Blood Wastage Research Articles

Problems/Issues in Blood Transfusion Process: A Focus Group Discussion (FGD) with Nursing Personnel in a Tertiary Care Center of North India

Background Blood and blood product transfusion is an essential component of the health care system. Nursing personnel constitute a significant aspect of the transfusion process as they are the last in the chain of the transfusion process to ultimately transfuse the blood and blood products to the recipient. Nurses face many problems/issues in this process. The present study highlights the problems/issues faced by them in the transfusion of blood and blood products. Objective To explore the problems/issues faced by nursing personnel related to blood and blood products transfusion process in a tertiary care hospital in North India. Methods A qualitative design was used. Three focused group discussions were conducted with 8–10 nurses in each group working in the Emergency Neurosurgery Ward of a tertiary care hospital in North India. Tools used were the sociodemographic and job profile of nurses and a focus group discussion (FGD) guide about blood and blood products transfusion. Each FGD session lasted for 15–20 minutes and data saturation was achieved after three FGDs. Colaizzi’s procedural steps were used to analyse the data. Themes and subthemes were generated. Results and Conclusion The problems/issues identified in the FGD were related to a lack of awareness regarding awareness, transportation, storage in the ward, thawing of fresh frozen plasma, problems in a blood bag, wastage of blood in case of children, inadequate nurse patients ratio, taking consent, Judicial request, proper prescription/orders, related to transfusion responsibilities, monitoring and documentation of blood, and blood products transfusion. The above problem/issues should be addressed and overcome to promote safe transfusion. It is recommended that regular In-service education programs should be planned for nursing personnel to update guidelines awareness, and the developed transfusion monitoring sheet should be implemented, to improve documentation and reduce transfusion errors.

Categorization of the Inevitable Causes of Blood and Components Wastage Detected in South Indian Urban Blood Centre

Background: Since there is no artificial substitute for human blood, it plays a vital role in the patient management in this era of modern medicine. Therefore the donated blood from a healthy donor is precious and must not be wasted without proper utilization. Blood wastage is a universal phenomenon which needs a careful approach with strict guidelines. The study aims at categorizing the various inevitable causes of wastage with an attempt to determine ways of preventing the loss due to non-utilization. Materials and Methods: A retrospective – cross sectional study was conducted in a newly started Stand-alone Blood Centre in South Indian Urban city between June, 2022 and June 2024.All the components including Whole Blood (WB), Packed Red Blood Cell Concentrate (PRBC), Platelet concentrate (PC) and Fresh Frozen Plasma (FFP) were included in the study. The reasons for blood and component wastage was noted down from the various Registers of the Blood Centre and all the data was analyzed using Microsoft Excel Spread Sheet. Results: A total of 2456 units of blood were collected. 5284 components were prepared from these which includes 42 units of Whole Blood, 2397 Packed Red Blood cells(PRBC), 2393 Fresh frozen Plasma(FFP), 452 Platelet Concentrate(PC).Overall discard rate was found to be 11.90%. PC discard rate was highest (49.34%) followed by WBU (19.04%), PRBC (13.01%) AND FFP (3.59%). The commonest cause for the discarding was expiry of the shelf life of blood bags (74.72%) followed by damaged bags (9.69%) and TTI’s (6.76%). Conclusion: Blood and its components wastage is an inevitable reality which needs to be approached as upmost priority. Zero wastage of blood and components may be targeted by recommendations like appropriate training of the blood bank staff, keeping negative group donors on reserve, strictly following FIFO policy while dispensing blood, whole blood unit collection may be minimized, encouraging Single Donor Platelets (SDP) by apheresis instead of Random Donor Platelets (RDP) preparation, Blood Utilization Committee to be made mandatory and permission for reciprocal sharing of blood components among blood banks.

Reducing blood product wastage through the inter-hospital redistribution of near-outdate inventory.

