Philippine Blood Coordinating Council TOTAL QUALITY MANAGEMENT in Blood Service Facilities
Philippine Blood Coordinating Council TOTAL QUALITY MANAGEMENT in Blood Service Facilities
Philippine Blood Coordinating Council TOTAL QUALITY MANAGEMENT in Blood Service Facilities
TOPICS:
Objectives:
Blood Safety is a global concern set by the World Health Organization in this region. WHO has
given much priority in promotion of voluntary, non-remunerated blood donation, laboratory
practices and blood transfusion aspects in our country.
The training has given strong importance on the Hierarchy of Quality wherein Total Quality
Management is the highest point to achieve.
Total Quality
Management
Quality System
Quality Assurance
Quality Control
Organizational Standards
Management
PROCESS
Training Assesment
DOCUMENTATION
Lesson Learned: Here in the Philippines RA 7719 known as National Blood Service Act of 1994
supports the advocacy of the WHO in which paid donors are transformed into voluntary blood
donors in order to provide safe blood to the people.
Lesson Learned: A well-organized blood transfusion service, with quality systems in all areas is a
prerequisite for the safe and effective use of blood and blood products.
Blood service facilities are also required to have a Donor Counselling and Care program.
That includes the following:
Lesson Learned: In order to deliver quality outcomes every BSF must achieve a high
donor satisfaction; they must feel valued, respected and acknowledged.
Lesson Learned: In order to adhere to these here are the overall strategies every
country needs:
Lesson Learned: Pre-transfusion testing is a vital process in selecting blood components that will not
cause harm to the recipient and will have acceptable survival when transfused. Confirming ABO
compatibility between the component and the recipient and detect most clinically significant
unexpected antibodies is the main concern of pre-transfusion testing.
Currently, here are the common TTI’s being screened in most countries:
1. Hepatitis B virus
3 clinical useful test to identify infection
HBsag-antigen ,anti-HBs-antibody
HBcAg- antigen, anti-HBc IgM, anti-HBc IgG-antibody
HBeAg-antigen, anti HBeAg-antibody
2. Hepatitis C virus
Anti- HCV-antibody
Nucleic acid Testing-confirmatory test.
3. HIV
Nucleic acid-based tests amplify and detect one or more of several target sequences
located in specific HIV genes.
4. Syphilis
Non-treponemal- measure Ab to cardiolipin.
e.gRPR,VDRL
Treponemal
e.g T.pallidum enzyme immuneassay test
5. Malaria
Lab diagnosis:
Giemsa stained blood film-gold standard
Rapid Diagnostic Tests
Other TTI’s
PCR.
Lesson Learned:
WHO has set key recommendation to all countries around the world to prevent the spread of
transfusion transmitted infections.
Screening of all blood donations should be mandatory
There should be national system for the evaluation and validation of all assays used for
blood screening
The minimum sensitivity and specificity level for screening preferably not less than
99.5%.
All reactive components should be stored separately for confirmatory testing
counselling and referral for treatment.
The 5S Steps
Sort – Determine what is needed and what is not needed. Remove unnecessary items and dispose them
properly.
Set in Order – “A place for everything and everything in its place” – Control at glance.Arrange necessary
items in good order
Shine – Structured cleaning roster performed routinely. Clean your work place and equipment.
Standardise – Maintain a high standard of housekeeping and workplace at all times.
Self discipline- Do things spontaneously without being told or ordered
Lesson Learned: A failure at any of these points will potentially affect the quality and safety of
the final blood product no matter how controlled the manufacturing process.
Lesson Learned: All activities associated with the processing of blood components
must be well-controlled and documented.
Lesson Learned: The blood cold-chain is a process that begins at the time of collection and continues
until the unit is transfused.
11. Pre and Post Donation Counselling - Dr. Gary U. Ong
Here are the principles of Pre and Post Donation Counselling:
To maintain the safety of blood supply
To protect the health of the VNRBD
To fullfill the ethical requirements
Lesson Learned: Those found to have and HIV infection are referred to the HIV Action Core
Team. (HACT).If reactive to hepatitis B and C, they encouraged to enrol in the Liver Study Group.
Any production, method, or process that derease the amount of WBC in the blood component.
Here are the benefits of luekoreduction:
Prevention of febrile non-hemolytic transfusion reaction
Prevention of HLA alloimmunization and platelet refractoriness
Prevention of leukocyte transmitted infections.
15. Lesson Learned: pre-storage LR can be considered equivalent to serologically negative CMV
allogeneic transfusion.
Lesson Learned: Having a system of retention and disposition of records consistent with the National
Archives of the Philippine guidelines.
Benefits:
Continuous improvement
Independent view
Communication
A means of discussing problems
Increase staff confidence
Improve understanding of the use and value of standards
Focuses minds on quality
Lesson Learned: Audit outcomes must continue quality improvement, the organizations operation
becomes more efficient, staff motivation improves and everyone is happy.
17. Inventory Management- Lurdel Y. Posadas, RMT
Inventory is the number of blood units of any one type that are in the blood bank on a given
day.
Minimal inventory levels; Method of estimating:
Average weekly use
Average daily use
Moving average
Lesson Learned: The greater the number of units, the higher the potential of outdating.
The fewer the units in the inventory, the more frequent the shortages and the greater the need for
emergency blood units.
RECOMMENDATIONS:
Blood service facilities must focus on retention of low risk blood donors because voluntary blood donors
from low risk populations who give blood regular are the foundation of a safe and adequate blood
supply.
More training for blood service facility staffs
Cold chain must be practice properly by purchasing good transport containers for the distribution of safe
and quality blood supplies.
Elective Transfusions must only do by night for most technical errors happens at night time.
Commitment to the prevention, early diagnosis and treatment of conditions that could result in the
need of transfusions. (Obstetrical, complications and traumas)
Hospital Blood transfusion committee must monitor and evaluate the clinical use of blood to reduce
unnecessary transfusion and use of blood products.
LAB