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【Objective】 To conduct the laboratory quality assessment between 12 blood stations in Hebei province, analyze the results and explore the accuracy and comparability of testing, so as to improve the level of testing ability and quality management. 【Methods】 With reference to the external quality assessment rules of National Center for Clinical Laboratories and combined with the instructions of quality assessment samples, daily testing process of the laboratories were assessed. The quality indicators include blood cell count (WBC, RBC, Hb, HCT, MCV, MCH, MCHC and PLT), biochemical items (TP) and coagulation parameters (FIB and FⅧ). 【Results】 There are still problems in laboratories in terms of personnel operation, instrument maintenance and the impact of different reagent batches, especially in biochemical items and coagulation parameters. The pass rate of biochemical items was the lowest, only 72.75%, and that of blood cell count was the highest, reaching 98.75%. 【Conclusion】 With the progress of the project, the quality monitoring level of daily blood sampling tests in the quality control laboratory of each blood station has been improved. However, it is still necessary for each laboratory to improve the testing ability and quality management to a higher level in Hebei.
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Resumo: Esta pesquisa avaliou indicadores do ciclo do sangue relacionados à doação, processamento e custo com o descarte de hemocomponentes. Trata-se de uma pesquisa exploratória, documental e de abordagem quantitativa com o objetivo de elaborar uma matriz de recomendações no ciclo do sangue do hemocentro coordenador do Estado do Paraná - Hemepar Curitiba. Considerou-se a avaliação de indicadores de desempenho, com base no estabelecido pela legislação e sob a perspectiva do aproveitamento máximo possível do sangue doado. Foram observados os dados relativos ao período de 2010 a 2015, com fonte em banco de dados do Sistema HEMOVIDA. Os resultados das variáveis quantitativas foram analisados quanto a frequências absolutas e relativas e sua evolução, utilizando-se o coeficiente de correlação de Spearman, comparando com os índices dos anos mensurados. Foi utilizado o teste para diferença de proporções para avaliar se a proporção de candidatos aptos/inaptos era diferente em relação ao grupo de voluntários/reposição, voluntários/convocação, voluntários/auto - transfusão, assiduidade, sexo e idade. Além disso, foi caracterizado o perfil dos dadores de sangue quanto à motivação, assiduidade, sexo, idade, número de bolsas coletadas, hemocomponentes processados e transfundidos, reações transfusionais, motivos de descarte de hemocomponentes e estimativa de custo financeiro evitável no período. Os resultados demonstraram maior frequência de doadores voluntários, do sexo masculino e com idade superior a 29 anos. O hemocomponente mais processado foi o concentrado de hemácias e o mais descartado o plasma fresco congelado, ao se considerar o descarte por causas potencialmente evitáveis. A reação transfusional mais frequente foi a febril não hemolítica. Houve relevância na identificação de potencialidades e fragilidades do ciclo do sangue, com destaque para a possibilidade de aumento na captação de doadores, redução no número de descartes por causas potencialmente evitáveis. Como fragilidades destaca-se a suspensão do fornecimento de plasma excedente à Hemobrás e das coletas externas, condições de difícil governabilidade, por se tratarem de questões relacionadas à gestão pelas instâncias estadual e federal. Os custos com os descartes por causas potencialmente evitáveis permitiram estimar a economia prospectiva a partir de ações organizacionais. Foi elaborada uma matriz de recomendações para o hemocentro coordenador com base nos resultados alcançados, demonstrando possibilidades de melhoria em metas institucionais e atendendo ao objetivo geral desta pesquisa.