Hospital transfusion services order blood products to satisfy orders and maintain inventory levels during unexpected periods of increased blood demand. Surplus inventory may outdate before being allocated to a recipient. Blood product outdating is the largest contributor to blood wastage. A province-wide redistribution program was designed and implemented to redistribute near-outdate plasma protein and related blood products from low-usage to high-usage hospitals. Program operations and details are described in this paper. Two transport container configurations were designed and validated for transport of all blood products. A cost-analysis was performed to determine the effectiveness of this redistribution program. A total of 130 hospital transfusion services contributed at least one near-outdate blood product for redistribution between January 2012 and March 2020. These services redistributed 15,499 products through 3412 shipments, preventing the outdating of $17,570,700 CAD worth of product. Program costs were $14,900 for shipping and $30,000 for staffing. Failed time limits or non-compliance with packing configurations resulted in $388,200 worth of blood products (97 shipments containing 816 products) being discarded. Courier transport delays was the most common reason (42/97; 43%) for transport failure. Redistributing near-outdate blood products between hospitals is a feasible solution to minimize outdating. Despite heterogeneity of Canadian blood product inventory, all products (each with unique storage and transport requirements) were successfully redistributed in one of two validated and simple containers. Total operation costs of this program were small in comparison to the $17.6 million in savings associated with preventing the discard of outdated products.

Impact of Implementing a Standard Operating Procedure to Reduce Blood Wastage in Blood Centers of Iran.

Blood wastage leads to additional costs and reduced blood availability to patients. Above all is the moral issue of wasting donor gifts. This study aimed to determine the rate of blood wastage before and after implementing a new standard operating procedure (SOP) in Iran. In this interventional study, a SOP for wastage management was prepared and implemented in all blood centers throughout the country. Data were extracted from the integrated software of the Iranian Blood Transfusion Organization (IBTO). The wastage rate of blood components in the post-intervention years (2016-2017) was then compared with that in the pre-intervention years (2013-2015) using the Z test. The overall wastage rate decreased by 36.86% (P<0.001, 95% CI [36.84-36.88]) after the intervention. Red blood cell (RBC) wastage decreased from 2.6% to 2.5%, platelet wastage from 19.5% to 10.6% and plasma wastage from 15.5% to 7.3% (P<0.001). The highest percentage of waste reduction pertained to plasma components, which decreased by 52.90% (P<0.001, 95% CI [52.86-52.94]). Expiration was the most common cause of RBC and platelet wastage. The most common causes of plasma wastage were RBC contamination and rupture or leakage of the bags. The intervention resulted in a drop of over 250000 discarded components each year, equal to approximately thirty-six million dollars in savings. This intervention effectively reduced waste and increased efficiency. Ongoing blood wastage reviews, auditing, and receiving feedback from the central headquarters were powerful tools in following the compliance of blood centers. Further studies are recommended, especially concerning blood wastage in hospital blood banks and various wards.

Blood Banking Capacity in Low-and Middle-Income Countries: Covid-19 Convalescent Plasma in Context.

Blood transfusion capacity in low- and middle-income countries (LMICs), encompassing both the safety and adequacy of the blood supply, is limited. The challenges facing blood banks in LMICs include regulatory oversight, blood donor selection, collection procedures, laboratory testing, and post-transfusion surveillance. A high proportion of LMICs are unable to fully meet clinical demands for blood products, and many do not meet even the minimum threshold of collection (10 units per 1000 population). Suboptimal clinical transfusion practices, in large part due to a lack of training in transfusion medicine, contribute to blood wastage. During the COVID-19 pandemic, high- and LMICs alike experienced blood shortages, in large part due to quarantine and containment measures that impeded donor mobility. COVID-19 convalescent plasma (CCP) was particularly appealing for the treatment of patients with COVID-19 in LMICs, as it is a relatively inexpensive intervention and makes use of the existing blood collection infrastructure. Nonetheless, the challenges of using CCP in LMICs need to be contextualized among broad concerns surrounding blood safety and availability. Specifically, reliance on first time, family replacement and paid donors, coupled with deficient infectious disease testing and quality oversight, increase the risk of transfusion transmitted infections from CCP in LMICs. Furthermore, many LMICs are unable to meet general transfusion needs; therefore, CCP collection also risked exacerbation of pervasive blood shortages.

