Parsa Sheybani, Ata Nazarzadeh , Mohammad Reza Keramati, Seyyede Fatemeh Shams ,
Volume 20, Issue 3 (7-2026)
Background: Blood products are vital yet scarce medical resources. In teaching hospitals, inefficient transfusion practices often lead to unnecessary waste, compromising both patient safety and healthcare costs. This study investigated the patterns and underlying causes of unused blood products at Imam Reza Hospital, a major tertiary center in northeast Iran, with the aim of identifying modifiable factors contributing to this problem.
Methods: This retrospective cross-sectional study extracted data from the Laboratory Information System (LIS) and the hospital dashboard for the period from March 2022 to 2025. Blood component reservation and return data from five large clinical departments were examined.
Results: Although the total number of returned units declined over time, the return percentage increased in the final year, indicating persistent inefficiencies. By department, Neurology and Gynecology showed the highest return percentages, whereas the Hematology-Oncology ward, Intensive Care Unit (ICU), and Emergency Department reported the highest absolute numbers of returns. Platelets were the most frequently returned product, whereas fresh frozen plasma had the highest relative return rate. The most consistently reported reason for returns was “Physician Decision / Order Canceled,” while returns due to “Patient Death” also showed a gradual increase over the study period.
Conclusion: The key problem identified was that, despite gradual improvements, systemic challenges-especially poor documentation, the absence of digital monitoring tools, and knowledge gaps in transfusion handling-continue to undermine efficient blood product use. Implementing the proposed plan, including real-time dashboards, mandatory documentation, clinical staff education, and AI-based demand prediction tools, could address these inefficiencies, substantially reduce waste, and enhance transfusion practices.