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Developing a validated framework for a Patient Blood Management (PBM) toolkit appropriate for the South African healthcare context
Patient blood management (PBM) is a patient-centred, systematic, evidence-based approach to improve patient outcomes by managing and preserving a patient's own blood while promoting patient safety and empowerment. The historic inappropriate use of risk-associated blood transfusions in treating anaem...
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| Format: | Thesis |
| Language: | English English |
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Department of Medicine
2026
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| _version_ | 1867613259490656256 |
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| access_status_str | Open Access |
| author | Rambiritch, Vanitha |
| author2 | Louw, Vernon |
| author_browse | Louw, Vernon Rambiritch, Vanitha |
| author_facet | Louw, Vernon Rambiritch, Vanitha |
| author_sort | Rambiritch, Vanitha |
| collection | Thesis |
| description | Patient blood management (PBM) is a patient-centred, systematic, evidence-based approach to improve patient outcomes by managing and preserving a patient's own blood while promoting patient safety and empowerment. The historic inappropriate use of risk-associated blood transfusions in treating anaemia and blood loss needs to be replaced with evidence-based PBM practices. This study was aimed at developing a validated framework of cost- effective, feasible, evidence-based PBM measures to guide the development of a toolkit that can support PBM implementation in hospitals, and assist clinicians in optimising the care of patients and minimising inappropriate blood transfusions. A mixed-methods research design was applied. One-on-one semi-structured interviews with PBM champion participants in the qualitative phase provided insight into the challenges and barriers to PBM implementation in South Africa, and the educational and clinical practice guiding tools needed to support implementation. The thematically analysed data from the literature and the interviews were used to develop statements that were subsequently rated by a panel of PBM experts in a three-round Delphi survey in the semi-quantitative phase of the study. Consensus was gained on the tools deemed essential for primary, secondary, and tertiary-level hospitals in South Africa, including the educational needs and overall barriers that need to be addressed. The findings revealed four broad categories of tools: (i) definitional tools to contextualise PBM and frame the importance of its implementation in South Africa; (ii) policy and procedural tools to guide evidence-based clinical practices, taking into account resource and infrastructure capabilities in the various levels of hospitals; (iii) education and training tools directed at bridging PBM educational gaps among doctors, nurses, healthcare leadership stakeholders, and patients; and (iv) planning, assessment and evaluation tools to assist hospitals with planning and implementing PBM interventions. The framework for a PBM toolkit as the outcome of this research contributes significant value by proposing an actionable, evidence-based model that adapts international PBM principles to resource-limited settings, promoting safer and more effective patient care while minimising inappropriate blood transfusions. Education supported by the right mix of clinical practice guiding tools informed by the PBM toolkit framework can make PBM implementation possible in South Africa and beyond. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/42651 |
| institution | University of Cape Town (South Africa) |
| language | English eng |
| last_indexed | 2026-06-10T12:33:17.409Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2026 |
| publishDateRange | 2026 |
| publishDateSort | 2026 |
| publisher | Department of Medicine |
| publisherStr | Department of Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/42651 Developing a validated framework for a Patient Blood Management (PBM) toolkit appropriate for the South African healthcare context Rambiritch, Vanitha Louw, Vernon Verburgh, Estelle Blood Patient blood management South Africa Healthcare Patient blood management (PBM) is a patient-centred, systematic, evidence-based approach to improve patient outcomes by managing and preserving a patient's own blood while promoting patient safety and empowerment. The historic inappropriate use of risk-associated blood transfusions in treating anaemia and blood loss needs to be replaced with evidence-based PBM practices. This study was aimed at developing a validated framework of cost- effective, feasible, evidence-based PBM measures to guide the development of a toolkit that can support PBM implementation in hospitals, and assist clinicians in optimising the care of patients and minimising inappropriate blood transfusions. A mixed-methods research design was applied. One-on-one semi-structured interviews with PBM champion participants in the qualitative phase provided insight into the challenges and barriers to PBM implementation in South Africa, and the educational and clinical practice guiding tools needed to support implementation. The thematically analysed data from the literature and the interviews were used to develop statements that were subsequently rated by a panel of PBM experts in a three-round Delphi survey in the semi-quantitative phase of the study. Consensus was gained on the tools deemed essential for primary, secondary, and tertiary-level hospitals in South Africa, including the educational needs and overall barriers that need to be addressed. The findings revealed four broad categories of tools: (i) definitional tools to contextualise PBM and frame the importance of its implementation in South Africa; (ii) policy and procedural tools to guide evidence-based clinical practices, taking into account resource and infrastructure capabilities in the various levels of hospitals; (iii) education and training tools directed at bridging PBM educational gaps among doctors, nurses, healthcare leadership stakeholders, and patients; and (iv) planning, assessment and evaluation tools to assist hospitals with planning and implementing PBM interventions. The framework for a PBM toolkit as the outcome of this research contributes significant value by proposing an actionable, evidence-based model that adapts international PBM principles to resource-limited settings, promoting safer and more effective patient care while minimising inappropriate blood transfusions. Education supported by the right mix of clinical practice guiding tools informed by the PBM toolkit framework can make PBM implementation possible in South Africa and beyond. 2026-01-22T10:01:37Z 2026-01-22T10:01:37Z 2025 2026-01-22T09:41:39Z Thesis / Dissertation Doctoral PhD http://hdl.handle.net/11427/42651 en eng application/pdf Department of Medicine Faculty of Health Sciences University of Cape Town |
| spellingShingle | Blood Patient blood management South Africa Healthcare Rambiritch, Vanitha Developing a validated framework for a Patient Blood Management (PBM) toolkit appropriate for the South African healthcare context |
| thesis_degree_str | Doctoral |
| title | Developing a validated framework for a Patient Blood Management (PBM) toolkit appropriate for the South African healthcare context |
| title_full | Developing a validated framework for a Patient Blood Management (PBM) toolkit appropriate for the South African healthcare context |
| title_fullStr | Developing a validated framework for a Patient Blood Management (PBM) toolkit appropriate for the South African healthcare context |
| title_full_unstemmed | Developing a validated framework for a Patient Blood Management (PBM) toolkit appropriate for the South African healthcare context |
| title_short | Developing a validated framework for a Patient Blood Management (PBM) toolkit appropriate for the South African healthcare context |
| title_sort | developing a validated framework for a patient blood management pbm toolkit appropriate for the south african healthcare context |
| topic | Blood Patient blood management South Africa Healthcare |
| url | http://hdl.handle.net/11427/42651 |
| work_keys_str_mv | AT rambiritchvanitha developingavalidatedframeworkforapatientbloodmanagementpbmtoolkitappropriateforthesouthafricanhealthcarecontext |