1. Introduction and Functions of Bloodbank

Introduction

Transfusion of blood and blood components is an established standard way of treating

patients who are deficient in one or more blood constituents and is therefore an

essential part of health care. A blood transfusion service is a complex organization

requiring careful design and management. Essential functions of a blood transfusion

service are donor recruitment, blood collection, testing of donor blood, component

preparation and supply of these components to the patients.

The organization of a blood transfusion service should receive utmost attention and care

for smooth functioning of various components of the service. The goal of blood

transfusion service is to provide effective blood and blood components which are as safe

as possible and adequate to meet the patients’ needs.

Functions of a Blood Transfusion Service

The basic functions of a blood transfusion centre may be listed as follows

1. Recruitment and retention of voluntary and replacement blood donors.

2. Collection, processing, storage and transportation of blood and its components.

3. Laboratory procedures

4. Participation in the clinical use of blood and blood components.

5. Teaching and training of personnel

6. Research and development

2. Need for Blood Bank

As a blood transfusion service deals with different functions related to donors and

patients, it is imperative to keep in mind the safety of both donors and recipients. The

blood transfusion service has to be planned and organized in such a way that it fulfils its

ideal aims and objectives i.e.

1. Recruitment of blood donors - voluntary & replacement

2. Care of donor, donated unit and the recipient

3. Maintain adequate blood stock

4. Provide clinically effective blood components

5. Optimal use of available blood

In India, blood transfusion services are mostly hospital-based. In a hospital-based blood

transfusion service, each hospital runs its own blood collection programme with or

without central regulation. This system utilizes existing institutions and does not require

creation of separate blood transfusion centres. As the organization of voluntary blood

donation in hospital-based system is usually unsatisfactory, replacement donors form

the main source of blood supply in the hospital. Replacement donors are usually friends

and family members of the patient and are under pressure to donate blood. A voluntary

donor system is far more satisfactory as there is no compulsion and the donor is

motivated to donate blood.

Different aspects of a blood transfusion service that need organization are

Utilization of space assigned or planning of premises of a blood transfusion

centre / service

Requirement of staff

Procurement, standardization and maintenance of equipment, reagents and other

consummables

  Donor recruitment and motivation programme

  Autologous donor programme

  Donor blood collection

  Laboratory procedures

o serological techniques

o screening for transfusion - transmitted diseases

  Documentation and record maintenance

  Implementation of quality assurance scheme

  Inventory control, storage and transportation

  Biosafety guidelines

  Medicolegal aspects - Licensing from Drug Controller of India (DCI)

  Continuing education, training and teaching for medical, technical, nursing and

other paramedical staff

  Research and development in Transfusion Medicine

  Formulation of Hospital transfusion committee and conducting medical audits.

  Guidelines for clinical use of blood and blood components

In planning the design of a blood transfusion service, the activities and flow of

operation should be considered for adequate utilization of space.

The functional plan of a blood transfusion service is thus basedon the paths

taken by the donors, the blood unit, blood samples and material. This is also

required for submission to the DCI and any subsequent modifications need to

be approved again.

1. Donor Complex

The donor complex consists of a donor waiting area, donor registration, medical

examination room with preliminary testing, blood collection area, apheresis

area, donor rest room and kitchen/pantry. The flow of donors should be uniform

and clearly defined to avoid unnecessary traffic in the corridors

The donor complex should be pleasant and comfortable. Donor educational

material can be made available to prospective donors in the reception or

waiting room. The donor organizers should be associated with donor complex

for donor motivation, recruitment and retention.

2. Blood storage

Initial storage of blood should be in the vicinity of the place where donor blood

is collected, this is called as the quarantine storage. After all the tests are

performed, blood should be stored in vicinity of the issue area.

3. Component preparation

The area for blood component should be close to quarantine storage. The

component laboratory should be clean, dust-free and well lit. The service of

blood component preparation needs a special licence from the DCI.

4. Serology laboratory

This laboratory is basically meant for red cell serology testing and donor and

patient samples. A separate laboratory may be designated for antenatal and

specialized serology.

5. Laboratory for transfusion transmitted disease

A separate laboratory should be designated for screening of all donor units for

transfusion-transmitted diseases.

6. Issue counter

Outside the serology laboratory a small counter should be designed for

accepting blood samples

and issue of blood, to avoid unnecessary and unauthorized entry of personnel

in the laboratory.

Besides the essential donor and laboratory complexes, the premises should

have provision for quality assurance laboratory, washing room, disposal

facilities, distillation room, day care/therapeutic area, conference room,

departmental library, administrative office, store and staff room. 4. Space requirement for a blood transfusion service

Blood transfusion centres are graded into 3 categories for space requirements.

  working 24 hours for 7 days

  3-7 UOB / Hosp Bed.

