Introduction to Transfusion Science PDF

Transfusion Science 1 MLSC 3200 Overview of the Modern Transfusion Medicine Department And Quality Control in the Blood Bank Lavern Bourne, Ph.D., MLT 2 3  A blood bank facility is...

Transfusion Science 1 MLSC 3200 Overview of the Modern Transfusion Medicine Department And Quality Control in the Blood Bank Lavern Bourne, Ph.D., MLT 2 3  A blood bank facility is involved in the collection, storage, processing, and distribution of human blood and blood they Typically, products for as function transfusion. unit of a larger organization such as a hospital or Organizati community blood center. on Blood banks also function as a part of a heavily regulated health-care industry. They are also governed by standards set by non- regulatory accrediting organizations such as AABB, CSTM 4  Main laboratory Patient samples tested for: ABOSC DAT Crossmatch Pre and post natal evaluations Issuing of blood products 5  Reference laboratory Resolution of: ABO/Rh discrepancies Antibody ID Positive DAT Warm and cold Autoantibodies Transfusion reactions 6  Component preparation and storage ABOSC on donor units Tests for Transfusion transmitted diseases (TTD) Separation of whole blood into components Storage of blood products at appropriate temperatures Apheresis procedures 7  Type of Blood Bank 1. Blood Bank with collection facilities: Few 2. Blood Bank without collection facilities: Majority 3. The primary collecting center is Canadian Blood Services(CBS) formerly called the Canadian Red Cross 8  Examples of federal/provincial bodies responsible for regulations and accreditation standards Health Canada: Federal laws: Government of Canada Blood Regulations SOR/2013-178. AC Diagnostics is operated by Accreditation Canada (formerly Institute for Quality Management in Healthcare(IQMH). “To promote quality improvement of laboratories and related services for the public good and the benefit of health professionals.” IQMH is a department of the OMA as the deemed agent of the Ministry of Health and Long-Term Care (MOHLTC) for external quality assessment (EQA) and accreditation of licensed medical laboratories in Ontario https://iqmh.org/ CSTM – Canadian Society of Transfusion Medicine The Canadian Society for Transfusion Medicine is a multidisciplinary society that promotes and supports the best practice in Transfusion Medicine in Canada through education, communication, and partnerships. www.transfusion.ca AABB - American Association of Blood Bankers www.aabb.org 9 BLOOD BANK EQUIPMENT 10  Refrigerat ors and Freezers Standard refrigerators maintained at 1 to 60C Use for storage of RBC and whole blood Freezers maintained at < -180C for FFP and cryoprecipitate. Freezers maintained at < -650C for frozen RBC All fridges and freezers must have alarm system and constant temperature monitoring chart. 11  Platelet Agitator  Use to prevent the formation of platelet aggregates and optimize the exchange of gases required for platelet survival.  Gentle rocking motion at room temperature https://www.youtube.com/watch?v=O4-m0KhhF cs 12 Platelet Agitator  Cell Washers Small ones used to prepare 5% washed RBCs Larger ones used to prepare large volume of washed RBCs 13  Sterile Connecting Devices Applications Pooling of blood components Preparation of aliquots for pediatric transfusion Addition of processing solutions 14 Sterile connecting devices https://www.youtube.com/watch?v=we0 87wry5IE Sterile connecting devices 15 Irradiators Used to render donor lymphocytes non-functional and protects against graft-versus- host disease in bone marrow transplant recipients, directed donations, immuno-suppressed patients. Irradiated product(RBC, Platelets) must have an irradiation sticker showing date and time of irradiation and expiry date of product. Red cells expire 14 days after they are irradiated 16 Quality Control in Transfusion Science 17  Degree of excellence. The quality improvement process is a style of management that puts quality first in all What activities. is Quality, safety, and Qualit effectiveness are built into a product. y? Quality cannot be inspected or tested into a product. 