Blood Bank Information System Research Articles

Rate of seroconversion in repeat blood donors at the national blood centre, kuala lumpur.

The World Health Organization (WHO) recommend that all donated blood are to be screened for at least three viral infections [human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV)]. The National Blood Centre, Kuala Lumpur (NBCKL) aims to reduce transfusion transmitted infections (TTI) as it still remains as one of the major risk for blood transfusion. A cross sectional study was conducted at the National Blood Centre, Kuala Lumpur from 1st January 2009 to 31st June 2010. Data from 581,020 donors were analyzed from year 2004 to 2008. All data were retrieved from NBCKL Blood Bank Information System (BBIS). A total of 201 repeat donors were included in the study based on the inclusion criteria but only 132 repeat donors agreed to participate. Information on sociodemographic, risk factors, knowledge of donors and high risk behavior were extracted from standardize questionnaire. Data were analyzed using SPSS version 14.0. The aim of this study was to determine the predictors of the seropositive infectivity among repeat blood donors at the NBCKL. The results showed Syphilis accounts for the highest and increasing seroconversion rate among other infections from 20.83% in year 2004 to 44.6% in year in year 2008. HIV and HCV infection also showed increasing seroconversion rate in 5years' time from 6.41% in year 2004 to 17.54% in year 2008 and 4.8% in year 2004 to 5.94% in year 2008 respectively. However, HBV infection alone showed a decreasing seroconversion rate from 20.83% in year 2004 to 10.4% in year 2008. Level of donors' awareness regarding high risk factors (activities or behaviour) can lead to higher risk of TTI with significant p value in this predictors model(p<0.05). Repeat blood donors with high risk activities are more likely to have seropositive results for HBV, HIV and Syphilis. This study found that the frequency of HCV seropositivity is higher among lapsed donor. Socio demographic factors such as male and working in the private sector predominates in all TTI markers. Majority of the respondents were aware about relation of high risk activities and risk of TTI.

Quality indicators for discarding blood in the National Blood Center, Kuala Lumpur

Background and Objective:The implementation of quality system and continuous evaluation of all activities of the Blood Transfusion Services (BTS) can help to achieve the maximum quantity and quality of safe blood. Optimizing blood collection and processing would reduce the rate of discard and improve the efficiency of the BTS. The objective of this study is to determine the rate of discard of blood and blood component and identify its reasons at the National Blood Centre (NBC), Kuala Lumpur, during the year of 2007 in order to introduce appropriate intervention.Study Designs and Methods:Data on the number of discarded whole blood units and its components, reasons for discard, and the number of blood components processed as well as the number of collected blood units were obtained from the Blood Bank Information System - NBC database. These were analyzed.Results:The total number of blood units collected in 2007 was 171169 from which 390636 units of components were prepared. The total number of discarded whole blood units and its components was 8968 (2.3%). Platelet concentrate recorded the highest of discard at 6% (3909) followed by whole blood at 3.7% (647), fresh frozen plasma (FFP) at 2.5% (2839), and cryoprecipitate at 2% (620). The rate of discarded packed red blood cells RBCs, plasma aphaeresis, and PLT aphaeresis was less than 1% at 0.6% (902), 0.6% (37), and 0.29% (14), respectively. RBC contamination of PLT and plasma were the major cause of discard at 40% (3558). Other causes include leakage (26% - 2306), lipemia (25% - 2208), and underweight (4% - 353).Conclusion:Good donor selection, training and evaluation of the staff, as well as implementation of automation will help to improve processes and output of BTS. This would reduce discard of blood components and wastage caused by non conformance.

Transitioning from ‘blood’ safety to ‘transfusion’ safety: addressing the single biggest risk of transfusion

Transfusion errors occur at all points in the transfusion chain, often occurring at multiple points in the transfusion process for the same patient. Such events have been reported to national haemovigilance programs in almost all countries, over and over again. An incredible number of safety changes have been implemented to improve blood safety, including but not limited to: nucleic acid testing for HIV/HBV/HCV, bacterial culture for platelet concentrates, use of male‐only plasma, and the introduction of pathogen reduction strategies. By contrast, very little momentum has developed behind transfusion safety, in hope of improving the safe delivery of blood to patients. This article will review the interventions that have been studied by transfusion medicine services in attempt to improve transfusion safety at every link in the transfusion chain. The most important and indispensable safety step is the introduction of an error tracking system. Such a system should capture all deviations from standard operating procedures, including near‐misses that are captured before the blood product is issued. Near‐misses are 300‐fold more common and represent latent safety concerns requiring urgent attention. The system should be anonymous to ensure that there is no barrier to reporting and no‐fault to recognize that the vast majority of errors are due to latent system errors. The errors should be coded by type and location to allow for the ability to query the error database for the purposes of benchmarking and tracking and trending after system changes. Such a system will allow hospital transfusion services to focus their initiatives at the steps in the transfusion chain most in need of repair at their institution. The system changes that have been studied include: confirmatory group testing, computerized physician order entry, prospective screening of transfusion orders before/after issue, controlled patient registration, regional blood bank information systems, positive patient identification at time of sample collection and the start of transfusion (using barcode or RFID technology), controlled release refrigeration devices, patient involvement in the transfusion process, and healthcare professional education. For each area, the specific technologies or examples will be detailed, the reports from the literature will be reviewed, and the obstacles to implementation will be discussed. Now that blood safety has been assured, we need to re‐focus our attentions on the single biggest threat to patients: errors in the transfusion chain at the hospital level. We need to ensure that patients get blood only when required, that they get the correct product of the correct blood group, at the right dose, at the appropriate infusion rate, to the correct patient, at the right time. We need to take a rigorous scientific approach to solving transfusion safety to ensure that each process change is properly tested and validated to verify that each newly introduced process is safe and effective.