1000-6000 UOB

consumed per year

8-15 UOB / Hosp

Bed. 6000-15000

UOB consumed

per year

16 UOB or more per Hosp.

Bed. over 15000 UOB

consumed per year

 

UOB-UNITS OF BLOOD 100-800 Bed, Hosp.,

District Hospit., Health

Service Hosp.,

Corporation Hosp., No

Super-specialities., non

teaching

400-1000 Bed

Hosp., Medical

College Specizlised

Hosp., Teaching

Hospital

800-1000 Bed Hosp., Apex

institutes. Metropolitan

Medical Colleges Hosp., All

super-specialities Teaching

Hosp., and Blood bank.

Donor complex (All in Square Metres)

1. Reception room 25 25 40

2. Medical examination room   15 25

3. Blood collection room 40 55 100

4. Donor rest room 15 25 30

5. Kitchen/Pantry 5 5 10

6. Apheresis room     40

7. Day care/ Therapeutic

area

  30 50

Laboratory area (All in Square Metres)

1. Laboratory for routine

donor work

25 25 30

2. Laboratory for routine

patient and Antenatal work:

work Platelets, HLA and

granulocyte serology

  35 50

3. Laboratory for specialized     50

4. Issue counter 18 20 20

5. Emergency laboratory     20

6. Hepatitis, HIV, VDRL,

Malaria

20 25 30

7. Wash room, distillation

plant etc.

20 25 30

8. Component basic &

coagulation work

  25 50

9. Component advanced

freeze drying

    100

General areas (All in Square Metres)

1, Doctors office 15 15x3 20x1, 15x3

2, Donor recruiter, social

worker, clerical staff

25 30 50

3. Blood bank office 15 20 25

4. Stores 20 25 35

5. Technicians’ common

room

15 20 25

6. Toilets 5x2 5x2 5x3

7. Trainee doctors’ room     25

8. Library/Conference room     30

TOTAL 248 Sq.m 460 Sq.m 1000 Sq.m

Requirement of Staff

Decision on the staffing pattern of a blood transfusion service must take into account

the specific function of the centre, It will also be influenced by the availability of

qualified trained personnel.

Standard for staff in a blood transfusion service

  working 24 hours for 7 days

 5000 donors units

processed per year

10,000 donors units processed

per year with round the clock

service

20,000 donors units processed

per year with round the clock

service

Blood Collection Room1. Jr. Doctors/

Residents2 4 4

2. Nurses 2 3 4

3. Social Worker 1 2 3

4. Attendants 1 2 3

Apheresis Room1. Nurse - 1* 3

2. Attendant - 1* 1

Laboratory1. Technician

Superviser- 2 4

2. Tech. Assistant 2 4 8

3. Technician5 (+3 for shift

works)11 13

4. Laboratory Asst. 1 2 4

5. Laboratory

Attendant

2 + (2 for shift

works)5 6

5. Laboratory 2 + (2 for shift 5 6

Attendant works)

Donor OrganizerAssociated clerical

staff- 1 2

Services Staff/Clerical Staff1. ClerlclTypist 1 1 1

2. Store Keeper 1 1 1

3. Cleaner/ Sweeper 1 1 2

Medical Doctor 1. Professor - - 1

2. Associate

Professor/Reader- 1 1

3. Assistant

Professor/Lecturer1 2 1

4. Senior Residents 1 2 3

* If apheresis facilities are available.

The incharge of the blood transfusion service should be a medical doctor with a

postgraduate degree/diploma in subject of Pathology, Laboratory Medicine or

Transfusion Medicine. He/She should be well trained, qualified and interested

in the speciality of Transfusion Medicine.

The numbers of the other staff working in a centre will vary depending upon

the quantum of work in the centre. The staff should be adequate in number,

competent and well-trained. 5. Equipment requirement

The blood transfusion centre should be equipped with the machines and instrument

appropriate to its functions. The quality and quantity of equipment required depends on

the number of blood units collected and procurred, the techniques used, the

infrastructure of the centre and the size of the hospital.

To ensure the smooth functioning of a transfusion centre, a comprehensive plan for the

procurement of basic equipment is essential. Each hospital has its own rules and

regulations for procurement of expensive equipment which should be followed. In order

to avoid ambiguity, specifications of a required equipment should be clearly and

precisely defined considering the space, operation and maintenance of the equipment.

National AIDS Control Organization (NACO) has drawn up specifications for all blood

bank equipment and assistance can be taken from NACO.

All instruments must be properly maintained and regularly checked for their

functioning.. The staff must be familiar with the use of all the equipment.

Regular quality monitoring checks on the equipment must be done and recorded. (Refer

Section Seven-Quality Assurance in Blood Transfusion Service).

Uninterrupted power supply should be maintained for all the equipment with efficient

back-up system.

