Abstract
In the survey conducted in 2013, among the 11,015 Japanese institutions receiving blood supply from the Japanese Red Cross Blood Center (JRCBC), the 4,894 institutions, which responded to the questionnaire, were enrolled. Blood management systems such as a unified management system were developed in Japan from 2005 through 2008. However, no significant improvement in efficiency of blood management has been observed since their implementation. In cases of small institutions (less than 300 beds), only 60% were able to implement a system. Nurses authorized by the Japan Society of Transfusion Medicine and Cell Therapy were present in only 32.7% of large institutions (more than 500 beds) and in only 4.7% of all institutions. The modifications regarding the requirements of facilities resulted in a large increase in the number of institutions which were able to establish criteria for obtaining hospital fees for transfusion management. In fact, the acquisition rate of hospital fees increased from 49.7% (2011) to 88.5% (2013) in medium to large institutions (more than 300 beds). Moreover, the introduction of a computer system to transfusion practice has increased gradually over the past 5 years, including implementation of a bar code-based identification system. Compared with fiscal year 2012, the numbers of blood products used according to the number of beds in fiscal year 2013 have changed as follows: Red blood cells and fresh frozen plasma, almost unchanged; platelet products, slightly increased; human albumin products, slightly decreased; intravenous immunoglobulin, increased; autologous blood products, decreased. There was no significant difference in the rates of adherence to the national guidelines of each blood product (77%-80%). Taken together, these observations suggest the importance of promoting the establishment of a blood management system in small institutions and to facilitating the appropriate use of blood products.