The effects of pen ink and surface disinfectants on red blood cells stored in plasticized polyvinylchloride transfusion bags.

Each unit of red blood cells (RBCs) produced represents a significant cost to the healthcare system. Unnecessary blood wastage should be minimized. In clinical settings, alterations to blood component bags after issue from the protected setting of the blood bank include pen markings, and those that are exposed to an infectious environment require surface disinfecting. These units may be discarded due to unclear effects on RBC quality. In this study, we investigate whether pen markings or surface disinfection negatively affects the quality of packed RBCs and whether pen ink diffuses through the blood bag. RBC bags were marked with pens (water, oil, or alcohol-based) or subjected to surface disinfection (ethanol, hydrogen peroxide [Preempt wipes], or benzalkonium chloride-based wipes [CaviWipes]) and sampled 24 h after applying the treatment and at day 42 post collection (n = 3 for each condition). The samples were analyzed for RBC in vitro quality markers. The presence of any ink in the RBC bags was investigated using mass spectrometry (n = 2). Data from 24 h and day 42 time points indicated no differences in RBC count, mean corpuscular volume, morphology, deformability, potassium content, or hemolysis for either pen markings or disinfectants when compared with their untreated controls (p > .05). No trace of ink was detected inside the bag. RBC units marked with ballpoint, gel, or Sharpie pens do not suffer a loss of in vitro quality, nor do RBC units which have been surface disinfected with 70% ethanol, Preempt wipes or CaviWipes.

Blood Products Wastage in Benghazi Hospitals, Libya: The Rate and Causes

Abstract Introduction/Objective Introduction: Despite the rising demand for blood and blood products, supplies are limited. Limiting blood wastage may compensate for fewer donors. This study examines blood waste in Benghazi. A close look at blood and blood product distribution can reveal areas of frequent wastage and the primary factors contributing of blood waste. This would aid in the development of waste prevention programs and raise awareness of the issue. Physicians, laboratory professionals and nurses can follow blood transfusion guidelines. Objectives: This study aimed to determine the rate of blood products wastage and identify the causes of Wastage in Benghazi hospitals in Libya. Methods/Case Report Materials and Methods: Data for this retrospective study describes the blood components utilization or waste for two years: 2015 and 2016 were obtained from hospital blood bank records of all public and private hospitals that Benghazi central blood bank supply with blood and blood components. Descriptive statistical methods analyzed the data. Results (if a Case Study enter NA) Results: In 2015 and 2016, Benghazi central blood bank supplied hospitals with 73511 units of blood. 35107(47.8%) were transfused. Wasted or discarded 33318(45.4)units. No data was available for 5086 units(6.8%). The most frequently wasted component was PRBCs(87%) followed by platelets(8%) and FFP(6%). The major cause of wastage for PRBCs is over-ordering (70.2%) followed by outdated units(18.5%), Returned after 30 minutes of issue (0.6%), Kept more than 3daysand expired(0.6%) and Issued to other hospitals(10.1%). The main cause of wastage for platelets is over-ordering (89%), and inappropriate ordering is the most common cause of waste of FFP(85%). PRBCs waste was mostly found in the surgical department, mainly obstetric(24%). For platelets, waste was mostly found in the hematology department(32%). for FFP, waste was mostly found in ER(47.1%). Conclusion The main cause of blood and blood component wastage is the unnecessary ordering of blood products. The most blood component discarded is PRBCs. Physicians are the most responsible for blood and blood component wastage. The blood ordering pattern needs to be revised, and the over-ordering of blood and blood component should be minimized. Medical staff must be educated to reduce blood wastage. Every hospital should implement a hospital transfusion committee to develop local guidelines and policies to monitor the rational use of blood and blood component.

Did interventions in a massive transfusion protocol program change transfusion practice?

