Prescription of hemostasis assessment in the surgical setting

The objectives of this work were to evaluate the knowledge and practices of BH prescription in the surgical environment, the impact of an information-training action on this knowledge and to elaborate a document to help in BH prescription. We conducted a prospective study in seven surgical departments. An evaluation of the correctness of BH prescription (practice-study) with an evaluation of knowledge (knowledge-study) was followed by an information-training action evaluated by a questionnaire. The practice-study included 163 patients of whom 126 (77%) had an inappropriate BH prescription. The knowledge study included 57 physicians, 33 of whom frequently prescribed a BH. The median score for the knowledge assessment questions was 5/8 [2.5-8] and 7/8 [4-8] after the information-training session. In conclusion, BH prescribing was not in accordance with SFAR recommendations. This was explained by: lack of knowledge, the practice of defensive medicine, and the absence of a collaborative climate between the different stakeholders.