Red cell transfusion in orthopaedic surgery: a benchmark study performed combining data from different data sources.

Previous studies have shown the usefulness of combining information from different data sources to identify and analyse variations in transfusion practices. Good knowledge of the conditions leading to blood use is a fundamental requirement for the assessment of the appropriateness of blood transfusion. In this study we combined blood transfusion data obtained from the Blood Bank information system with patients' data from the Hospital Discharge Database, based on the ICD9 classification system, from 1,827 surgical procedures performed in seven different orthopaedic divisions in the Ravenna area between January and December 2009. Hip and knee replacement surgery (primary or revision) and operations following femoral fractures (partial hip replacement and reduction with internal fixation) were considered. For a subgroup of patients clinical and transfusion data were also combined with haemoglobin values obtained from the laboratory information system. Of the 1,827 surgical procedures, 1,038 (56.8%) were followed by transfusion of red cells. The likelihood of receiving a transfusion varied depending on the patient's sex (49% for males, 60% for females), age, and on the surgical procedure, being higher for interventions following femoral fractures and for revisions of hip replacement: about 70% of patients undergoing these interventions required transfusion. A large variability in transfusion rates was observed between the seven divisions, which was only partially explained by the different types of surgery (post-traumatic or elective) performed by any of them: relevant variations were also observed for the same type of intervention. Combining information from different data sources could be a time-sparing way to gain useful information about transfusion practices, so contributing to optimising blood usage.

Turbid plasma donations in whole blood donors: fat chance?

Blood donations resulting in "nontransparent turbid milky" plasma must be discarded. The aim of this study was to objectively determine opacity and to identify risk factors for turbid plasma donations. This case-control study included 238 whole blood donors who provided turbid plasma (cases) and 309 random control subjects with normal plasma. Participants filled in a questionnaire regarding cardiovascular risk factors. Fat intake was assessed using a validated questionnaire. Opacity and lipids were measured. Additional data were retrieved from the blood bank information system. Mean differences and odds ratios were calculated with 95% confidence intervals. Cases had a less favorable cardiovascular profile compared to control subjects. The usual intake of fat was not associated with turbid plasma donation. In a multivariate model, having dinner before donation (OR, 4.9; 95% CI, 2.2-11.1), triglyceride levels (OR, 7.1; 95% CI, 4.6-10.8), and smoking (OR(yes vs. no) , 2.5; 95% CI, 0.9-6.7; and OR(ever vs. no) , 5.7; 95% CI, 1.8-18.4) were associated with an increased risk. Opacity was clearly increased in turbid plasma. Total cholesterol levels were 0.51 (95% CI, 0.35-0.66) mmol/L and triglyceride levels 4.28 (95% CI, 3.92-4.68) mmol/L higher in cases. High-density lipoprotein cholesterol levels were 0.34 (95% CI, -0.39 to -0.30) mmol/L lower. Forty-two percent of all cases had very high triglyceride levels (≥ 5.65 mmol/L) compared to less than 1% of control subjects. Donors who provided a turbid donation have a less favorable cardiovascular profile compared to other donors. Having dinner, high triglyceride levels, and smoking are independent risk factors for turbid plasma donations.

Hospital blood bank information systems accurately reflect patient transfusion: results of a validation study

