الفهرس 
BLOOD BANKS STRUCTUREOnly 14 pages are availabe for public view
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Abstract
Transfusion of blood & blood products is an essential part of health care for patients deficient in one or more blood components. Therefore, organization of blood transfusion services must be based on a national blood policy, including relevant legislation, rules and regulations, which in turn must be an integral part of any national health policy.
In this study, 600 blood donation processes in two main university hospitals blood banks Eldmerdash and Elhuessin were assessed as regard predonation eligibility criteria, blood donation process, post donation care and infection control related to It . They represented 10% of the performed blood donation processes .Moreover all health care workers were inquired about their knowledge and performance according to written policies, procedures and standards adopted by blood bank management committee, as well as documentation, training & regular self assessment, 5% of available registers was assessed in term of their completeness of necessary data of donor, recipient and blood bag information.
The aim of the study was to assess the quality of services provided by health care workers in blood banks compared to national Egyptian standards in terms of: organizational management, standards of quality for blood donation, documentation, training programs, regular self assessment, and infection control related to blood donation.
A descriptive study design was applied in main blood bank in Ain-Shams and Elhuessin blood bank in Al-Azhar university hospitals. All workers in the blood banks were included in the study.
10% of the expected blood donation processes during the 3 months of the field work were observed and their corresponding checklist was completed, 5% of blood donation documents during the year 2009 were revised.
Data Collection tools:
a) Questionnaires: Two questionnaires were administered, one for the head manager and the other for all health care workers in the blood banks.
b) Checklist: To survey the blood donation processes was designed that include predonation blood donor assessment for eligibility criteria, completion of a blood donor questionnaire, vital data assessment, skin inspection and medical examination, blood donation process procedure, blood bag inspection, donor post donation care, infection control and hand washing, wearing gloves, working surface area cleaning, needles recapping, wastes disposal, registration and documentation.
- Documents were revised for completion of registered data namely blood bag number, donor name, date of donation, blood group, amount and type of blood, recipient patient’s name, hospital number, department, patient’s blood group, data of person delivering blood: ID, name and signature.
The results revealed the following finding:
- As regard eligibility criteria of the donor, both blood banks inquire about appropriate age, date of last blood donation and assignment of a serial number for the donor. Neither Eldmerdash nor Elhuessin blood bank health care workers asked about physical exercise before donation and in about 70% of the observed blood donation processes health care workers asked about last meal intake.
- Elhuessin blood bank health care workers did not ask female donors about pregnancy, and only 28% asked about lactation.
- Infectious diseases (AIDS, hepatitis and malaria), chronic illnesses as cardiac diseases, epilepsy, neurological disorders, hypertension, cancer, liver and renal diseases and diabetes. Travel from malaria areas, drugs intake, blood disease, and history of surgery were inquired about in almost all observations in Eldmerdash blood bank while in Elhuessin , history of cancer, drugs intake and surgical history was obtained in 85-94%.
- In general Eldmerdash blood donation process observations showed better adherence to quality standards in terms of eligibility criteria for blood donation, completion of blood donor questionnaire, assessment of vital data, skin and lymph nodes examination, skin preparation and disinfection, procedures followed during blood donation, post donation care, presence of resources for infection control, wearing gloves before donation, needle recapping and fluid wastes disposal.
- However, Eldmerdash health care workers showed less adherence to quality standards in terms of performing physical exercise inquiry, last meal inquiry, predonation Hemoglobin assessment, lymph nodes examination, predonation blood bag inspection for color and leakage, giving the donor 20 minutes rest post donation, post donation instructions for keeping plaster for 12 hours, measures to be taken if bleeding occurred, avoiding vigorous work, avoiding smoking, and exposure to sunlight. Hand washing procedure was not appropriately followed by Eldmerdash health care workers in terms of: hand washing before working and before examination, washing hands after examination, washing hands after removal of gloves and washing hands after cleaning of blood DROP. Hand washing technique was not appropriately followed by health care workers in Eldmerdash blood bank. Wearing gloves for clinical examination and changing gloves between donors were not performed by Eldmerdash blood bank health care workers.
- In Elhuessin blood bank, health care workers showed adherence to quality standards in terms of eligibility criteria for blood donation except for: physical exercise inquiry, female donor assessment for pregnancy, lactation and chronic diseases assessment. A donor questionnaire was not available in Elhuessin blood bank. Only blood pressure was assessed in Elhuessin blood bank, while other vital data namely pulse, temperature and weight were not assessed.
- Appropriate skin inspection and examination was not performed in Elhuessin blood bank. Again blood bag inspection for color and leakage was not performed in Elhuessin blood bank. Blood bag weight monitoring was not performed in Elhuessin blood bank
- Post donation instructions were not addressed to the donor as he was not given a 20 minutes rest after donation in Elhuessin blood bank. Hand washing was not performed in the appropriate situations and hand washing technique was not followed respective to standards in Elhuessin blood bank. There was no basin for hand washing; soap and antiseptic were not available in the blood donation area in Elhuessin blood bank. Wearing gloves was missed during corresponding situations. Blood DROP disinfection was performed in only 50% of cases and health care workers did recapping needles after usage. There was no special container fluid waste disposal in Elhuessin blood bank.
- There was a misconception of the role of incident events registry in both blood banks.
- The number of doctors was relatively less in Elhuessin compared to Eldmerdash blood bank, but health care workers in both blood banks were aware of the presence of laws, infection control policies, blood bank operations policies, infectious waste disposal and different activities registration policies.
- As regard procedures and standards, health care workers showed awareness of infection control procedures, different blood bank operations procedures, collection of infectious wastes and registration of different activities procedures. Health care workers reported that they followed standard procedures in 84% of cases in Eldmerdash and 88% in Elhuessin blood banks. Less than half of health care workers in both blood banks reported that there was no financial or emotional incentive for following quality standards.
- Half of health care workers in both blood banks reported that they attended training courses: a minority before employment and the majority on job. Health care workers in both blood banks reported that there was no program for sustainable professional development and there was no plan for post training evaluation of assisted courses.
- For services provided to health care workers, half of health care workers denied the availability of vaccination and post needle stick injuries follow up care. None of Eldmerdash blood bank health care workers and 3 of Elhuessin blood bank health care workers reported a screening service for HCV and HBV. 38% of Eldmerdash and 12% of Elhuessin health care workers reported the presence of a form for needle stick injury notification and registration. 45% of health care workers in both blood banks received HBV vaccine.
- Aspects of quality standards in Eldmerdash and Elhuessin blood banks are still lacking though more evident in Elhuessin blood bank.