Factors associated with failure of clinical screening among blood donors who have altered serological results in the Centro Regional de Hemoterapia de Ribeirão Preto

OBJECTIVE: This study aimed to investigate the frequency of positive results for hepatitis B and C, HIV and syphilis in blood donations at the Centro Regional de Hemoterapia de Ribeirão Preto, to describe donors with positive results according to some demographic and socioeconomic variables, to identify risk factors associated to these donors and the reasons that they were not detected during clinical screening. METHODS: A descriptive study was performed between July 1st 2005 and July 31st 2006 by interviewing 106 donors after medical consultations where they were informed of positive results for hepatitis B, hepatitis C, HIV or syphilis. RESULTS: There was a predominance of first-time donors, males, under 50-year olds, married individuals, from Ribeirão Preto, with elementary education, low economic status and of people who donated at the request of friends or relatives. Hepatitis C was the most frequently detected infection (56.6%), followed by hepatitis B (20.7%), HIV (12.3%) and syphilis(10.4%). About 40% of donors had omitted risk factors for different reasons: because they trusted the results of serological tests, did not feel comfortable about talking of risk factors or did not consider them relevant. Other justifications were the duration of the interview, the interviewer was unskilled, embarrassment and doubts about confidentiality. CONCLUSION: The results indicate the need for changes in the approach to clinical screening and a review of methods to attract and guide potential donors.

Evaluation of the return rate of volunteer blood donors

BACKGROUND: To convert first-time blood donors into regular volunteer donors is a challenge to transfusion services. OBJECTIVES: This study aims to estimate the return rate of first time donors of the Ribeirão Preto Blood Center and of other blood centers in its coverage region. METHODS: The histories of 115,553 volunteer donors between 1996 and 2005 were analyzed. Statistical analysis was based on a parametric long-term survival model that allows an estimation of the proportion of donors who never return for further donations. RESULTS: Only 40 percent of individuals return within one year after the first donation and 53 percent return within two years. It is estimated that 30 percent never return to donate. Higher return rates were observed among Black donors. No significant difference was found in non-return rates regarding gender, blood type, Rh blood group and blood collection unit. CONCLUSIONS: The low percentage of first-time donors who return for further blood donation reinforces the need for marketing actions and strategies aimed at increasing the return rates.

Uso de modelos bayesianos de volatilidade estocástica no estudo temporal dos registros de doações de sangue. / Using Bayesian stochastic volatility models in a temporal study of the records of blood donors.

Na área das finanças, modelos como o ARCH (autoregressive conditional heteroscedaticity), GARCH (general autoregressive conditional heteroscedasticity) e o modelo de volatilidade estocástica (MVE) são amplamente utilizados na análise de séries de tempo. Por outro lado, essas ferramentas são pouco difundidas na área da saúde. No presente estudo, buscamos transportar os conceitos do MVE para a análise dos registros de doações de sangue do Hemocentro de Ribeirão Preto, São Paulo, realizadas no período de julho de 1996 a junho de 2005. Para isso, utilizamos uma modelagem bayesiana baseada em métodos Monte Carlo em cadeia de Markov. Esse modelo é capaz de apontar os períodos de maior alteração do fluxo de doadores de sangue captados na rotina mensal do Hemocentro ao longo dos anos, e os seus resultados são de grande utilidade para o planejamento de campanhas de doação e captação de doadores, quando identificados os períodos mais críticos para os estoques de bolsas de sangue. O MVE evidencia que, nos anos que compõem o período estudado, o número de doações é caracterizado por uma grande diminuição no número de doações em dezembro, um aumento posterior no mês de janeiro e novamente uma queda em fevereiro.

In studies from the financial literature, models as ARCH (autoregressive conditional heteroscedaticity), GARCH (general autoregressive conditional heteroscedasticity) and the volatility stochastic model are extensively used in the analysis of time series. However, the application of these tools in the health is inexpressive. In the present study, we aimed to adapt the concepts from the volatility stochastic model to the analysis of the records of blood donors who attend Ribeirão Preto Blood Center, São Paulo, Brazil, between July 1996 and June 2005. For this purpose, we used a Bayesian approach based in Markov chain Monte Carlo (MCMC) methods. This model can identify the periods of time when the flux of blood donations collected in the mensal routine of the Blood Center is subject to the largest variation over the years, and its results are very useful for the planning of donation campaigns and search for blood donors, when the most critical periods of blood supply are identified. The volatility stochastic model shows that in the studied period, there is a large decrease in the number of blood donations in December, a subsequent increase in January, and a new decrease in February.

Avaliação do conhecimento sobre hemoterapia e segurança transfusional de profissionais de enfermagem / Evaluation of knowledge about hemotherapy and transfusional care of nurses

Os riscos envolvidos na transfusão de sangue e hemoderivados podem ser conseqüentes de procedimentos inadequados, erros ou omissões dos profissionais responsáveis pela transfusão. O presente estudo objetivou determinar o nível de conhecimento sobre o assunto e a adequação das práticas transfusionais dos profissionais de Enfermagem que atuam em um grande hospital universitário do interior de São Paulo. O estudo foi realizado durante um treinamento teórico em Hemoterapia, onde foi aplicado um instrumento de coleta de dados antes e após o treinamento, caracterizando estes profissionais e avaliando seus conhecimentos sobre o tema. Participaram enfermeiros, auxiliares e técnicos de enfermagem responsáveis pela administração de transfusões. Mais da metade se sente pouco ou mal informada sobre o assunto. Grande parte referiu que os pacientes não são orientados sobre sinais e sintomas de reações transfusionais, ainda referindo procedimentos incorretos para aquecimento do sangue. A avaliação de conhecimentos evidenciou lacunas importantes na capacitação destes profissionais.

The risks involved in blood and blood component transfusion can be caused by inadequate procedures and mistakes or omissions by professionals responsible for transfusion. The present study aims at evaluating the level of knowledge on this issue and about the adequacy of the transfusional practices of nurses at a large university hospital in the State of São Paulo, Brazil. The study was conducted during an in-service training course on hemotherapy. A data collection instrument was applied before and after the training, when the professionals were asked about their knowledge of transfusion practices. Study participants were nurses and nursing assistants, all of whom were responsible for transfusion procedures. More than half the participants felt that they were given little information or were badly informed about transfusions. A large portion of the professionals mentioned that the signs and symptoms of transfusion reactions are not explained to patients. Many participants reported inadequate blood warming procedures. The evaluation of the knowledge showed significant defects in the education of these nursing professionals.