A Study of Physicians’Knowledge and Attitude about the Fresh Frozen Plasma Utilization in Medical Centers
Date Issued
2006
Date
2006
Author(s)
Hung, Chi-Ming
DOI
zh-TW
Abstract
The purpose of this study is primarily to understand the extent of physicians’ knowledge and attitude about Fresh Frozen Plasma (FFP) utilization in medical centers. This is to investigate the physicians’ FFP utilization with the relationship between knowledge and attitude. This is to investigate the related factors between knowledge and attitude, further to understand the executions of the medical center blood transfusion committee affecting the knowledge and attitude of the physicians’ FFP utilization.
This study was a cross-sectional study, towards the 18 medical centers nationwide in Taiwan, using mail post questionnaires for investigations. The questionnaire, based on literature research, personal interview with some physicians from different specialties and superior levels at blood banks. The contents are further being verified and qualified through expert’s validity. There are two parts of the questionnaires, one was analyzed at hospital level and had 18 valid samples with response rate of 100%, which are to be filled by the chairman of blood transfusion committee. The second part was analyzed at a individual level and had 860 valid samples with response rate of 11.5%. The results indicate relative high uniformity in terms of credibility.
Major findings from the research include：
1. The knowledge toward FFP utilization:
There are approximately 40% of the physicians with insufficient knowledge on blood. Fewer seniority residence physicians have apparent lower knowledge levels in comparison with the higher seniority senior residences or specialists. Due to the different specialties and hospitals in different regions, the level of knowledge differ as well, i.e.: how to get the clinical physicians to understand more on the blood transfusion risks and indications, in order to decrease inappropriate blood transfusions.
2. The attitude toward FFP utilization：
a) The audit after prescription includes the below, regular audit on the blood usage status at different specialties, regular publish the blood usage index, random check on the inappropriate usage on physicians with records etc, private hospital physicians and age, clinical experiences, as the higher ranks with more positive attitude. If the hospital conduct audit on a regular basis, which would affect the attitude of the physicians, further to decrease the inappropriate use on blood plasma.
b) The reminding before prescription includes providing indications and blood transfusion guideline and risk factors to physicians for references. The blood transfusion guideline should be placed in a place aiding for reading convenience, warning words before prescription and warnings on computers etc, age and clinical experiences, as the more senior physicians with more positive attitudes, which would have different affective levels on different specialties, result in great effects on gynecology and ER, but not great effects on ENT and Surgical appliances.
c) The hospitals have accommodated on National Health Insurance (NHI) scheme using the item, FFP to replace high priced Albumin to lower the expenses used. In terms of different specialties, the surgery specialties are more affected by the NHI scheme budget cut. In terms of clinical experiences and lower rank or non-senior administration superiors are more easily affected. If the hospital have positive on NHI budget measures, then the subsequent effects are also positive. If the measures proposed by the hospitals are negative, which then result negatively on medical qualities.
d) The main effects on blood transfusion committee are pointed towards if the committee in the hospital has developed their functionalities. The above could also affect the physician attitudes, age, clinical experiences, and the higher ranks with more positive attitudes. In terms of specialties, the blood transfusion board has greater impacts on gynecology, pediatrics, and surgeries.
e) The patients’ family effects include “the unstable status of the patients, blood transfusion would increase the recognitions of the family, hence decrease medial disputes”; and “the patients’ family request blood transfusion due to increase severity of the illness, and the physician prescribe unnecessary blood transfusions”. Senior aged physicians or with more clinical experiences would have less effect on the above mentioned factors. In terms of specialties, the physicians on ER or surgeries are more easily affects by the patients’ family.
From all the findings above, this study recommended:(1)The hospital should propose concrete training manuals on blood transfusion for residence physicians, conduct occupational education in a regular basis, establish the warning system, to make the blood transfusion committee in real practice.(2)The related association should propose related symposium to reinforce learning discussions or symposium classes, in propagations on establish the blood transfusion specialties physicians, expanding the professional levels on physicians in terms of occupational educations. (3) The health officers should reinforce the contents of hospital audit, conduct the mutual communications within hospitals for related activities, give awards or to support correct usage on blood for hospitals in the outlying regions. (4)The future research could increase the contents of the qualitative studies, improvements on data collections, increasing amount and levels of the people visited, further to investigate on the related factors on effects of the physicians’ attitudes in blood utilization.
Subjects
新鮮冷凍血漿
醫師的認知與態度
Fresh Frozen Plasma
physicians’ knowledge and attitude
Type
thesis