University of Hertfordshire

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Original languageEnglish
JournalEur J Cancer Care (Engl)
Publication statusIn preparation - 2020

Abstract

To explore factors contributing to decisions to transfuse platelets in cancer care outside guidelines.BackgroundTwo national audits of platelet transfusions had demonstrated that up to a third of platelets transfused in the UK were outside of clinical indications stipulated in national guidelines. Evidence regarding contributory factors is lacking.MethodsTwo case studies were examined, using instrumental case study methodology, to qualitatively explore factors that influence the decision to transfuse platelets. Interviews (n=10) were conducted around cases in haematology and critical care. In-depth review of documentary evidence was undertaken and propositions were developed to provide rigour during the investigation. Thematic analysis and triangulation of documents was undertaken to find specific factors, and propositions analysed, as per instrumental case study methods.ResultsBoth cases emphasised how patient complexity, and individual response to platelet administration, was an influencing factor. Other themes that emerged included uncertainty of clinical situations coupled with uncertainty about platelet availability. Other factors worthy of further investigation include the concept of professional safety and the trustworthiness of platelet thresholds against platelet monitoring for bleeding episodes.ConclusionThe findings indicated several factors influence decisions to transfuse, including clinical context, and individual ability to trust guidelines and assume any perceived risks.

ID: 18922719