Abstract: This study evaluated blood cycle indicators related to donation, processing and cost with the disposal of blood components. This is an exploratory, documentary and quantitative approach with the objective of elaborating a matrix of recommendations in the blood cycle of the coordinating hemocenter of the State of Paraná - Hemepar Curitiba. The evaluation of performance indicators was considered, based on the established by the legislation and from the perspective of the maximum possible use of donated blood. The data for the period from 2010 to 2015 were observed, with source in a database of the HEMOVIDA System. The results of the quantitative variables were analyzed for absolute and relative frequencies and their evolution, using Spearman's correlation coefficient, comparing with the indices of the years measured. The proportional difference test was used to assess whether the proportion of eligible / unfit candidates was different in relation to the volunteer / volunteer group, volunteers / volunteers, self - transfusion, attendance, gender and age. In addition, the profile of blood donors was characterized in terms of motivation, attendance, sex, age, number of bags collected, blood transfusions processed, blood transfusion reactions, reasons for the disposal of blood components and estimated avoidable financial cost in the period. The results showed a higher frequency of voluntary donors, males and those older than 29 years. The most processed blood component was the red blood cell concentrate and the most recently discarded the fresh frozen plasma when considering the disposal for potentially preventable causes. The most frequent transfusion reaction was febrile non - hemolytic. There was relevance in the identification of potentialities and fragilities of the blood cycle, highlighting the possibility of increased donor recruitment, reduction in the number of discards due to potentially preventable causes. The most notable weaknesses are the suspension of supply of surplus plasma to Hemobrás and external collections, difficult to govern, because they are issues related to the management by the state and federal authorities. The costs of discarding for potentially avoidable causes allowed us to estimate the prospective economy from organizational actions. A matrix of recommendations was prepared for the coordinating hemocenter based on the results achieved, demonstrating possibilities for improvement in institutional goals and meeting the general objective of this research.
Subject(s)
Quality of Health Care , Blood Banks , Blood Donors , Indicators of Health Services , Hemotherapy ServiceABSTRACT
Objective:To discuss innovative development under the "6 requirements" guidance of supply-side structural reform,and provide direction of development reference for promoting the development of blood collection and supply.Methods:It reviewed the development of blood collection and supply in a certain blood center,analyzed the integrating degree between the main business development measures and "6 requirements" of supply-side structural reform.Results:There was a better compatibility between the main measures and "6 requirements" of supply-side structural reform.Conclusion:Based on the "6 requirements" guidance of supply-side structural reform,innovative development could be led to effectively break the current bottleneck at blood collection and supplyment.
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The Korean government previously established a national blood policy and national blood system based on basic and essential legislation. This achievement was the result of collaborative efforts between the Korean Centers for Disease Control and Prevention, the Korean Society of Blood Transfusion, the Korean Society for Laboratory Medicine, the Laboratory Medicine Foundation, and/or the Korean Association of External Quality Assessment Service. To ensure a safe and effective transfusion, a comprehensive quality assurance (QA) system to assess every process from donor selection to transfusion is mandatory. From a blood safety perspective, selection of appropriate donor blood screening tests for transfusion-transmissible infections (TTI) and the QA program is of great importance. In this article, we review legislation regarding the national blood policy and national blood system as well as the selection logic regarding diagnostic immunologic tests for TTI and quality assurance efforts for TTI of each blood center.
Subject(s)
Humans , Blood Safety , Blood Transfusion , Donor Selection , Immunologic Tests , Logic , Mass Screening , Quality Control , Tissue DonorsABSTRACT
BACKGROUND: The Korea Centers for Disease Control and Prevention (KCDC) has been providing a nationwide, one-day training program for workers of hospital blood centers once a year since 2013. We evaluated the achievement levels of the program through surveys. METHODS: The survey was conducted immediately after the program in 2015, 2016, and 2017. Respondents' occupations, institutions, program contents, and operational aspects were asked. RESULTS: The response rate was 56.2%∼73.2%. The occupations of respondents were medical technologists 66.9%∼75.7%, nurses 16.1%∼22.1%, and others (administrators, et al.) 1.5%∼11.3%. About 86.1%∼88.2% of respondents answered that the program as a whole was satisfactory or very satisfactory; 88.9%∼94.7% thought that it is necessary or very necessary; 77.9%∼84.1% answered that the appropriate length of the program was one day; 53.8%∼69.1% answered that the appropriate number of program is once per year; and 23.4%∼53.8% or 40.3%∼61.4% answered that the appropriate season for the program by the KCDC should be the first or the second quarter, respectively. CONCLUSION: This study suggests that the training program plays a useful role in meeting the needs of workers for hospital blood centers.