Safety in use of equipment

Intrinsic safety of the equipment and safety of its operation are essential. Greatest

number of accidents involving equipment are caused by improper use of the equipment

and a failure to install it correctly or unsatisfactory maintenance.

Only centrifuges with lids that latch firmly should be used. If spoilage occurs due to

breakage or loosening of cap, it must be immediately cleaned with disinfectants.

Refrigerators and freezers should be defrosted periodically and the interiors should be

cleaned with detergent and disinfectant. Water bath, test-tube racks, incubator, etc.

should be regularly cleaned once a month.

Electrical Supply

While planning a laboratory, sufficient electrical outlets above or at the back of benches

are essential. Two or more outlets may be needed for each technician. In addition,

enough electrical outlets should be there in each laboratory for easy installation and

operation of the equipment.

All essential equipment required for blood storage, storage of kits, reagent and blood or

serum samples must have back-up emergency electrical generators. It is preferrable to

have a full back-up emergency electric supply for essential services such as the blood

transfusion service.

Reagent requirements

All the reagents and kits used in the blood transfusion service must be checked for

reactivity, specificity and validity. The oldest reagents should be used first (First in, first

out) and there should be a system to check when stocks are low.

A regular supply of reagents and kits should be ensured. The antisera must be carefully

stored and grossly checked on each day of use for any contamination.

Cleaning of glassware

Glassware used in blood transfusion laboratory must be cleaned thoroughly. Cell-serum

mixture must not be allowed to dry on the glass.

Immediately after completion of any technical procedure, dirty tubes and slides should

be placed in a suitable disinfectant. Buckets kept under the work benches containing

disinfectants are convenient for this purpose.

Disinfectants recommended for general laboratory use are sodium hypochlorite (ig/dI)

and aldehydes such as glutaraldehyde (2%) or formaldehyde (5%). After soaking in the

disinfectant for 24 hours, glassware is placed in hot detergent solution and washed in

hot water. Glassware is then dried in hot air oven in an inverted position. It is absolutely

essential that no traces of the detergent should remain on the glassware.

Dirty glassware can give rise to erroneous results and/or may cause haemolysis of red

cells.

6. Donor Recruitment and Motivation Programme

Hospital-based blood transfusion services may either initiate their own donor

recruitment drive or coordinate with the central voluntary agencies such as Red

Cross, Red Crescent, Bloodindex which are involved in blood collection. The

coordination may be in terms of sending a team of medical officer, laboratory

technologist and donor attendant for outdoor mobile blood donation camps to

participate in collection of blood organized by voluntary agencies.

This programme is required to develop a voluntary donor base in the regional

community by donor appeals, community or personal-based approach. It is of

utmost importance to retain the motivated and once recruited blood donors.

Success of any donor recruitment programme can be assessed by the number of

regular donors donating blood.

Repeated donor appeals before conducting an outdoor voluntary donation camp

help in effective donor motivation and recruitment.

Donors recruiters or trained social workers can play a significant role in

developing voluntary donor registry, encouraging healthy family members to

become voluntary donors and allaying apprehensions of prospective donors.

Very strict environmental cleanliness, donor screening and procedure of blood

collection should be maintained while conducting outdoor voluntary donation

camps.

Donor records

It is of prime importance to keep proper and effective records of blood donors.

Confidentially of donor records must be strictly maintained.

Donor records must be complete and should have adequate information for

contacting the donor. Donor deferral records must also be documented.

8. Laboratory Techniques

Serology techniques

The laboratory has multifold activities

Processing of donor blood

Pretransfusion testing of recipient

Preparation of components

Quality control procedures

Histo-compatibility testing (optional)

Erroneous results in serological testing may prove fatal in a blood transfusion

laboratory.

All laboratory samples must be preserved for at least 7 days after the test. Any

transfusion reactions reported to the blood transfusion service must be

properly worked-up with detailed repeat laboratory testing on donated unit and

recipient’s samples (pre-and post-transfusion). A complete record of the type

of transfusion reaction and results of the investigation must be kept.

Adequate controls must be set up with each technique to avoid false reactions.

Screening for transfusion transmitted diseases

Efforts are made in all transfusion services to reduce the risk for transfusion

transmitted diseases. Infections for which screening should be done depends

on endemic infections in that area e.g., parasite, bacteria and viruses; and

funds available.

It is mandatory in India, to screen all donated blood units far Hepatitis B viral

infection (HBsAg), HIV infection (anti-HIV-1 and anti-HIV-2), syphilis (anti-

treponemal antibodies by VDRLJTPHA test) and malaria (peripheral blood smear

examination), and HCV.

To achieve the goal of transfusion safety and prevent transfusion - transmitted

infections it is imperative to use highly sensitive and specific test assay

systems to detect weak reactions.

The test assay system or test kits should be revalidated. Procedures should be

strictly adhered to and appropriate test and internal control (positive and

negative) must be put with each batch of test. A test run validity and proper

calculations are also important to avoid any false-negative or positive results.