18  Quality philosophy required that each step in the process must be controlled to meet quality standards. Quality Managem ent in Transfusio n Science Bringing philosophy into practice require the following building blocks: Quality Quality Quality Control Assuran System (QC) ce (QA) (QS) 19  Reveals when method, equipment or procedure are not working as expected Qualit y Routine, performed Contr Reagent QC daily Calibration of Temperature monitoring centrifuges ol (QC) Determined by Regulation, Manufacturer Package accreditation 's operator inserts standards manuals 20  Accurately labeling and testing blood Example components. s of QA Timely, accurate in transfusion services Transfusi for physicians and on other health care Science personnel. Safe and efficacious blood transfusions to patients. 21 Patient ID is important 22 23  MANUAL REQUISITIONS In order to be acceptable for processing blood samples, the manual requisitions MUST have the following: Patient’s ID on the requisition MUST be the same as the patient’s sample Signature of the phlebotomist Date and time of collection and receipt Indication of priority and tests to be done. 24  Blood Samples In order to be acceptable for processing, blood samples should be labelled with: At least 2, preferably 3, patient identifiers: Acceptable Patient Identifiers are:  Patient’s Full name  Patient’s ID number (never changes)  Patient’s Date of Birth (DOB)  Specimen Number (different every time a new sample is drawn from the patient) Aliquots of the specimen must be labelled with exactly the same information as the original blood sample The type of aliquot must also be included on this tube i.e. Plasma or Serum 25 What do you think? 26 Essential Elements of a Transfusion Lab Biosafety Program. 27 Equipment Have a process for installation and validation of analyzers, automated pipettes, freezers, refrigerators, computers Records kept for equipment repairs, installation, calibration, maintenance. 28  Docume Approved information either written or electronic Written policies, process flowcharts, SOPs, forms, nts worksheets Documen ts and Capture results or final testing information Records Written forms or electronic Kept for designated number of years Use permanent ink. Not pencil. Record information immediately. Remember if it isn’t recorded it is considered that it was never done. Entries must be legible. Print if necessary. Original entries must be visible. This means that Records any errors must not be obscured by correction tape or fluid or scratched out. When making a correction, put one line through it and write the correct result close to the original result. Corrections include the date and the initials of the person making the correction. Ensure that all required information is recorded. Remember to sign your work! 29  The Goals of a biosafety program 01 02 03 Reduce the Reduce the Reduce the risk of harm risk of harm risk of from handling from transmission patient and reagents and of diseases donor blood chemicals because of specimen used blood transfusion 30  Safety training program Safety should include training in: Chemical, biologic, radiation, electrical, and mechanical hazards, infection control, facilities maintenance. Everyone is responsible for keeping the workplace safe. Regulatory agencies such as The Canadian Centre for Occupational Health and Safety (CCOHS) promotes safe workplaces. 31 Classification of Work Activity MOST TRANSFUSION THE ONTARIO TECH LABS OR BLOOD LABORATORY IS A CENTERS ARE LEVEL LEVEL 2. 2. 32  Universal Precautions Blood and certain body fluids of all patients are considered potentially infectious. 33  Personal Protective Equipment (PPE) Lab coats Gloves Eye and face protection 34  Use antimicrobial soap and water to mechanically Hand remove soil and transient bacteria. washi Alcohol Based ng Antiseptic Hand Cleaners maybe used if hands are not soiled. 35 Eye Wash and Safety Shower Everyone should be trained to use the equipment properly. 36  Work Area All work Laboratories surfaces are to be should be kept clean disinfected at and tidy. the end of the lab. 37  Spills Treat spills as potential hazardous 38  Needle Precautions Do not re-cap, bend, or remove needles from syringes. Place in sharps containers found at every work station. 39  Storage Reagents and specimen samples Blood bank refrigerators should should be stored in areas separate have working alarm systems and from blood products( if possible in a continuous temperature monitoring different refrigerator). charts. 40