Abstract Current literature supports improved clinical outcomes in the setting of trauma when a Massive Transfusion Protocol (MTP) adheres to transfusion at, or close, to a 1:1 ratio (RBC:Plasma). At our institution, between 2008 and 2015, the number of MTP activations increased ten-fold, accompanied by increased wastage of blood products and stress on the transfusion service. In response, in 2016-2018, we undertook an extensive root-cause analysis, and deployed multiple interventions, including clinician education and multiple process changes to the MTP, which succeeded in reining in inappropriate activation of the MTP, as we have previously published. Heretofore, we have not addressed whether these interventions also affected the ratio of blood products transfused during MTPs activated at our institution. Here, we test the hypothesis that the changes deployed in 2016-2018 were associated with improved adherence to the desired 1:1 ratio. The study is a retrospective analysis of massive transfusion data collected from 2008 to 2022. We reviewed RBC and Plasma units transfused to all patients receiving blood products through the MTP during this period. All patients transfused seven or more RBC and/or Plasma units following MTP activation were included in the study (total n = 443). Activations were classified by year. For each patient, the (RBC:Plasma) ratio transfused was calculated and assessed for adherence to a 1:1 ratio, with a ratio of 2:1 or greater classified as “suboptimal”. Our institution does not use Whole Blood. MTP usage at our institution gradually increased from 2008, when the MTP was established, to 2016, when the MTP procedure was revised. Suboptimal transfusion ratios (RBC:Plasma) also increased from 2008-2016. Between 2008 and 2013, 15% of patients received suboptimal ratios following MTP activation. In 2014-2016, suboptimal ratios were observed in 25% of MTPs. Following multiple interventions, the frequency of MTP activation dropped precipitously, as described, and was accompanied by a decrease in the percentage of suboptimal ratios; in 2020 to 2022, 11% of MTPs involving seven or more transfused units had a suboptimal ratio. In summary, the dramatic increase in activations of the MTP observed between 2008 and 2016 at our medical center was accompanied by an increase in suboptimal RBC:Plasma transfusion ratios. Interventions deployed between 2016 and 2018 led not only to reduced blood wastage, and lower stress of BB staff, but also to improved adherence to best transfusion practices, in the form of appropriate (RBC:Plasma) ratios transfused during MTPs.

Optimizing electronic blood ordering and supporting administration workflows to improve blood utilization in the pediatric hospital setting.

Red blood cell wastage occurs when blood is discarded rather than transfused, and ineffective ordering results in unnecessary crossmatch procedures. We describe how a multimodal approach to redesigning electronic ordering tools improved blood utilization in a pediatric inpatient setting and how using innovative application of time series data analysis provides insights into intervention effectiveness, which can guide future process improvement cycles. A multidisciplinary team used best practices and Toyota Production System methodology to redesign electronic blood ordering and improve administration processes. We analyzed crossmatch to transfusion ratio and red blood cell wastage time series data extracted from our laboratory information system and electronic health record. We used changepoint analysis to identify statistically discernible breaks in each time series, compatible with known interventions. We performed causal impact analysis on red blood cell wastage time series data to estimate blood wastage avoided due to the interventions. Changepoint analysis estimated an 11% decrease in crossmatch to transfusion ratio and a 77% decrease in red blood cell monthly wastage rate during the intervention period. Causal impact analysis estimated a 61% reduction in expected wastage compared to the scenario if the interventions had not occurred. Our results show that electronic health record design is an important factor in reducing waste and preventing unnecessary crossmatching, and that time series analysis can be a useful tool for evaluating the long-term impact of each stage of intervention in a longitudinal process redesign effort for the purpose of effectively targeting future improvement efforts.

Blood Transfusion Request and Utilization: The Trend in a Tertiary Health Care Centre in North Central Nigeria

