Was the transfusion administered at a clinically appropriate time (according to hospital protocol)? ",null,null,null,null,null,null,null,null,null,"12."]
[null,"      (Eg. Between 08:00 and 20:00 for all non urgent cases)"]
[null,"12. Was the transfusion concluded within 4 hours from removal from controlled storage? ",null,null,null,null,null,null,null,null,null,"13."]
[null,"      (An appropriate facility, medical refrigeration equipment or container validated for storage of blood products)"]
[null,"13. Has all appropriate documentation been retained in the patient record? ",null,null,null,null,null,null,null,null,null,"14."]
[null,"14. If auditor has access to pathology system and/or request form documentation:"]
[null,"      Is transfusion history available/documented:"]
[null,"      Are special requirements documented if required:"]
[null,"15. Did an adverse event occur during this transfusion episode:",null,null,null,null,null,null,null,null,null,"16."]
[null,"      Was this identified and managed according to hospital protocol:"]
[null,"      Was it reported according to hospital protocol:"]
[null,"Further information "]
[null,"If you have any further information, please use the text box below:"]

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["Rationale:"]
[null,"Data point","What Guideline/Standard does it support","The data point is being collected to assess..","An example of how this data point can be used to support quality improvement","Notes/Definitions"]
[null,"AUDIT INFORMATION"]
[null,"Retrospective ",null,null,null,"A method of evaluation by examining the transfusion process as reflected in the patient records of patients who have already received a blood transfusion"]
[null,"Date of transfusion"]
[null,"PATIENT DEMOGRAPHICS"]
[null,"Patient gender ",null,"Collection of this data allows for filtering and reporting on specific patient groups and time frames",null,"Sex at the time of transfusion - male, female, indeterminate"]
[null,"Patient age ",null,null,null,"Age of the patient at the time of transfusion, calculated from the date of birth in years"]
[null,"Was this an emergency transfusion",null,null,null," Emergency transfusions may be clinically indicated to be administered After Hours"]
[null,"NUMERICAL OUTCOMES"]
[null,"Pre-transfusion Hb","NSQHS Standard 7.1; 7.7.1",null,null,"The Hb level obtained closest to the time before the transfusion episode"]
[null,"Post-transfusion Hb ","NSQHS Standard 7.1; 7.7.1",null,null,"The Hb level taken closest after the completion of the transfusion episode"]
[null,"Discharge Hb ","NSQHS Standard 7.1; 7.5.1",null,null,"The last Hb level taken before patient discharge"]
[null,"Number of units transfused","NSQHS Standard 7.5; 7.7"]
[null,"RBC AUDIT DETAILS"]
[1,"Clinically significant",null,null,null,"A bleeding diagnosis that may have contributed to the decision to transfuse"]
["2,3","Aligns with guidelines","Patient Blood Management Guidelines;  NSQHS Standard 7.1.1","..compliance with Patient Blood Management guidelines",null,"Seek senior clinical advice for assistance "]
[4,"Patient information","ANZSBT Guidelines for the Administration of Blood Products 2.1;  NS 7.9; 7.10","..whether patients and carers are informed about blood product treatment options and the associated risks and benefits"]
[5,"Consent","ANZSBT Guidelines for the Administration of Blood Products Section 2;  NSQHS Standard 7.5.1; 7.11  NSQHS Standard 11","..whether there is evidence of the patient having consented to the transfusion in accordance to State and local policy",null,"Consent must be documented by the prescriber in either the patient's progress notes or on a generic consent form                                                                                   A process of communication between a patient and their medical officer that results in the patient’s authorisation or agreement to undergo a specific medical intervention. This communication should ensure the patient has an understanding of all the available options and the expected outcomes such as the success rates and/or side effects for each option. "]
[6,"Prescription "," NSQHS Standard  7.1 ; 7.2.1; 7.5 ",null,null,"An authorisation written by a health care professional for the administration of a blood product and must include Patient details: family name, given name, date of birth, gender, unique identification number, if available"]
[null,null,null,null,null,"Date, timing and urgency of transfusion"]
[null,null,null,null,null,"Blood product to be administered"]
[null,null,null,null,null,"Special blood product requirements, if applicable"]
[null,null,null,null,null,"Route of administration"]
[null,null,null,null,null,"Number of units (dose)"]
[null,null,null,null,null,"Duration over which blood product is to be administered"]
[null,null,null,null,null,"Special instructions, if applicable"]
[null,null,null,null,null,"Legibily written name and signature of prescriber, and a contact telephone number/pager number/ Medicare provider number"]
[null,null,null,null,null,"The patient's known allergies, history of adverse drug reactions and previous transfusion reactions"]
[7," Documented indication for transfusion ","ANZSBT Guidelines for the Administration of Blood Products Section 1,  6.8 and 6.13; NS 7.5","..whether  relevant clinical information is documented in the medical record",null,"Refers to any written comment (this admission) by a medical officer regarding the reason for this transfusion episode"]
[8,"Identification ","ANZSBT Guidelines for the Administration of Blood Products 6.9.9.1;  6.9.2.2; NSQHS Standard 7.1.3","..whether the patient was adequately identified prior to transfusion",null,"Leave field blank if performing a retrospective audit"]
[9,"Patient observations","ANZSBT Guidelines for the Administration of Blood Products 6.11  NS7.1; 7.5.1","..whether nursing observations are doumented as per local policy"]
[11,"Clinically appropriate time","ANZSBT Guidelines for the Administration of Blood Products6.7 ","..the number of transfusions that occurred overnight or outside working hours",null," Refer to local policy."]
[14,"Transfusion history ","NSQHS Standard 7.5; 7.6.2","..whether  relevant clinical information is documented in the medical record",null,"This information may be obtained from the pathology collection form or electronic ordering system. Leave field blank if unable to determine"]
[14,"Special requirements","ANZSBT Guidelines for the Administration of Blood Products 3.1; NSQHS Standard 7.5","..whether special requirements have been documented in the medical record ",null,"The special requirements(irradiated, CMV seronegative) must also be documented on the prescription each time the product is administered."]
[14,"Documented in clinical record","ANZSBT Guidelines for the Administration of Blood Products Section 1"]
[15,"Adverse event documentation","ANZSBT Guidelines for the Administration of Blood Products 8.2;NSQHS Standard 7.6","..whether adverse events are being documented and reported in accordance with mandated and local policy",null,"If adverse event has occurred, further specific auditing may be undertaken"]
[15,"Adverse event correct reporting"]

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