Improving Documentation Quality of Blood Transfusion Request Forms: A Two-Cycle Quality Improvement Initiative at a Tertiary Hospital in Sudan

Proper completion of blood transfusion request forms is vital for patient safety and quality assurance. Inadequate documentation increases the risk of transfusion errors, medico-legal complications, and compromised patient outcomes. Objective: To assess and improve the completeness and accuracy of blood transfusion request forms at Dongola Teaching Hospital through a two-cycle quality improvement initiative that included both evaluation and implementation phases. Methods: This two-cycle closed-loop clinical audit, conducted as a quality improvement project, incorporated retrospective and prospective elements and was guided by the Plan-Do-Study-Act (PDSA) model. In the first cycle, 50 transfusion request forms were reviewed (May 2025). Deficiencies were identified, and a standardized form was introduced with staff training. In the second cycle (September 2025), 42 forms were audited against the same benchmarks. Data were analyzed using descriptive statistics and comparative proportions with significance testing (p<0.05). Results: Significant improvements were observed across most documentation parameters. Patient demographics, clinical details, and laboratory information showed marked gains between the first cycle (n = 50) and the second cycle (n = 40): date of birth (35 [87.8%]), file number (39 [97.6%]), current Hb level (40 [100%]), and transfusion indication (33 [82.9%]). Laboratory documentation also improved substantially, including the collector's signature (39 [97.6%]) and collection date/time (39 [97.6%]). However, a slight decline was noted in the documentation of the number of units requested (34 [85.4%]). Conclusion: The intervention significantly improved form completeness and accuracy, enhancing transfusion safety and compliance with international standards. Continuous monitoring, regular feedback, and periodic re-audits are essential to sustain these improvements over time.