About
The Red Cell Dosage Calculator is a web-based application (registered medical device) for use within the UK National Health Service. Its purpose is to calculate the volume of red blood cells to transfuse to a patient with anaemia, to reach a target haemoglobin level.
It is an innovation conceived and designed by Dr Sharran Grey, Honorary Consultant Clinical Scientist at Bolton NHS Foundation Trust. It was inspired by her doctoral research on 'accelerated red cell transfusion' which highlighted the importance of the volume of red cell transfusion in the context of a patient's body weight.
A baseline audit showed that only 35% of patients met their target haemoglobin level when an empirical policy of 1 or 2 units of red cells was in place, with 26% being under-transfused and 39% being over transfused.
A team of colleagues at Bolton NHS Foundation Trust (collectively known as the Transfusing Wisely Team) were involved in development of a prototype application, testing, validation, assessment of clinical effectiveness, MHRA Medical Device registration, UKCA marking and clinical implementation. This successful collaboration has delivered a number of benefits:
- Around 90% of patients who have red cells prescribed as per number of units recommended by the application now meet their target haemoglobin, reducing cases of over and under-transfusion.
- Red cell usage was reduced by around 18% in the first year of implementation, ensuring appropriate use of donor blood and delivering cost savings.
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Compliance with national guidance on
weight-adjusted red cell dosing:
- NICE Guideline NG24.
- Serious Hazards of Transfusion Report recommendations.
- National Comparative Audit of Transfusion-Associated Circulatory Overload report recommendations.
- National Patient Safety Alert: Reducing risks for transfusion-associated circulatory overload (NatPSA/2024/004/MHRA).
- A personalised approach to aiming for 'right first time' patient blood management.
The Importance of Using UKCA Marked Clinical Applications
It is crucial to prioritize the use of clinical applications that bear the UKCA (UK Conformity Assessed) mark, which has replaced the CE mark after Brexit. The presence of this mark, regulated by the MHRA (Medicines and Healthcare products Regulatory Agency), ensures that the application meets necessary criteria and is both operationally functional and clinically secure. It is advisable to avoid using medical applications that lack a UKCA mark.
Please note that the medical device registration with the MHRA (UKCA mark) is applicable to users in England, Scotland, and Wales ONLY. Therefore, this class 1 medical device is not registered for use in Northern Ireland or outside the UK and cannot be marketed in these regions. Additionally, the application is based on the specifications of UK red cell units and is not suitable for use outside the UK.
Application Developers
Technical Solutions Worldwide Ltd is a software and cybersecurity company that has collaborated with Bolton NHS Foundation Trust and many other NHS Trusts across the UK for over 20 years. The company boasts a diverse portfolio of solution-based healthcare projects.
This long-standing partnership leverages medical, scientific, and software programming expertise to develop a validated and clinically effective application.
- A Web-App for weight-adjusted red cell dosing: post-development implementation and clinical effectiveness (2018). 181, (supplement 1), p. 146
- A Web-App for weight-adjusted red cell dosing: post-development implementation and clinical effectiveness (2018). – British Society of Haematology conference poster
- A red cell dosage calculator could promote single unit red cell transfusion, prevent over-transfusion and reduce red cell usage (2016). 173 (supplement 1), p.158-159
- A red cell dosage calculator could promote single unit red cell transfusion, prevent over-transfusion and reduce red cell usage (2016) – British Society of Haematology conference poster