The donated units with a positive marker of infection must be isolated soon

after completion of the test and discarded after proper disinfection or

incinerated if facility is available.

A continuous supply of validated test kits is essential for successful screening

of all donated units. Adequate storage of kits at recommended temperature

must be maintained for proper functioning of the test kits and reagents.

9. Documentation & Record Maintenance

Documentation provides the ability to trace prospectively and retrospectively all steps

in all procedures, dating from collection of the blood to monitoring techniques,

component preparation, laboratory testing, issue and transfusion of blood.

An effective record system helps to judge the performance of the blood transfusion

service, traces any donated unit of blood from its source to the final fate and also helps

in legal or investigational purposes. Various aspects which need proper documentation

are :

1. . Donor records inlcuding details of donor information, rare donor panels, donor

deferraLs and adverse donor reactions.

2. Record of results and interpretation of all laboratory tests.

3. Patient’s record (for all patients and specifically important in patients with

multiple transfusions, previous transfusion reactions, presence of unexpected

antibodies or cross-match problems).

4. Record of component preparation.

5. Inventory of blood, blood components, reagents and consummables, etc.

6. Record of compatibility testing.

7. Record of discarded blood units.

8. Record of issue of blood.

9. Quality control record (which helps in taking corrective actions to improve the

performance of any procedure or working of any equipment and reagents).

Record and documents also help to identify possible sources of error in any technique.

The results of manually performed tests should be recorded carefully in a clean and

easily understandable way i.e. as the laboratory worksheet. Laboratory worksheets

should be preserved as permanent record of the test performed and the readings

obtained.

Records of the reagents and kits used for a particular test with their batch no., lot no.

and expiry dates should be maintained so that in case of any problem, it is easier to find

the source of error.

All records must include the date and signature of the laboratory staff performing the

test. Records should be retained for at least 5 years and kept confidential.

Computers are being widely employed in maintaining the records. With the growing

demand for improving the efficiency, accuracy and effectiveness it has become

imperative to introduce computers in the blood transfusion service.

Computers can help the functions of a blood transfusion service in

Donor identification / registration

Donor blood collection

Processing of blood

Maintenance of records of laboratory testing

Inventory management

Issue & labelling of blood

10. Continuing Education in Blood Transfusion Service (training, teaching and research)

Ongoing training and continuing education fo the staff are crucial elements of an

efficient blood transfusion service. As there have been significant advances in the field

of transfusion medicine i.e 

blood components, advances in immunology, blood group serology, coagulation,

microbiology and clinical application of blood transfusion, there is a strong need or

regular educational programmes for different categories of staff working in the blood

transfusion centre.

The teaching programme should be based on the basic functions of the service and give

necessary theoretical and practical technical skills to ensure upgraded knowledge and

ability to perform all the procedures with skill and talent.

It is extremely important to have teaching sessions for the hospital staff and clinicians

to help in appropriate utilization of blood and promotion of autologous blood transfusion

programme. Continuing education of medical residents and senior staff is required to

achieve rational, optimal and safe utilization of blood. In addition, the possibilities of

active research makes the service more attractive for well- qualified doctors and

scientists.

The medical and paramedical staff should be encouraged to participate in seminars,

workshops and conferences to update their knowledge, widen their vision and interest in

the subject.

A training programme for transfusion centre staff should also include methods for

improving the organization of donor recruitment and donor appeals. The laboratory

technical staff should be trained in all practical aspects of blood group serology,

immunology and quality control measures.

The staff working in the blood transfusion sErvice should be rotated in different

laboratories to prevent monotony and boredom and avoid any mishaps which may occur

due to lack of interest by the laboratory staff. Newly recruited staff should have an

initial orientation to the workspace.

Hospital Transfusion Commmittee

The functions of a hospital transfusion committee are to :

Establish broad policies for use of blood and blood components.

Lady down procedures for auditing transfusion practice and review of blood usage

(medical audit).

Follow up adverse reactions i.e. post-transfusion infections and transfusion

reactions.

Assist the staff of blood transfusion centre in promoting good transfusion

reactions.

Assist the staff of blood transfusion centre in promoting good transfusion practice

amongst the hospital staff.

Coordinate with the blood transfusion centre in recruiting blood donors and

promoting autologous donations.

The members of a hospital transfusion committee would be :

Representative from clinical departments that use large quantities of blood i.e.

surgery, anaesthesiology, gynaecology & obstetrics, cardiothoracic surgery, etc.

Representatives of blood transfusion service, hospital administration and nursing

staff.