Subject(s)
Humans , Education , Korea , Medical Laboratory Personnel , Occupations , Seasons , Surveys and QuestionnairesABSTRACT
The primary goal in transfusion medicine is to promote high standards of quality in all aspects of transfusion, including production, management, and transfusion of blood components. To achieve this goal, a transfusion service quality management system should be established. Such a system should include several organizational structures, responsibilities, policies, processes, procedures, and resources with provided specifications and regulations. In this review, we summarize the current knowledge and practices regarding the quality management of hematology tests applied to the donor selection and production of blood components, including red blood cells, platelets, fresh frozen plasma, and cryoprecipitates in the field at blood centers.
Subject(s)
Humans , Donor Selection , Erythrocytes , Hematology , Plasma , Social Control, Formal , Tissue Donors , Transfusion MedicineABSTRACT
Objective To improve the protective strategy of occupational risks for technicians in blood centers so as to ensure their health and safety.Methods The occupational risk factors were analyzed by the 5W1H method,and the corresponding protective measures were introduced.Then,the protective measures were verified dynamically by the PDCA circulation,and were standardized and further spread.The projects with poor effect were replanned and entered the PDCA recycling.Results The system of the 5W1H method combined with PDCA circulation could identify and control various occupational risks,and effectively prevent the occupational detriments.Condusion Combined application of the 5W1H method with PDCA circulation is an effective way to protect the health and safety of technicians in blood centers and an effective mode to improve the management of occupational risks.
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BACKGROUND: Donor screening test is one of the most important processes for blood safety management. Korea Center for Disease Control and Prevention (KCDC) has been conducting an annual proficiency test program that includes the distribution of specially manufactured panels for hepatitis B surface antigen (HBsAg) and antibody to hepatitis C virus (anti-HCV) to blood centers. Here, KCDC reports the results of these proficiency tests for HBsAg and anti-HCV blood donor screening for all licensed blood centers in Korea between 2012 and 2015. METHODS: Panels for the proficiency tests were manufactured and distributed to blood centers by Chung-Ang University Hospital, which has been participating in the Korea Blood Safety Commission. Well-proven reactive sera and healthy donor's sera acquired from the Human Serum Bank in Chung-Ang University were used to make the panels. To identify the S/CO ratio of the panel, three medical institutes triple-checked the results of each panel. RESULTS: Most blood centers reported correct answers for the proficiency test with six panels. The average percentages (year) of correct answers were as follows: 98.7% (2012), 98.5% (2013), 99.1% (2014) and 99.6% (2015) for the HBsAg proficiency tests; and 97.7% (2012), 99.5% (2013), 99.1% (2014), and 99.8% (2015) for the anti-HCV proficiency tests. CONCLUSION: To improve the blood center's ability for donor screening tests, KCDC will continue the proficiency test program by managing specialized panels for HBsAg and Anti-HCV tests. Furthermore, we will investigate the level of satisfaction to improve the quality of the program.
Subject(s)
Humans , Academies and Institutes , Blood Donors , Blood Safety , Donor Selection , Hepacivirus , Hepatitis B Surface Antigens , Korea , Mass ScreeningABSTRACT
O objetivo é relatar a experiência de uma Educação Popular em Saúde (EPS) sobre a doação de sangue. Trata-se de um relato descritivo, de abordagem qualitativa, realizado por acadêmicos de enfermagem junto a um público maior de universitários. A ação ocorreu com dinâmica de fotografias, discussão através de painel e evocação de palavras, atividades que proporcionaram uma ação conjunta de ensino/aprendizagem com metodologias ativas, troca de saberes e transformação de comportamentos. Portanto, foi possível construir novos entendimentos, valorização da autonomia e solidariedade para com os sujeitos...
