{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:27:50Z","timestamp":1760956070736,"version":"3.40.5"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T00:00:00Z","timestamp":1607126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vox Sanguinis"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Judicious utilization of platelet products protects a limited resource and mitigates risks of transfusion. At many institutions, computer physician order entry systems provide prompts to guide transfusion decisions; many capture the indication for transfusion, and generate metadata when orders are dissonant with guidelines. We conducted a retrospective review to examine adherence to and overrides of hospital guidelines for platelet transfusion to identify opportunities for improved transfusion practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Physician override reports (1\/1\/2018\u20133\/31\/2019) were examined and physician\u2010entered justification comments accompanying override orders were extracted, in addition to patient\u2010specific data (clinical service, age, sex, and pretransfusion platelet count). Two transfusion medicine physicians independently assessed comments in context of patient data and institutional guidelines and categorized as: indicated, protocol driven, or not indicated. Following adjudication, consensus was reached between the two reviewers. Override keyword frequencies were also determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over 15\u2010months, 1373 override orders were placed for 558 unique patients (25% of all adult inpatient platelet transfusions). haematology\/oncology providers placed 573 (42%) override orders (261 unique patients), 46% of which were categorized as \u201cnot indicated\u201d, based on consensus review. Overall, 470 (34%) override orders were categorized as \u201cnot indicated\u201d. Examples of recurring key words included \u201cbleeding\/risk of bleeding\u201d, \u201cfalling platelet count\u201d, \u201cplatelet goal of XX\u201d.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A large percentage of override orders for platelet transfusions were determined to be \u201cnot indicated\u201d and out of compliance with institutional guidelines. The metadata captured identified concerns regarding clinical transfusion practice and opportunities for revised indications (e.g. threshold for retinal haemorrhage).<\/jats:p><\/jats:sec>","DOI":"10.1111\/vox.13050","type":"journal-article","created":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T13:28:33Z","timestamp":1607174913000},"page":"702-712","source":"Crossref","is-referenced-by-count":2,"title":["Assessing inpatient platelet ordering practice: evaluation of computer provider order entry overrides"],"prefix":"10.1111","volume":"116","author":[{"given":"Kerry L.","family":"O\u2019Brien","sequence":"first","affiliation":[{"name":"Department of Pathology Harvard Medical School Beth Israel Deaconess Medical Center  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yigu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology Harvard Medical School Beth Israel Deaconess Medical Center  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8868-7198","authenticated-orcid":false,"given":"Lynne","family":"Uhl","sequence":"additional","affiliation":[{"name":"Department of Pathology Harvard Medical School Beth Israel Deaconess Medical Center  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14165"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14618"},{"key":"e_1_2_7_4_1","unstructured":"FDA CBER:Bacterial risk control strategies for blood collection establishments and transfusion services to enhance the safety and availability of platelets for transfusion 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