AUDIT SYSTEM FOR BLOOD PRODUCT USAGE IN SANGLAH GENERAL HOSPITAL DENPASAR BALI

Blood transfusion is one of the essential therapy components. One indicator of the blood services quality in Sanglah General Hospital Denpasar Bali Indonesia is achieving the target of unused blood order ? 10% per month. These targets have not been achieved. The number of unused blood orders reached 6,719 bags per year (600 bags per month or 21.5%). Unused blood orders were mostly from Department of Internal Medicine (40.9%), followed by Department of Surgical (35.6%), Department of Obstetrics and Gynecology (15.5%), and Department of Pediatrics (8%). The condition can cause several problems such as the disorder of blood supply, the inefficiency of pre-transfusion testing, and decreased quality of blood product. Base on the condition, it is necessary to research audit system for usage of blood product in the Sanglah Hospital. The study aimed to analyze the influence of audit system to reduce unused blood order and to decrease the number of Crossmatch per Transfusion ratio (C/T ratio). Design of study was a pre and posttest intervention study. The population in this study were all forming of blood requests in the Sanglah Hospital. The sample was a blood request form the Department of Internal Medicine of the last two months. Intervention in this study was the development and dissemination of guidelines for the use of blood products, followed by concurrent audit and prospective audit of the sample. The study showed there were decline of the unused blood orders and C/T ratio before and after implementation of the audit system for usage of blood products. Reduction of unused blood order in the Sanglah Hospital was 5.4%, and in the Department of Internal Medicine was 5.2%. The causes of unused blood orders were patient died, overestimation of blood order, transfusion delays because of waiting for the schedule of hemodialysis, the patient had fever, blood product, and the occurrence of administration errors. Reduction of the C/T ratio in the Sanglah Hospital was 0.094 and in the Department of Internal Medicine is 0,072. An audit system for usage of blood products can reduce unused blood orders and decrease C/T ratio. Key words: Audit system, blood products, the C/T ratio, unused blood orders