Background: An effective blood transfusion service is anchored on an adequate supply of safe blood and its components as well as its accessibility and appropriate clinical use. There is a contrast in blood supplies and utilization between the high, middle and low-income countries necessitating the formulation of appropriate modalities to ensure judicious use of blood while minimizing wastage.&#x0D; Aims: This study was aimed at assessing the blood transfusion request trend in our institution and its utilization with the intent of curtailing the wastage of safe blood for transfusion.&#x0D; Study Design: It is a retrospective study.&#x0D; Place and Duration of Study: Jos University Teaching Hospital Blood Bank from January 2022 to December 2022.&#x0D; Methodology: Appropriately filled blood transfusion request forms of the Jos University Teaching Hospital compared with the blood bank In-house records from January 2022 to December 2022 were reviewed. Request dates, requesting Department, Unit or Specialty, indications for request, Number of units requested, and number eventually utilized were used to determine blood transfusion indices which are indicative of efficient and significant blood use.&#x0D; Results: Eight thousand, five hundred forty-eight (8,548) blood transfusion request forms from the blood bank and patients' folders were reviewed and compared with the Blood Bank's in-house records. Requests for blood transfusion for over 460 indications were received from twenty-six (26) departments and units. There was a general Crossmatch: Transfusion ratio (C: T) of 1.7 with a transfusion index (TI) of 1.2 and transfusion probability (TP) of 48.0%.&#x0D; Conclusion: Transfusion requests were characterized by low utilization across departments and units. This calls for the establishment of a transfusion protocol for the determination of blood volume required for every indication so that this limited commodity will be made available and accessible when needed.

Study of reasons for discarding whole blood and its components in a blood bank in a rural tertiary care teaching hospital in Maharashtra

Abstract Introduction: Each unit of blood is valuable; thus, it must be used as efficiently as possible with the least amount of waste. Supply of blood in an emergency requires stringent storage conditions with quality checked and should be available at the time of demand to the needy. So blood banks play a vital role in this demand-supply process. On the other hand, because of the biological nature of blood, it is very vulnerable to contamination by infections, early expiry and hemolysis. The purpose of this study was to determine the reasons for the wastage of blood and blood components. Materials and Methods: At our tertiary care teaching hospital blood bank we conducted a retrospective analysis of data of all whole blood and blood component samples collected from January 2013 to December 2020. Results: 391 (9%) of the 4022 entire blood bags collected were discarded 132 (32%) of them were eliminated due to hemolysis and lipolysis and the same 32% expired due to completion of the life span of RBC. Sero-reactivity for TTI or transfusion-transmitted diseases was 22.4% and only 13% were rejected for use because of some leakage or inadequate quantity of blood in the bag. Conclusion: An adequately conducted donor screening, notification and counseling of permanently deferred donors will help in discarding less number of bags that are positive for different TTI. Properly implemented blood transfusion policies will help to utilize the blood components in a proper way resulting in discarding the number of blood bags due to expiry.

A study on the usage and wastage of blood components in blood bank of B.P. Koirala Institute of Health Sciences, Dharan

Background: Human blood till date has no substitute. Transfusion of blood and its components is a lifesaving procedure. Hence, optimum utilization and minimum wastage of blood and its components should be strictly monitored. Materials and Methods: This is a prospective study conducted on data collected from the blood bank of B.P. Koirala Institute of Health Sciences, Dharan, Nepal for a duration of 1 year from year 2015 to 2016. The sample size was calculated by using systematic random sampling with every third sampling interval sample collection method. The study included usage and wastage of packed red blood cells, platelet concentrate, fresh frozen plasma, and cryoprecipitate including data on the supply of blood components to different departments, age distribution, gender distribution, and distribution of blood components based on blood groups. Results: A total of 1641 units of blood component were included in the study. A total of 92.9% (1524 units) were used and 7.13% (117 units) were wasted. The renal disorder was the most common cause of blood component utilization. The medicine department utilized the majority of the blood components. The expiry was the most common cause of wastage. Among the wasted blood components, platelet concentrate was the maximum. Conclusion: Blood components are a life-saving resource. It should be evaluated and analyzed properly for utilization in a justifiable manner. The hospital should act in accordance so that maximum blood components are utilized in a safe manner and waste is minimized to the least.

Cold storage of whole blood in an additive solution containing apoptotic and necrotic inhibitors.