Hospital transfusion laboratories collect information regarding blood transfusion and some registries gather clinical outcomes data without transfusion information, providing an opportunity to integrate these two sources to explore effects of transfusion on clinical outcomes. However, the use of laboratory information system (LIS) data for this purpose has not been validated previously. Validation of LIS data against individual patient records was undertaken at two major centers. Data regarding all transfusion episodes were analyzed over seven 24-hour periods. Data regarding 596 units were captured including 399 red blood cell (RBC), 95 platelet (PLT), 72 plasma, and 30 cryoprecipitate units. They were issued to: inpatient 221 (37.1%), intensive care 109 (18.3%), outpatient 95 (15.9%), operating theater 45 (7.6%), emergency department 27 (4.5%), and unrecorded 99 (16.6%). All products recorded by LIS as issued were documented as transfused to intended patients. Median time from issue to transfusion initiation could be calculated for 535 (89.8%) components: RBCs 16 minutes (95% confidence interval [CI], 15-18 min; interquartile range [IQR], 7-30 min), PLTs 20 minutes (95% CI, 15-22 min; IQR, 10-37 min), fresh-frozen plasma 33 minutes (95% CI, 14-83 min; IQR, 11-134 min), and cryoprecipitate 3 minutes (95% CI, -10 to 42 min; IQR, -15 to 116 min). Across a range of blood component types and destinations comparison of LIS data with clinical records demonstrated concordance. The difference between LIS timing data and patient clinical records reflects expected time to transport, check, and prepare transfusion but does not affect the validity of linkage for most research purposes. Linkage of clinical registries with LIS data can therefore provide robust information regarding individual patient transfusion. This enables analysis of joint data sets to determine the impact of transfusion on clinical outcomes.

Donor profiles: demographic factors and their influence on the donor career

Studying the contribution of demographic factors to the donor career provides important knowledge to be used for donor management. The aim of this study is to gain insight into donor characteristics, more specifically into the demographic profile of active vs. resigned donors, and multi-gallon vs. occasional donors. The study population consisted of all registered Dutch whole-blood donors between 1 January 2004 and 1 January 2005 (N = 370 470). The effect of several blood donor characteristics and demographic variables on (i) resigning donating and (ii) being a multi-gallon donor were assessed. Blood donor characteristics were extracted from the blood bank information system and included age, sex, blood group, number of donations and invitations. Demographic characteristics were constituted by population data on urbanization level, socio-economic status (income, housing value), and ethnicity. Men clearly resigned less often than women (odds ratio (OR) 0.73, 95% confidence interval (CI) 0.72-0.75). Being older than 24 years, having a high income, a high-priced house, living in less urbanized areas or areas with relatively few ethnically diverse people also reduced the stopping risk. With respect to multi-gallon donorship, men were five times more often multi-gallon donor than women (OR 5.27, 95% CI 5.15-5.39) irrespective of the number of donation invitations. Furthermore, multi-gallon donors appeared to live in urbanized areas and have a higher income than occasional donors. Our results show that different donor profiles can be distinguished. Differences between active and resigned donors include age, the number of donations, sex, socio-economic-status, ethnicity, and urbanization level. The factors highly associated with being a multi-gallon donor are sex, age, socio-economic status, and to a lesser extent urbanization level. Donor profiles do provide the blood bank with knowledge on their donor population, which may be used as valuable information for donor recruitment and retention policies.

On decision making support in blood bank information systems

Information and computer technology popularizes in blood banks for its potentials in working efficiency as well as service quality. But, in the face of the explosive data and information, one of the challenges in blood bank information systems is how to make good use of them for decision making support. In this paper, we desire to explore the mechanisms of decision making support in blood bank information systems. Firstly, the properties of data and decisions in a blood bank are examined carefully; then, we introduce the development of computerized decision making support with special concerns on blood donation and transfusion service; finally, a case study is presented to evidence our understanding on decision making support in blood bank information systems.

Barcode Technology in Blood Bank Information Systems: Upgrade and Its Impact

This paper desires to explore the role of barcode technology in blood bank information systems via addressing its upgrade and the consequent impact. Firstly, it briefs the application and effect of barcode technology in blood donation and transfusion service. In the second, the barcode paradigms of Macau Codabar and ISBT 128 are carefully examined and compared in accordance with the procedure and specifications of barcode upgrade. Then, the impact due to upgrade is assessed from the perspectives of blood bank information system, blood banks, and even blood donation and transfusion service. It finally discusses the considerations on implementing the upgrade of barcode technology in blood bank information systems.

SIBAS: A blood bank information system and its 5-year implementation at Macau

Automation systems and information technology can greatly help medical facilities to improve their working efficiency and optimize the whole workflow. This article surveys electronic information management in blood donation and transfusion service, and explores the rationale and archetype of blood bank information systems, then exemplifies a successful in-running system—Sistema Integrado de Bancos de Sangue (SIBAS), which is developed by the Institute of Systems and Computer Engineering of Macau (INESC-Macau) in cooperation with the Macau Blood Transfusion Center (CTS-Macau). Its implementation and the related lessons are briefly introduced too. In essence, this article is oriented to serve as a reference of contemporary blood bank information systems.

Blood bank information and control system

The design and implementation of a minicomputer blood bank information system is presented. It supports inventory control and provides statistics also allowing for optimal management decisions. Test runs in the Nuremberg General Hospital showed its time-saving effects. Outdating and shortage figures were reduced. The users' attitudes towards the system were explored; results were used to facilitate implementation difficulties.