11. Guidelines for Clinical Use of Blood and Blood Components

Blood Bank Management

Introduction and Functions

Need For Blood Bank

Blood Bank Premises Design

Basic Equipments and Reagents

Donor Recruitment and Motivations

Donor Blood Collection

Laboratory Techniques

Documentation and Record Maintenance

Continuing Education in Blood Transfusion

Guidelines for clinical use of blood

Consummables and equipment for bloodbank

Blood Zone

About blood

About Blood Transfusion

Autologous Blood Transfusion

Effects of blood transfusion

Blood facts

Blood Diseases and Disorders

Eligibility test

Why many people don't donate blood

Blood Components

Human immune system

Blood Donor Requirements

Blood Products

Blood Substitutes

Blood types

Apheresis

Q&A - Blood

Foods to increase your blood

Food to increase immunity

Rh Factor

What are Blood Groups

Health calendar

Glossary

The director and other staff members of blood transfusion centre should actively

interact with the clinicians and formulate guidelines for effective and optimal use

of blood and blood components.

Blood and blood components should be requested for only if other modes of

therapy have proved ineffective and if the benefit of transfusion outweights the

risk associated with it. Following broad guidelines should be followed.

<!--[endif]-->Use of red cell and platelet concentrate, fresh frozen plasma and

cryoprecipitate as indicated.

As far as possible transfusion of whole blood should be avoided and efforts should

be made to initiate blood component therapy. If the transfusion service does not

have the facility for preparing blood components, all efforts of the technical

experts and hospital administrators should be directed to initiate blood

component preparation in thç blood transfusion service.

As far as possible, fresh blood transfusion with < 3 days old red cells and single

unit transfusion should not be used.

Transfusion avoidance strategies should be followed.

Transfusion trigger may be lowered to <7gIdl haemoglobin value specially if the

fall in I-lb had not been rapid.

Efforts should be made to reduce number of donor exposures to a patient.

Programme for autologous blood transfusion should be initiated, promoted and

sustained.

12. Essential Consumables and Equipment for a Blood Transfusion service

Consumables

Blood Collection and Administration

Disposable lancets.

Disinfectants and dressings.

Material and supplies for the determination of haemoglobin concentration and

haemotocrit (Copper suphate at the basic level).

Blood collection containers preferrably plastic, including disposable needles.

Multiple blood bags for component preparation where feasible.

Test tubes for sample collection.

Transfusion administration sets with needles.

Labels for blood containers, samples and records.

Supplies for donor refreshment.

Laboratory

Test tubes and microscope slides.

Reagents for blood grouping and compatibility testing.

Test reagents and supplies for screening for transfusion tranmissible infections.

Laboratory glassware (beakers, flasks, pipettes).

Disinfectants and detergents.

Sharps containers for disposal of contaminated articles.

Protective clothing and disposable gloves.

Timers.

Aspirator bottles.

Office

Stationery and material for adequate

documentation of blood donors, donations, laboratory testing, blood storage and

transportation.

Equipment

Blood Collection and Administration

Donor beds.

Balances for controlling the blood collection procedure, blood collection monitor

and shaker.

Domestic scales for weighing donors.

Suitable vehicles for blood collection and distribution, and Blood Transport

Containers.

Miscellaneous equipment and surgical items, eg., scissors, forceps,

sphygmomanometers, tourniquets,

stethoscopes, thermometers.

Necessary refreshments.

Laboratory and office

Bench centrifuges for separation of samples and

serological testing.

Microscope

37° C incubators and/or water baths.

Refrigerators with temperature monitoring system.

-20° C freezer with temperature monitoring system.

Emergency generator.

Voltage stabilizers.

Containers and coolant (or ice) for transportation of blood and blood components.

Laboratory scales.

Plasma extractors, hand sealers and tube strippers.

Plastic or cardboard holders for blood units and frozen plasma.

Laboratory thermometers.

Autoclave.

Equipment necessary for producing chemically pure and / or pyrogen-free water

(eg. delonizer, distillation apparatus).

Laboratory and office furniture.

12. Essential Consumables and Equipment for a Blood Transfusion service

Consumables

Blood Collection and Administration

Disposable lancets.

Disinfectants and dressings.

Material and supplies for the determination of haemoglobin concentration and

haemotocrit (Copper suphate at the basic level).

Blood collection containers preferrably plastic, including disposable needles.

Multiple blood bags for component preparation where feasible.

Test tubes for sample collection.

Transfusion administration sets with needles.

Labels for blood containers, samples and records.

Supplies for donor refreshment.

Laboratory

Test tubes and microscope slides.

Reagents for blood grouping and compatibility testing.

Test reagents and supplies for screening for transfusion tranmissible infections.

Laboratory glassware (beakers, flasks, pipettes).

Disinfectants and detergents.

Sharps containers for disposal of contaminated articles.

Protective clothing and disposable gloves.

Timers.

Aspirator bottles.

Office

Stationery and material for adequate

documentation of blood donors, donations, laboratory testing, blood storage and

transportation.

