Improving Awareness about Patient Blood Management in Portugal: A Call for Action Arising from a Delphi Panel
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/17518 |
Resumo: | Introduction: Anaemia and iron deficiency are associated with increased mortality and poor surgical outcomes. Consensus in their definitions is expected to optimize their management, which is encompassed by patient blood management, providing patient-centred care while improving patient safety and clinical outcomes. Patient blood management implementation is even more relevant in contingency times and faces barriers due to lack of standardization, among others. The aim is to establish a consensus on these diagnoses and implement patient blood management principles in clinical practice in Portugal.Material and Methods: Eight experts in Transfusion Medicine, Haematology, Anaesthesiology, Internal Medicine, and Obstetrics/Gynaecology were assembled; a focus group was conducted, defining 33 statements. A Delphi panel was conducted, with experts from the clinical specialities named above as well as from General Surgery, Urology, and Orthopaedics.Results: The Delphi panel’s rounds had 70 (Round 1) and 46 (Round 2) respondents. Specialists were consensual in only two statements, on the existence of a preoperative patient blood management consultation for candidates to elective surgeries in which the use of blood derivatives is anticipated and, on the importance of the correction of postoperative anaemia and iron deficiency. Of the remaining 31 statements, 27 reached high agreement or disagreement by the respondents.Conclusion: Consensus was reached in only two (6%) of the 33 statements. There was a consensual agreement on the relevance of establishing patient blood management as the standard of care and of valuing preoperative and postoperative patient blood management interventions. Nevertheless, our results point to the lack of awareness regarding patient blood management principles – which could result in better postoperative outcomes, shorter hospitalizations, reduced costs and increased availability of beds. Training and literacy initiatives could help further implement patient blood management standards in Portuguese hospitals. |
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Improving Awareness about Patient Blood Management in Portugal: A Call for Action Arising from a Delphi PanelMelhorar a Consciencialização sobre Patient Blood Management: Um Repto de Ação a Partir de um Painel de DelphiAnemiaIron-DeficiencyBiomarkers/ bloodBlood TransfusionConsensusIron DeficienciesPerioperative CareAnemiaAnemia por Deficiência de FerroBiomarcadores/ sangueConsensoCuidados PerioperatóriosDeficiências de FerroTransfusão de SangueIntroduction: Anaemia and iron deficiency are associated with increased mortality and poor surgical outcomes. Consensus in their definitions is expected to optimize their management, which is encompassed by patient blood management, providing patient-centred care while improving patient safety and clinical outcomes. Patient blood management implementation is even more relevant in contingency times and faces barriers due to lack of standardization, among others. The aim is to establish a consensus on these diagnoses and implement patient blood management principles in clinical practice in Portugal.Material and Methods: Eight experts in Transfusion Medicine, Haematology, Anaesthesiology, Internal Medicine, and Obstetrics/Gynaecology were assembled; a focus group was conducted, defining 33 statements. A Delphi panel was conducted, with experts from the clinical specialities named above as well as from General Surgery, Urology, and Orthopaedics.Results: The Delphi panel’s rounds had 70 (Round 1) and 46 (Round 2) respondents. Specialists were consensual in only two statements, on the existence of a preoperative patient blood management consultation for candidates to elective surgeries in which the use of blood derivatives is anticipated and, on the importance of the correction of postoperative anaemia and iron deficiency. Of the remaining 31 statements, 27 reached high agreement or disagreement by the respondents.Conclusion: Consensus was reached in only two (6%) of the 33 statements. There was a consensual agreement on the relevance of establishing patient blood management as the standard of care and of valuing preoperative and postoperative patient blood management interventions. Nevertheless, our results point to the lack of awareness regarding patient blood management principles – which