Whole blood (WB) reigns superior to component therapy for the treatment of hemorrhagic shock on the battlefield. Though cold storage of WB offers a shelf life of 21 to 35 days, storage lesions and the potential for blood wastage remain. Storing WB in an additive solution (AS) containing apoptotic inhibitors may help preserve blood cell viability and improve blood quality over extended cold storage. Non-leukoreduced WB was obtained from healthy individuals and dosed with: AS, AS+Necrostatin-1 (AS+N1), AS+Boc-D-fmk (AS+B; apoptosis inhibitor), AS+Q-VD-OPh (AS+Q; apoptosis inhibitor), and Control (0.9% saline). Blood bags were kept refrigerated (1°-6°C) for 21 days. Bags were tested on days 0, 7, 14, and 21 for complete blood count, metabolism, clot formation, aggregation function, platelet activation, and red blood cell quality. Platelet count was better preserved in all AS-containing samples. All groups displayed increased glucose consumption and lactate production with storage. Furthermore, all groups displayed a similar decline in clot strength (max amplitude) over the 21-day storage period. Bags that received AS displayed greater preservation of GPIIb expression and lower phosphatidylserine exposure. P-selectin expression was increased in all AS groups. Treatment of hemorrhagic shock with WB transfusion is logistically simpler than component therapy. Results from our study suggest that refrigerated WB stored with an AS containing apoptotic and necrotic inhibitors helps better preserve platelet count but does not improve platelet function. The future development of WB ASs is warranted to optimize both platelet quality and hemostatic function.

Causes of blood product discard in the blood bank of tertiary health center over 5 years: A retrospective study

Abstract Background: Blood and its constituents are necessary for human survival, and no major surgical procedure can be completed without using blood. Wastage of blood and blood products should ideally never occur. This study aimed to examine the load of blood discarded in our blood bank, the causes of the discard, and to reduce blood discard to a minimum by using innovative procedures and approaches. Materials and Methods: A 5-year retrospective research was conducted at the Department of Blood Bank, D. Y. Patil Hospital and Research Centre, Navi Mumbai, from 2018 to 2022. Results: Throughout our research period of 5 years, the average number of blood units collected was 4655/year. With an average of 2.5 blood products made from every whole blood collected, there were, on average, 117167/year blood products made. There was an overall decreasing trend of blood products discarded from 11% in 2018 to around 5% in 2022. The main reasons for blood discard were expired blood products (average 4.9%/year), transfusion-transmitted diseases (TTDs) (average 2%/year), and less quantity (average 0.5%/year). Conclusion: Expiry/outdated units were determined to be our study’s most prevalent reason for disposal. Over the years, the discard percentage has been reduced by half to 5% in 2022. Better blood bag collection, storage, and usage management might eliminate this discard. The coronavirus disease pandemic has been a pivot point, in which the discard rate gradually decreased despite less blood collection. TTDs were another major cause of blood discard in our blood bank (2%). By arranging revision training courses and educating our blood bank workers, we can reduce TTD as a cause of blood wastage.

Blood Transfusion and Associated Factors in Pregnant Women Admitted to a Tertiary Care Hospital in Southeast Iran

Background: Effective blood transfusion is a life-saving practice in obstetrics and gynecology emergencies that can prevent blood product wastage in hospitals. Objectives: This study was performed to evaluate the appropriateness of the use of blood products in pregnant women in a tertiary care hospital in Zahedan, southeast Iran. Methods: This cross-sectional study was carried out from September 2019 to March 2020 to assess the patterns of blood utilization in a tertiary care hospital in Zahedan, Iran. Blood bank registries and the data of 1,500 pregnant women were used for data analysis, using blood transfusion indices, including cross-matched to transfusion (C/T) ratio, transfusion probability (T), and transfusion index (TI). Results: Out of 1,064 units of requested blood products, 581 (54.6%) were cross-matched, and 774 (72.7%) were transfused to patients. The blood transfusion indices of C/T, T%, and TI were 2.11, 48.48%, and 0.76, respectively. The transfusion rate was 6.2%, and the commonest associated obstetrics complication requiring transfusion was uterine atony (32.2%), followed by anemia (17.2%). There was a statistically significant relationship between the type of delivery, uterine and placental problems, coagulation disorders during pregnancy, number of deliveries, and residence place, and the probability of blood transfusion (P &lt; 0.05). Conclusions: The overall blood utilization indices were encouraging; however, the proportion of blood wastage was relatively high. Regular auditing is needed to optimize the use of blood and blood products in obstetrics and gynecology departments.

