. http://www.smh.com.au/news/0106/16/pageone/pageone10.html
Doctors give 'dangerous' transfusions
By Judith Whelan, Health Writer
Doctors continued giving blood transfusions to patients after being told they did not need the treatment and that it could kill them, an expert on hospital safety has revealed.
Dr Ross Wilson, head of the NSW Council for Quality in Health Care, said the cases showed it was not enough to merely tell medical staff how they needed to change their practices.
"It's a bit like getting a ticket from a speed camera - it won't stop you from going out and speeding again," he said.
Last year, a team directed by Dr Wilson carried out an audit of blood use in 10 NSW hospitals.
It found that one in three transfusions were being administered when, under NSW Health guidelines, they should not have been.
The guidelines call for a blood transfusion if the patient's haemoglobin level is seven or below.
One should not be given if the level is 10 or above. (A healthy male's haemoglobin level is about 14 to 16, a woman's 12 to 15.)
"In the middle is a grey area where clinical judgment should be used," Dr Wilson said.
Giving an unnecessary transfusion could kill a patient by inducing heart failure, he said.
It could also transmit viruses, or there was a risk of the donor blood being incompatible with the recipient's.
Dr Wilson suggested that other checks and balances be introduced into the hospital system, such as doctors being asked to fill out forms that reinforce transfusion guidelines or double-check their requests for transfusions in computerised links to the blood supply service.
Such changes would be likely to be opposed by doctors, on the grounds that they would interfere with their ability to make clinical judgments about their patients.
The audit results were made public in January, and the researchers told the doctors of the results.
But when they took another audit a month later, the results were the same; the doctors had not changed their practices.
"I have no reason to expect they'd be any different now," Dr Wilson said.
Doctors were not deliberately endangering patients' lives, he said.
"There are some practitioners who think increasing the haemoglobin level of patients increases the safety of patient care."
He said the study showed that "new change strategies" had to be introduced to decrease the risk of mistakes being made.
For instance, the best-practice guidelines could be included on the form doctors filled out to request a blood transfusion, or computer systems could be linked to the blood bank so that guidelines could be cross-checked with the transfusion request.
Dr Wilson said: "Ultimately, and this is the method I prefer, patients would be informed about it so they could question their physician directly."
That might include fact sheets being given to them or their families, he said.
Six years ago Dr Wilson co-authored the study Quality in Australian Health Care, which found that about 18,000 people a year died as a result of complications they developed directly as a result of the medical treatment they received.
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ChristianObserver stated the following
The original article has been 'selectively edited' and you will see that the final sentence of the article has been placed within the body of the quotation within Awake!. This sentence relates to an entirely different study by Dr Ross Wilson into medical accidents - not deaths from transfusion, although its positioning suggests that it does the latter. If there were 18,000 transfusion related deaths per year in Australia, there would be outrage I would have thought!
This is what is called a "misleading insertion".
Marvin I had a chit chat not only with the reporter but I have also contacted the father. I have directed him to this site and have been getting a few people to call him back. Do you want to talk to him?
I am on strike today so I don't know if I will be able to get to my Email but I may be able to get it to you another way - let me know.
hawk
p.s. - orginial thread is http://www.jehovahs-witness.com/forum/thread.asp?id=22324&site=3
