Implementation of technical supervision of the public blood management agencies of Federal District and its effects on hemovigilance activities

Abstract

Objective: To analyze the impact of the implementation of technical supervision in the Transfusion Agencies (TAs) of the public blood network hospitals of Federal District (DF) on hemovigilance activities, from 2009 to 2019. Methods: Retrospective descriptive cross-sectional study with a quantitative approach. Two secondary databases were used: one with information on Transfusion Reactions (TRs) registered in the System of Notifications in Health Surveillance (Notivisa) and another with information on the number of transfusions performed, reported in the Hemotherapy Production Information System (Hemoprod). The information from each TA was separated into two periods: “without a supervisor” and “with a supervisor”. Results: 1,096 TRs were reported and 574,708 transfusions were performed. Considering only confirmed, probable and possible TRs, the number of TRs increased to 981, of which 85.43% were immediate, Allergic (37.92%) and Febrile non-hemolytic reaction (33.74%). More than 80% were mild, however, 2 deaths were attributed to transfusion (0.21%). They occurred predominantly in women (56.27%) and between 25 and 35 years (16.50%). The Transfusion Outpatient (22.43%) was the hospital sector with the highest occurrence of TRs, with Concentrated Red Blood Cells being the blood component most involved in these records (68.40%). In the “no supervisor” period, the notification rate was 0.220 and the underreporting was 92.666%, using the French parameter for comparison (3 TRs/1,000 transfusions). In the “with supervisor” period, the notification rate was 2.297 and the underreporting was 23.417%, showing that the inclusion of supervisors had an impact on the hemovigilance scenario in the TAs of the hospitals in the public blood network of the DF, reducing underreporting by 74.78%.