The goal is to report the experience of Popular Education in Health (EPS) on blood donation. It is a descriptive narrative, qualitative approach, performed by nursing students with a wider audience of students. The action took place with dynamic photographs, through discussion panel and recall of words, which provided a joint action teaching / learning with active methodologies, exchange of knowledge and transforming behaviors. So it was possible to construct new understandings, appreciation of autonomy and solidarity with the subjects...
El objetivo es dar a conocer la experiencia de la Educación Popular en Salud (EPS) sobre la donación de sangre. Es una narración descriptiva, enfoque cualitativo, realizado por estudiantes de enfermería con un público más amplio de estudiantes. La acción se Ilevó a cabo con fotografías dinámicas, a través de la mesa redonda y el recuerdo de Ias palabras, 10 que proporciona una ensenanza acción conjunta / aprendizaje con metodologías activas, intercambio de conocimientos y comportamientos de transformación. Así que era posible construir una nueva comprensión, apreciación de la autonomía y Ia solidaridad con los sujetos...
Subject(s)
Humans , Blood Donors/education , Health Education , Students, Nursing , Qualitative ResearchABSTRACT
BACKGROUND: Korean Blood Safety Commission has implemented external proficiency testing (PT) for blood grouping test (BGT) to help improve the quality of blood centers since 2011. We analyzed the results of 2014 PT for BGT to help in planning the future PT for BGT and to improve the quality of blood centers. METHODS: Whole blood survey samples including three panels for ABO grouping and three panels for D typing were sent to 69 institutes. Evaluation criteria for BGT were as follows: 'Good' for answers matched with intended results, 'Acceptable' for correct answers other than that of 'Good', 'Unacceptable' for answers other than those of 'Good+acceptable' as correct answers; and 'Not graded' for answers in case of different answers in the two standard laboratories. RESULTS: All of the answer rates of 'Good' for D typing were 100%. However, the answer rates of 'Good' for cell typing, serum typing and interpretation for 14-ABO-2 samples with discrepant result between cell typing and serum typing were 39.1%, 29%, and 47.8%, respectively. Those of 'Unacceptable' for cell typing and interpretation for 14-ABO-2 samples were 2.8% and 1.4%. CONCLUSION: Because the answer rates of ABO grouping for samples with discrepant result between cell typing and serum typing were not high, education for this case is needed. Diversity of materials for PT would be necessary for more accurate evaluation of the performance of BGT in blood centers.
Subject(s)
Academies and Institutes , Blood Grouping and Crossmatching , Blood Safety , EducationABSTRACT
BACKGROUND: It was reported that a continuous education program and external proficiency testing (PT) for blood grouping test (BGT) might be necessary because some blood centers of medical institutions could not correctly examine ABO subtype and D variant, according to the results of the first year project in 2011. Therefore, the results of PT for BGT in blood centers in 2012 and 2013 were compared to those in 2011 in order to assess the impact of projects during a period of three years and to help in planning the future PT for BGT. METHODS: Whole blood survey samples composed of three panels for ABO grouping and three panels for D typing were sent to 74 and 71 institutes in 2012 and 2013, respectively. Evaluation criteria for BGT were as follows: 'Good' for the answers matched with intended results, 'Acceptable' for the correct answers other than that of 'Good', and 'Unacceptable' for the answers other than those of 'Good+acceptable' as correct answers. RESULTS: The answer rates of 'Unacceptable' for ABO subtype were 1.4% in 2012 and 4.2% in 2013. However, the answer rate of 'Good' increased from 44.6% in 2012 to 83.1% in 2013. The answer rate of 'Unacceptable' for D variants showed a marked decrease, from 16.2% in 2012 to 1.4% in 2013. CONCLUSION: Projects for PT for BGT during a period of three years have improved laboratory quality in blood centers. However, the acquisition and change of the materials for PT would be necessary in order to continuously and practically provide help to blood centers.