could result in better postoperative outcomes, shorter hospitalizations, reduced costs and increased availability of beds. Training and literacy initiatives could help further implement patient blood management standards in Portuguese hospitals.Introdução: A anemia e ferropenia estão associadas a um aumento da mortalidade e a piores resultados no período pós-operatório. Consensualizar as suas definições permitirá otimizar a sua gestão. O patient blood management engloba essa gestão, com relevo acrescido em situações de contingência, focado nos cuidados centrados no doente e na melhoria da segurança e dos outcomes. As barreiras à implementação de princípios patient blood management prendem-se, entre outras, com falta de padronização. Pretende--se estabelecer um consenso sobre estes diagnósticos e implementação de patient blood management na prática clínica em Portugal.Material e Métodos: Foram reunidos oito especialistas em Imuno-hemoterapia, Hematologia Clínica, Anestesiologia, Medicina Interna e Obstetrícia/ Ginecologia. Foi realizado um focus group, onde foram definidas 33 afirmações. Além disso, foi realizado um painel Delphi, com especialistas das áreas mencionadas acima, assim como de Cirurgia Geral, Urologia e Ortopedia.Resultados: As duas rondas do painel Delphi tiveram, respetivamente, 70 e 46 respondedores. Estes foram consensuais em apenas duas afirmações, na existência de consulta pré-operatória de patient blood management para os candidatos a cirurgias eletivas em que se antecipa o uso de hemoderivados e, na importância da correção da anemia e ferropenia pós-operatórias. Das 31 afirmações restantes, 27 atingiram alta concordância ou discordância pelos respondentes.Conclusão: Foi alcançado consenso em apenas duas (6%) das 33 afirmações. Houve consenso sobre a relevância de estabelecer o patient blood management como standard of care e a valorização das intervenções de patient blood management pré e pós-operatórias. No entanto, os resultados indiciam falta de consciencialização sobre os princípios de patient blood management – que poderiam levar a melhores resultados pós-operatórios, com redução do tempo de hospitalização e dos custos e maior disponibilidade de camas. Iniciativas de formação e literacia poderiam ajudar a uma melhor implementação dos princípios de patient blood management nos hospitais portugueses.Ordem dos Médicos2022-05-27info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/17518oai:ojs.www.actamedicaportuguesa.com:article/17518Acta Médica Portuguesa; Vol. 35 No. 10 (2022): October; 749-757Acta Médica Portuguesa; Vol. 35 N.º 10 (2022): Outubro; 749-7571646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/17518https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/17518/6643Direitos de Autor (c) 2022 Acta Médica Portuguesahttp://creativecommons.org/licenses/by-nc/4.0info:eu-repo/semantics/openAccessRobalo Nunes, AntónioBrilhante, DialinaMacedo, AnaBeato, VeraGomes, DianaGonçalves-Aguiar, JoséLima, FátimaMairos, JoãoMelo-Lencastre, Teresa2022-12-20T11:08:03Zoai:ojs.www.actamedicaportuguesa.com:article/17518Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:57.813246Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Improving Awareness about Patient Blood Management in Portugal: A Call for Action Arising from a Delphi Panel Melhorar a Consciencialização sobre Patient Blood Management: Um Repto de Ação a Partir de um Painel de Delphi |
title |
Improving Awareness about Patient Blood Management in Portugal: A Call for Action Arising from a Delphi Panel |
spellingShingle |
Improving Awareness about Patient Blood Management in Portugal: A Call for Action Arising from a Delphi Panel Robalo Nunes, António Anemia Iron-Deficiency Biomarkers/ blood Blood Transfusion Consensus Iron Deficiencies Perioperative Care Anemia Anemia por Deficiência de Ferro Biomarcadores/ sangue Consenso Cuidados Perioperatórios Deficiências de Ferro Transfusão de Sangue |
title_short |
Improving Awareness about Patient Blood Management in Portugal: A Call for Action Arising from a Delphi Panel |
title_full |
Improving Awareness about Patient Blood Management in Portugal: A Call for Action Arising from a Delphi Panel |
title_fullStr |
Improving Awareness about Patient Blood Management in Portugal: A Call for Action Arising from a Delphi Panel |
title_full_unstemmed |
Improving Awareness about Patient Blood Management in Portugal: A Call for Action Arising from a Delphi Panel |
title_sort |
Improving Awareness about Patient Blood Management in Portugal: A Call for Action Arising from a Delphi Panel |