Equipment

Blood Collection and Administration

Donor beds.

Balances for controlling the blood collection procedure, blood collection monitor

and shaker.

Domestic scales for weighing donors.

Suitable vehicles for blood collection and distribution, and Blood Transport

Containers.

Miscellaneous equipment and surgical items, eg., scissors, forceps,

sphygmomanometers, tourniquets,

stethoscopes, thermometers.

Necessary refreshments.

Laboratory and office

Bench centrifuges for separation of samples and

serological testing.

Microscope

37° C incubators and/or water baths.

Refrigerators with temperature monitoring system.

-20° C freezer with temperature monitoring system.

Emergency generator.

Voltage stabilizers.

Containers and coolant (or ice) for transportation of blood and blood components.

Laboratory scales.

Plasma extractors, hand sealers and tube strippers.

Plastic or cardboard holders for blood units and frozen plasma.

Laboratory thermometers.

Autoclave.

Equipment necessary for producing chemically pure and / or pyrogen-free water

(eg. delonizer, distillation apparatus).

Laboratory and office furniture.

donor selection introductionYou are here : Home / Blood Bank Zone / Donor selection and Blood collection / 1.

Introduction

1. Introduction

Collection of blood is the most important function of a blood transfusion centre. If the procedure of donor selection and blood colection is carried out meticulously, it will assure a safe and adequate blood supply. To obatain safe blood and blood components it is important to ensure that the donors are healthy and free from transfusion transmissible infections. Therefore, the practice of recruiting voluntary, non-paid donors should be followed.

Donor Selection

Aim

The aim of the subsection is to acquaint the medical officers with different types of blood donors and the need to build up a panel of regular, voluntary non-paid donors. Also to make them aware of the criteria for selection of safe donors and the conditions for permanent and temporary rejection of donors.

Types of Blood Donors

Blood donors may be of 3 types

1. Paid commercial donors

2. Replacement donors

3. Voluntary donors

Paid Commercial donors or professional blood donors (blood sellers) receive monetary returns for donation of blood. These donors are usually not healthy, are often anaemic and at risk of transfusion- transmissible infections.

Replacement donors usually are the family members or friends of a patient and donate blood for their relative in need. This type of donation help to maintain blood stock when voluntary donations are not available. However, pressure from the family may force an individual to donate blood even when he or she is not suitable as a donor. Voluntary donors are individuals who are self-motivated and onate blood with the prime aim of hleping an unknown patient. They receive no payment for it and do not have any desire for personal benefits. These donors more often meet the criteria fo safe donors. They are more likely to be free from transfusion-transmissible infections and hence assure a safe blood supply. They can be motivated to become regular donors.

Recruiting Safe Donors

Many people are reluctant to donate blood due to lack of information, Education of the community at large may help change the attitudes and beliefs about blood donation and encourage people to donate blood. Educational leaflets, films and posters may be used for this purpose.

Educational talks can be arranged for small groups. This has the advantage that people can ask questions and clarify their apprehensions. Emphasis should be laid during the talk on conditions when blood should not be donated particularly regarding high risk behaviour. The ensures the potential donors that their safety is as important to the transfusion centre as that of the recipient.

The objective of a blood transfusion centre should be to retain individuals who donate blood once, as regular donors. Individuals who donate blood at least twice a year or whenever called upon to do so can be regarded as regular donors. They are considered to be safe donors as their blood is regularly tested at the time of each donation. They can be relied upon in emergencies to donate blood. Each transfusion centre must develop ways to recruit donors and retain them. Newer and more efficient methods may be developed according to the needs of the hospital.

Donor Education & Information

Common forms of risk behaviour which disqualify a potential donor from blood donation are * Heterosexual / Homosexual promiscuity * Sexually transmitted diseases * Intravenous drug abuse * Chronic alcoholism

Individuals practising such behaviour may be at risk of blood borne infections which can transmitted during transfusion.

It is the responsibility of the transfusion centre to educate all donors about what constitutes risk behaviour. A leaflet which enlists the various high risk activities

permanently disqualifying a potential donor may be provided to donors. If the donor discovers that his blood may be unsafe for transfusion, a confidential means of self-exclusion should be developed by the transfusion centre.

Self-deferral means that donors make the decision not to donate blood as they understand their blood may be unsafe for the recipient. This may be due to their high risk behaviour or poor health.

Some donors may be under family or peer pressure to donate blood and may be afraid to self defer. They man inform the transfusion centre later of their risk category. It is also important that strict confidentiality must always be maintained under such circumstances and the donor assured of it. Self- deferral ensures blood safety as recently acquired transfusion transmissible infections may not be detected even by most sensitive laboratory tests.

In Indian situation total voluntary blood donation, self-deferral and other strategies appear as distant goals. The level of education in the predominant donor population i.e. replacement donors may not be very high, however donor education does play a significant role in deferring donors with high risk and assuring safety of blood.

