Patient Blood Management Guidelines Progress Update : December 2018

Published Modules

The Patient Blood Management (PBM) Guidelines are a series of six modules that focus on evidence-based PBM. Each module has been written for clinicians treating specific patient groups including Critical Bleeding/Massive Transfusion (2011), Perioperative (2012), Medical (2012), Critical Care (2012), Obstetrics and Maternity (2015) and Neonatal and Paediatrics (2016). Electronic versions of the modules and the accompanying Quick Reference Guides are available on the NBA website. Hard copies can also be ordered free of charge, within Australia and New Zealand, via the online order form.

Update of the Patient Blood Management (PBM) Guidelines 

Now that the suite of modules has been completed, the National Blood Authority (NBA) has turned its attention to maintaining their currency.

The NBA has established a Jurisdictional Blood Committee (JBC) Working Group consisting of government and clinical representatives who are overseeing the process for the project. 

A review and update of the Patient Blood Management (PBM) Guidelines is underway.

A review and update of the Patient Blood Management (PBM) Guidelines is underway.

The draft research protocol for the review of the current evidence base for the perioperative
(Module 2), medical (Module 3), critical care (Module 4), obstetrics and maternity (Module 5) and neonatal and paediatric (Module 6) settings was forwarded to all relevant colleges and societies in September 2018 for comment before the literature searches and screening commence. The JBC Working Group met in December 2018 to consider the feedback and finalise the research protocol.

The review of the evidence base will:

  • highlight changes to the evidence since the modules were published
  • inform whether the existing themes of the PBM Guidelines should be retained or amended
  • inform a research question list

Findings from the review of the evidence base are expected in mid-2019.

The critical bleeding/massive transfusion population (Module 1) has been excluded from this process because the update of Module 1 commenced prior to the decision to review and update all modules together. The Clinical/Consumer Reference Group finalised the research protocol in August 2018 and the systematic review process is now underway.  The research questions for the update of Module 1 can be found at the links below.

The second edition of Module 1 is expected to be completed in mid-2019.The draft guideline will be released for consultation before it is finalised. Content from this module will be incorporated or cross-referenced in the updated versions of the other modules, where appropriate.

In a parallel process, the NBA is investigating alternative methodologies to update clinical practice guidelines with the aim of transitioning to a more sustainable process that will allow clinical guidance to be updated as new evidence is published and clinical practice evolves.

The findings and a preferred option for maintaining the currency of the PBM Guidelines will be presented to senior government officials in mid-2019.

While the review is underway, the original modules remain available on the NBA’s website to guide practice.

Education 

BloodSafe eLearning Australia (BEA) provides online courses relating to PBM and clinical transfusion practice for health professionals. The courses are available free of charge on www.bloodsafelearning.org.au and include courses on Patient Blood Management, Critical Bleeding, Perioperative, Critical Care, Medical and Specialties, Obstetrics and Maternity and Iron Deficiency Anaemia. A course based on the PBM Guidelines: Module 6 – Neonatal and Paediatrics has been developed and is now available. Also available in the resource centre are short videos on:

  • IV iron administration in primary care
  • The perioperative patient – communication and consent
  • Minimising blood loss in cardiothoracic surgery
  • An overview of patient blood management
  • Gastrointestinal bleeding – patient assessment and transfusion.

Implementation activities 

To support the implementation of the PBM Guidelines, the NBA facilitates the development of tools and materials to support implementation at a health provider level. A range of tools and materials are available, free of charge here. Tools currently under development will support the implementation of recommendations and practice points in PBM Guidelines Modules 5 and 6.

If you would like to automatically receive updates on the PBM Guidelines, please register via BLOODportal.

For further information please contact the NBA at guidelines@blood.gov.au.