ABSTRACT
Introduction: The Bombay phenotype is a rare blood group determined by the absence of H antigens. Bombay individuals produce anti-H, a clinically significant antibody that react against all ABO blood group. Anti-H can mask underlying alloantibody during antibody investigation, a challenge in current transfusion practice. The aim of this article is to explore saliva inhibition, a novel method to detect underlying alloantibody in Bombay individuals. Case Presentation: The case is a 93-year-old female transfused with pre-donated autologous blood for a surgery. We determined anti-H subclass and thermal amplitude, secretor status, and optimal ratio of saliva and Bombay plasma. Plasma samples containing anti-H were spiked with anti-Fy(a) to determine the effectiveness of saliva inhibition in uncovering underlying alloantibodies. Results: Anti-H was confirmed to be predominately IgM with broad thermal amplitude. Tube immediate spin (IS) showed stronger anti-H reactivity compared to column agglutination technology (CAT). Spiked anti-Fy(a) was successfully detected using saliva inhibition method. Conclusion: Tube IS appears more sensitive to anti-H. Saliva inhibition appears to be a promising method to detect underlying alloantibody in the plasma of Bombay phenotype individuals.
ABSTRACT
In 2008, Salford Royal NHS Foundation Trust introduced a ward-based performance assessment framework, the Nursing Assessment and Accreditation System, which is designed to foster a culture of safety by helping nurses monitor the quality of care. It is based on the trust's Safe, Clean and Personal Every time approach to service provision and is designed to support communication, accountability, teamworking and leadership, attention to safety and quality improvement, to ensure that patients are placed at the centre of the care services provided.
Subject(s)
Accreditation , Benchmarking/methods , Nursing Service, Hospital/standards , Patient Safety , Quality Improvement , Humans , United KingdomSubject(s)
Attitude of Health Personnel , Hospital Restructuring/organization & administration , Nurse Administrators/organization & administration , Nurse Administrators/psychology , Nurse's Role , Nursing Service, Hospital/organization & administration , England , Hospitals, District , Hospitals, General , Humans , Models, Nursing , Models, Organizational , Nursing Evaluation ResearchABSTRACT
THE GOVERNMENT re-established the matron role in response to public reports about dirty wards and poor standards.