Voluntary donors usually are college students who are young and enthusiastic but very few of them actually become regular donors.

All efforts must be made to motivate voluntary donors to become regular donors. Donor Identification/Registration

It should be possible to trace every unit of blood donated by the donor. The following information pertaining to each donor must be recorded.

1. Date of donation 2. Name, age (date of birth) and sex of donor 3. Father’s/Husband’s name 4. Address and telephone no - office -residence 5. Blood group, if known 6. Type of donor voluntary, replacement, professional or autologous. 7. Date of last donation 8. Donor adverse reaction, if any, during last donation 9. Previous rejection from donation and its reason 10. Consent in writing

Criteria for Donor Selection

Stringent and critical donor selection is a very important approach for the ultimate objective of blood safety. Recruitment of healthy blood donors is important both for the safety of donor and the recipient.

The suitability of a donor for blood donation is determined by medical history, physical examination and few preliminary laboratory tests. These guidelines ensure that the donor is in good health and protects the recipient from any ill effects of disease transmission.

Medical History

A brief medical history should be recorded for all prospective donors. The donor must be explained the need to give accurate information about his health status and any medication or drugs that he may be taking. Donor must be assured that donfidentiality will be maintained under all circumstances. A medical officer/trained nurse should take the history.

It is preferable to record the medical history on the day of donation. Each time a donor comes to donate blood, a standard history questionnaire should be filled. This ensures a systematic collection of the information. It also provides a permanent record of the health status of the donor. In donors who donate blood regularly it provides base line data regarding their health.

All donors must be treated courteously and any doubts/apprehensions must be cleared. This will encourage them to become regular donors. Careful donor selection plays a major role in determining donor and recipient safety.

Centium BBIS V2.0 is a blood bank information system that is endorsed by the Malaysian Ministry of Health available from Centium Software Sdn. Bhd. Developed to the exact government regulations and international standards, it fully automates data and information in a blood bank from end to end. With a host of features which consists of but not limited to Blood Camp scheduling, worklist generation, Serology and Grouping results interpretation as well as real time component status monitoring. Customizable & Secure Blood Banking system with extensive functionality to manage, control operations, increase productivity and efficiency, handling donor recruitment to patient transfusion.

Centium Blood Bank Information SystemCentium BBIS V2.0 is a blood bank information system that is endorsed by the Malaysian Ministry of Health available from Centium Software. Developed to the exact government regulations and international standards, it fully automates data and information in a blood bank from end to end. With a host of features which consists of but not limited to Blood Camp scheduling, worklist generation, Serology and Grouping results interpretation as well as real time component status monitoring,

Centium BBIS offers a robust, efficient and secure blood bank management system capable of handling even large Blood Bank operations.

Centium BBIS V2.0 among others provides the following to optimize any blood bank operations :

Donor ManagementDonor Registration, vetting, donor recall, blood camp scheduling, donor incentive and referral.

Lab Test ManagementHL7 compatibility for integration with automated analyzers, Result interpretation, supports results gathering for tests such as DAT, Haemolysin Titre, GXM, GSH, other test can be configured.

Component ManagementResult interpretation, shelf life monitoring, product processing management, External Receive, External Product Request, Component Status Reports, Barcode Tracking.

Transfusion ManagementMother & Infant Transfusion, Test Ordering, Order and Reserve Products, Adverse Transfusion Management.

Inventory ManagementBlood Bags and Reagents Management, Receive and return of stock, Stock Status Reports

ReportsSome of the reports that are available in Centium BBIS are Blood Bag Traceability Report, Stock Movement Report, Component Movement Report, Donor / Recipient Tracing Report, Blood Request Details Report, Rare Blood Group Report, Confirm Non Reactive Report, Reactive Blood Reports (Hepatitis B, Hepatitis C, Syphilis, HIV), Various Blood Processing Report, Blood Disposal Report, Donor Rejection Report, Transfusion Reaction Report. The software also generates regulatory reports with additional reports can be customized to suit operational neads.

What tests are performed in blood banking?

A certain set of standard tests are performed in the laboratory once blood is

donated, including, but not limited to, the following:

typing: ABO group (blood type)

Rh typing (positive or negative antigen)

screening for any unexpected red blood cell antibodies that may cause

problems in the recipient

screening for current or past infections, including the following: o hepatitis viruses B and C

o human immunodeficiency virus (HIV)

o human T-lymphotrophic viruses (HTLV) I and II

o syphilis

Irradiation to blood cells is performed to disable any T-lymphocytes

present in the donated blood. (T-lymphocytes can cause a reaction when

transfused, but can also cause what is called "graft-versus-host" problems

with repeated exposure to foreign cells.)