Subject(s)
Academies and Institutes , Blood Grouping and Crossmatching , EducationABSTRACT
Information on the blood safety management system in Japan was collected by visiting the Ministry of Health, Labour and Welfare (MHLW), Japanese Red Cross Blood Service Headquarter, Kanto-Koshinetsu Block Blood Center, and Yurakucho Blood Room of Tokyo Metropolitan Blood Center, in July 2014, to improve the quality of the blood management system in Korea. In Japan, all blood products are supplied by the Japanese Red Cross Blood Service. In April 2012, the function of screening tests and blood product production of the provincial blood centers was transferred to the block blood centers. Donor suitability is assessed by medical doctors and EKG was tested for donors over 40 years old annually. To prevent bacterial contamination, the shelf life of platelets was shortened to 4 days after production, but routine bacterial screening test was not performed. Adverse reactions and infection following transfusions are reported to MHLW through the Red Cross Blood Service, and the case was reviewed by Pharmaceuticals and Medical Devices Agency (PMDA). Before transfusion, HBsAg, anti-HBs, anti-HBc, anti-HCV, and HCVcAg of the recipient is tested, and testing for HIV antigen is performed if the recipient has risk factors for HIV infection. Even when hepatitis B NAT is positive, look back is not performed if anti-HBc is negative and there is no history of blood donation within 125 days before the current donation. Good Manufacturing Practice (GMP) for blood centers was introduced in the 1990s and PMDA performs the test every 5 years. In introduction of GMP in Korea, it is necessary to decide how to absorb the expense.
Subject(s)
Humans , Asian People , Blood Donors , Blood Safety , Electrocardiography , Hepatitis B , Hepatitis B Surface Antigens , HIV , HIV Infections , Japan , Korea , Mass Screening , Red Cross , Risk Factors , Tissue DonorsABSTRACT
Objective: To summarize the improvement of accounting objectives, account title and so on by comparing the new“Public Institution Accounting Standard” and “Public Institutions Accounting System” with the old ones. Methods: The manufacturing costing method is used to estimate blood cost. Results and Conclusion: Suggestions are provided from perspectives of blood inventory control, cost management and budget management.
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OBJECTIVE: Celiac disease is a permanent enteropathy caused by the ingestion of gluten, which leads to an immunemediated inflammation of the small intestine mucosa. The prevalence of celiac disease varies among different nations and ethnic backgrounds, and its diversity is determined by genetic and environmental factors. São Paulo city is one of the largest cities in the world, with a vast population and an important history of internal migratory flow from other Brazilian regions, as well as immigration from other, primarily European, countries, resulting in significant miscegenation. The aim of the present study was to estimate the prevalence of adults with undiagnosed celiac disease among blood donors of São Paulo by collecting information on the ancestry of the population studied. METHODS: The prevalence of celiac disease was assessed by screening for positive IgA transglutaminase and IgA endomysium antibodies in 4,000 donors (volunteers) in the Fundação Pró-Sangue Blood Center of São Paulo, São Paulo, Brazil. The antibody-positive subjects were asked to undergo a small bowel biopsy. RESULTS: Of the 4,000 subjects, twenty-four had positive tests, although both antibody tests were not always concordant. For example, ten subjects were positive for IgA tissue transglutaminase only. In twenty-one positive patients, duodenal biopsies were performed, and the diagnosis of celiac disease was confirmed in fourteen patients (Marsh criteria modified by Oberhuber). In this group, 67% claimed to have European ancestry, mainly from Italy, Portugal and Spain. CONCLUSION: The prevalence of celiac disease is at least 1:286 among supposedly healthy blood bank volunteers in São Paulo, Brazil.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Blood Donors/statistics & numerical data , Celiac Disease/epidemiology , Blood Banks , Brazil/epidemiology , Celiac Disease/ethnology , Cities/epidemiology , Racial Groups/statistics & numerical data , Epidemiologic Methods , Immunoglobulin A/blood , Transglutaminases/bloodABSTRACT
BACKGROUND: To ensure safety of blood transfusion, accuracy in performance of blood grouping tests (BGT) is essential. External proficiency testing (PT) for BGT has not been conducted in Korea. The first PT for BGT in domestic blood centers was conducted in order to evaluate the domestic status of accuracy of BGT in blood centers and to aid in improving the quality of blood centers. METHODS: Whole blood survey specimens consisting of three panels for ABO grouping and two panels for Rh typing were sent to 81 blood centers. Evaluation criteria for BGT were as follows: 'Good' for answers with 100% referee consensus, 'Acceptable' for correct answers other than those of the referee, and 'Unacceptable' for answers other than those of 'Good+acceptable' as correct answers. RESULTS: Rates of correct answers on three panels for ABO grouping were all 100%; however, that of cell typing for the panel with BW was 61.7%, and 31 blood centers incorrectly reported normal 'B' type as an answer. The rate of correct answers for the Rh negative panel was 100%; however, that for the weak D panel was 84%, and 13 blood centers incorrectly reported Rh negative type as an answer. CONCLUSION: Findings from this study demonstrated that some hospital blood centers were not able to correctly detect blood groups with weak antigens. Therefore, to improve the quality of blood centers, intensive education for blood center staff and continued PT for BGT should be required.
