Effectiveness of transfusion audits and practice guidelines.

To seek evidence of the effectiveness of transfusion audits and practice guidelines in improving transfusion practice, transfusion audit literature was reviewed. The inherent limitation of this approach is that investigators are more likely to report success and less likely to report unsuccessful experiences. Measures of success included decrease in units transfused, decrease in inappropriate units transfused, or increase in appropriate transfusion practice. Side benefits of audits included continuous improvement in practice guidelines, improvement in technologists' education, opportunities for consultation, and identification of areas for further research. Most successful programs had a common thread: individual education of the ordering physician by the transfusion medicine physician. In addition, for most successful programs, audits occurred in a timely manner, either before transfusion or during the 24 hours or weekend after the transfusion. In conclusion, several reports provide corroborating evidence to suggest that transfusion audits can improve transfusion practice if performed in a timely manner and if individual education of ordering physicians is provided by transfusion medicine physicians.