"Leukocyte-reduced blood" has been filtered to remove the white blood

cells which contain antibodies that can cause fevers in the recipient of the

transfusion. (These antibodies, with repeated transfusions, may also

increase a recipient's risk of reactions to subsequent transfusions.)

What are the components of blood?

While blood, or one of its components, may be transferred, each component

serves many functions, including the following:

red blood cells - carry oxygen to the tissues in the body and are

commonly used in the treatment of anemia.

platelets - help the blood to clot and are used in the treatment of

leukemia and other forms of cancer.

white blood cells - help to fight infection, and aid in the immune process.

plasma - the watery, liquid part of the blood in which the red blood cells,

white blood cells, and platelets are suspended. Plasma is needed to carry

the many parts of the blood through the bloodstream. Plasma serves many

functions, including the following: o helps to maintain blood pressure

o provides proteins for blood clotting

o balances the levels of sodium and potassium

cryoprecipitate AHF - a portion of the plasma that contains clotting

factors that help to control bleeding.

Albumin, immune globulins, and clotting factor concentrates may also be

separated and processed for transfusions.

Phlebotomy

Phlebotomy is the act of drawing or removing blood from the circulatory

system through a cut (incision) or puncture in order to obtain a sample for

analysis and diagnosis. Phlebotomy is also done as part of the patient's

treatment for certain blood disorders.

Describe and perform the venipuncture process including:1. Proper patient identification procedures.2. Proper equipment selection and use.3. Proper labeling procedures and completion of laboratory requisitions.4. Order of draw for multiple tube phlebotomy.5. Preferred venous access sites, and factors to consider in site selection,

and ability to differentiate between the feel of a vein, tendon and artery.6. Patient care following completion of venipuncture.7. Safety and infection control procedures.8. Quality assurance issues.

Identify the additive, additive function, volume, and specimen considerations to be followed for each of the various color coded tubes.

List six areas to be avoided when performing venipuncture and the reasons for the restrictions.

Summarize the problems that may be encountered in accessing a vein, including the procedure to follow when a specimen is not obtained.

List several effects of exercise, posture, and tourniquet application upon laboratory values.

VENIPUNCTURE PROCEDURE

The venipuncture procedure is complex, requiring both knowledge and skill to perform. Each phlebotomist generally establishes a routine that is comfortable for her or him. Several essential steps are required for every successful collection procedure:

1. Identify the patient.2. Assess the patient's physical disposition (i.e. diet, exercise, stress, basal

state).3. Check the requisition form for requested tests, patient information, and

any special requirements.4. Select a suitable site for venipuncture.5. Prepare the equipment, the patient and the puncture site.6. Perform the venipuncture.7. Collect the sample in the appropriate container.8. Recognize complications associated with the phlebotomy procedure.9. Assess the need for sample recollection and/or rejection.10.Label the collection tubes at the bedside or drawing area.11.Promptly send the specimens with the requisition to the laboratory.

ORDER FORM / REQUISITION

A requisition form must accompany each sample submitted to the laboratory. This requisition form must contain the proper information in order to process the specimen. The essential elements of the requisition form are:

Patient's surname, first name, and middle initial. Patient's ID number. Patient's date of birth and sex. Requesting physician's complete name. Source of specimen. This information must be given when requesting

microbiology, cytology, fluid analysis, or other testing where analysis and reporting is site specific.

Date and time of collection. Initials of phlebotomist. Indicating the test(s) requested.

An example of a simple requisition form with the essential elements is shown below:

LABELING THE SAMPLE

A properly labeled sample is essential so that the results of the test match the patient. The key elements in labeling are:

Patient's surname, first and middle. Patient's ID number. NOTE: Both of the above MUST match the same on the requisition form.

Date, time and initials of the phlebotomist must be on the label of EACH tube.

Automated systems may include labels with bar codes.

Examples of labeled collection tubes are shown below:

PHLEBOTOMY PROCEDURE ILLUSTRATED:

Patient identification Filling out the requisition Equipment Apply tourniquet and palpate for vein Sterilize the site Insert needle Drawing the specimen Drawing the specimen Releasing the tourniquet Applying pressure over the vein Applying bandage Disposing needle into sharps Labeling the specimens

Inventry managment

What is "Inventory Management" Inventory management is the active control program which allows the management of sales, purchases and payments.

Inventory management software helps create invoices, purchase orders, receiving lists, payment receipts and can print bar coded labels. An inventory management software system configured to your warehouse, retail or product line will help to create revenue for your company. The Inventory Management will control operating costs and provide better understanding. We are your source for inventory management information, inventory management software and tools.

A complete Inventory Management Control system contains the following components:

Inventory Management Definition Inventory Management Terms Inventory Management Purposes Definition and Objectives for Inventory Management Organizational Hierarchy of Inventory Management Inventory Management Planning Inventory Management Controls for Inventory Determining Inventory Management Stock Levels