Background The aim of this audit, the first of its kind, is to examine the practise of red cell transfusion in hospices and identify opportunities for improving patient care through the increased use of Patient Blood Management. 200 hospices throughout the UK are invited to participate, which collects data on the reason for red cell transfusion, whether investigations have been conducted to manage reversible iron deficiency anaemia, and on patient safety aspects of transfusion administration to identify ways to reduce the risk of patients receiving blood intended for someone else. Many transfusions are potentially avoidable, giving the opportunity to reduce the burden on the patient and reduce costs for hospices.

Methods Participating hospices collect data in a 3 month period from the case notes of inpatients or day patients who have received a red cell transfusion. Data is entered onto an online proforma and reported back in a format that allows each hospice to compare its own performance against national results. The reports act as a benchmark, allowing hospices to evaluate their performance against pre-determined standards.

Results Results from other, similar national comparative audits have shown that there is room for improvement in compliance with evidence based patient blood management practise, particularly in respect of testing for anaemia and in the area of patient safety. We expect this audit to produce similar results.

Conclusion The audit will demonstrate areas of practice which are amenable to change, particularly in the spheres of anaemia investigation and management, as well as patient safety. These include being sure of the reason for transfusion and the benefits the patient will derive, making the patients aware of the risks and alternatives to transfusion and ensuring that patients are adequately monitored especially with the increasing awareness of the prevalence of Transfusion Associated Circulatory Overload.