author |
Robalo Nunes, António |
author_facet |
Robalo Nunes, António Brilhante, Dialina Macedo, Ana Beato, Vera Gomes, Diana Gonçalves-Aguiar, José Lima, Fátima Mairos, João Melo-Lencastre, Teresa |
author_role |
author |
author2 |
Brilhante, Dialina Macedo, Ana Beato, Vera Gomes, Diana Gonçalves-Aguiar, José Lima, Fátima Mairos, João Melo-Lencastre, Teresa |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Robalo Nunes, António Brilhante, Dialina Macedo, Ana Beato, Vera Gomes, Diana Gonçalves-Aguiar, José Lima, Fátima Mairos, João Melo-Lencastre, Teresa |
dc.subject.por.fl_str_mv |
Anemia Iron-Deficiency Biomarkers/ blood Blood Transfusion Consensus Iron Deficiencies Perioperative Care Anemia Anemia por Deficiência de Ferro Biomarcadores/ sangue Consenso Cuidados Perioperatórios Deficiências de Ferro Transfusão de Sangue |
topic |
Anemia Iron-Deficiency Biomarkers/ blood Blood Transfusion Consensus Iron Deficiencies Perioperative Care Anemia Anemia por Deficiência de Ferro Biomarcadores/ sangue Consenso Cuidados Perioperatórios Deficiências de Ferro Transfusão de Sangue |
description |
Introduction: Anaemia and iron deficiency are associated with increased mortality and poor surgical outcomes. Consensus in their definitions is expected to optimize their management, which is encompassed by patient blood management, providing patient-centred care while improving patient safety and clinical outcomes. Patient blood management implementation is even more relevant in contingency times and faces barriers due to lack of standardization, among others. The aim is to establish a consensus on these diagnoses and implement patient blood management principles in clinical practice in Portugal.Material and Methods: Eight experts in Transfusion Medicine, Haematology, Anaesthesiology, Internal Medicine, and Obstetrics/Gynaecology were assembled; a focus group was conducted, defining 33 statements. A Delphi panel was conducted, with experts from the clinical specialities named above as well as from General Surgery, Urology, and Orthopaedics.Results: The Delphi panel’s rounds had 70 (Round 1) and 46 (Round 2) respondents. Specialists were consensual in only two statements, on the existence of a preoperative patient blood management consultation for candidates to elective surgeries in which the use of blood derivatives is anticipated and, on the importance of the correction of postoperative anaemia and iron deficiency. Of the remaining 31 statements, 27 reached high agreement or disagreement by the respondents.Conclusion: Consensus was reached in only two (6%) of the 33 statements. There was a consensual agreement on the relevance of establishing patient blood management as the standard of care and of valuing preoperative and postoperative patient blood management interventions. Nevertheless, our results point to the lack of awareness regarding patient blood management principles – which could result in better postoperative outcomes, shorter hospitalizations, reduced costs and increased availability of beds. Training and literacy initiatives could help further implement patient blood management standards in Portuguese hospitals. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-05-27 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/17518 oai:ojs.www.actamedicaportuguesa.com:article/17518 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/17518 |
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oai:ojs.www.actamedicaportuguesa.com:article/17518 |
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eng |
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eng |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/17518 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/17518/6643 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2022 Acta Médica Portuguesa http://creativecommons.org/licenses/by-nc/4.0 info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2022 Acta Médica Portuguesa http://creativecommons.org/licenses/by-nc/4.0 |
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openAccess |
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application/pdf |
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Ordem dos Médicos |
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Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 35 No. 10 (2022): October; 749-757 Acta Médica Portuguesa; Vol. 35 N.º 10 (2022): Outubro; 749-757 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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