Subject(s)
Blood Group Antigens , Blood Grouping and Crossmatching , Blood Transfusion , Consensus , Dietary Sucrose , KoreaABSTRACT
BACKGROUND: Blood supply in Korea has been unstable in more than a year because transfusion-related infection was repeated in patients receiving blood that the Korean Red Cross Blood Center (KRCBC) had supplied. The purpose of this study is to contribute to stable and efficient blood supply in our country by analysis of present status of hospital blood banks as blood donation center and their satisfaction levels with the KRCBC. METHODS: From July to August 2004, we performed questionnaire survey in 129 hospital blood banks that the KRCBC issued donor card in 2003. Among them, 73 hospitals replied and we analyzed them. RESULTS: Fifty-one (69.8%) among 73 hospital blood banks collected less than 100 cases of blood donation in 2003 and 16 of them collected no blood component. Satisfaction level with KRCBC was only 1.8 in hospitals less than 300 beds. Improvement in the delivery of blood components and blood testing of donated blood were in highest need among all areas of services supplied by KRCBC. Hospitals more than 1,000 beds answered that they would not transfer the collection service to KRCBC no matter how NAT be performed in all donated blood because of the directed and autologous donation of their hospitals. CONCLUSION: Satisfaction level of Hospital blood banks in Korea with blood services of KRCBC was rated below average, especially in hospitals less than 300 beds. It is important that the government should be the subject of national blood services and suggest appropriate schemes such as national audit program through close cooperation with the KRCBC and hospitals.
Subject(s)
Humans , Blood Banks , Blood Donors , Hematologic Tests , Korea , Red Cross , Tissue and Organ Procurement , Surveys and QuestionnairesABSTRACT
BACKGROUND: Blood transfusion service has been expansively developed in quantity. As hospital users require better services, needs for qualitative improvements has increased. Currently, only limited information is available on the level of satisfaction of hospital users with services delivered by blood centers. The purpose of this study is to evaluate the levels of satisfaction of hospitals with services from the Korean Red Cross Blood Centers. METHOD: To assess quality of customer service provided by 8 blood centers of the Korean Red Cross, a questionnaire survey was performed. The questionnaire was composed of 19 items that are related to hospital users'ss satisfaction with several aspects of services including blood delivery, efficacy and safety of blood components, laboratory test, exchange of information about blood, and the supply of newly developed blood products. RESLUTS: Hospital users were largely satisfied with services provided by Red Cross Blood Centers (dissatisfaction rate: 2.3%). The level of overall satisfaction of blood collecting hospitals were relatively lower than those of the rest (p<0.01). Improvement in the delivery of blood components was in highest need among all areas of services. Most respondents recognized high need for sharing information on blood and transfusion between hospitals and blood supply centers. The demand for newly developed blood components was significantly higher in large hospitals with blood bank than those without blood bank (p<0.05). CONCLUSION: The safety of blood recipients and the efficiency of blood supply should be further improved through better blood-related services. Because of limitations in available resources, all the field of services can not be improved at the same time. For this reason, it is important to identify appropriate approaches through close cooperation between the blood centers and hospitals. To this end, a mechanism for active exchange of information should be devised.