Blood Inventory Management During COVID-19 Pandemic Using a Simple Mathematical Tool: A Two-Year Study from a Tertiary Care Hospital in North India.

Multiple recurrent waves of the coronavirus disease 2019 (COVID-19) resulted in major fluctuations in blood supply and demand, which presented a major challenge for the blood centres to maintain adequate blood inventory. Hence, the primary aim of the present study was to determine whether safety stock as a simple mathematical tool can be used to maintain optimum blood inventory to meet all blood demands. The secondary aim of the study was to test whether daily blood stock index (DBSI), which was a novel index developed by the authors and derived from the calculated safety stock, can be used to minimize blood wastage due to the outdating of packed red blood cells (PRBC)/whole blood (WB) units. The present study was a descriptive, cross-sectional study conducted from 1st October 2019 to 31st December 2021 at a blood centre of a tertiary care hospital. For the purpose of data analysis, the time period of study was divided into 7 periods signifying different phases during the COVID-19 outbreak. Data of PRBC/WB (referred to as red cell) collection, red cell issue and the daily red cell stock were collected for these 7 time periods. Safety stock, percentage of out-dated whole blood/packed red blood cell units (OB) and DBSI were calculated based on the data extracted. Red cell collection as well as red cell utilization decreased during the 1st as well as the 2nd wave of the COVID-19 outbreak. The blood centre was able to meet the blood demand of the hospital at all times, as the daily average red cell stock remained above the calculated safety stock during all periods. OB (12.4%) and DBSI (2.3) were highest during the lockdown period of second wave of COVID-19 outbreak (period E). A strong direct relationship was seen between OB (dependent variable) and DBSI (predictor variable) [R = 0.79; p = 0.03]. Firstly, safety stock is a simple, user-friendly mathematic tool which can be used for efficient blood inventory management not only at times of a pandemic/disaster but also during routine times. Secondly, DBSI is a logical and empirical tool to reduce OB units and consequently reduce blood wastage.

How do I/we forecast tomorrow's transfusion? A focus on recipients' profiles.

Red blood cell (RBC) transfusion is a life-saving medical intervention and has an essential role in the management of surgical patients. However, blood donations and supply levels are decreasing, therefore there is an unmet need for the accurate prediction of the transfusion probability for surgical patients. Multiple methods have been established to predict the need for RBC transfusion. Maximum surgical blood order schedules are widely used in the clinical setting. However, these lists are not designed to accurately predict RBC utilization for an individual case as factors such as preoperative haemoglobin level, total body blood volume, comedications are not considered. Artificial intelligence and related technologies based on machine learning modelling are valuable alternatives to predict transfusion probability taking into account patient individual risk factors including among others comorbidities, laboratory parameters, use of oral anticoagulation, ASA score, surgeon's ID or applied blood saving measures. Overall, forecasting the need for a RBC transfusion can facilitate personalized medicine, quality assurance, decrease blood wastage, decrease costs, and increase patient safety. Furthermore, transfusion prediction models could facilitate blood management strategies before surgery.

Determination of rate, causes and cost of wastage of blood and its products in two blood donation centers in Riyadh

Background and aims: Wastage of all blood products is an important issue for health providers worldwide. Optimizing blood collection and processing would reduce the rate of wastage and improve the efficiency of the blood transfusion services. The aim of this study is to determine the rate of wastage of blood and blood components and identify its reasons at two hospitals in Riyadh. Method: A retrospective study was conducted on the data retrieved from the blood donation centers records on production and wastage of blood products during the period from November 2016 to October 2017 at two hospitals in Riyadh. The data were analyzed with MS Excel and SPSS 20. Results: A total of 3220 units of whole blood were collected in both hospitals during the study period. The most prepared blood component in both hospitals was packed red blood cells (PRBCs) 96.9%, followed by fresh frozen plasma (FFP) 58.66%, and platelets (PC) 52.67%. The wastage rates for safe blood components during the study period were 3.75% for PRBCs, 6.62% for FFP, and 75.8% for Platelets. The highest wastage rate of safe blood components was for Platelets (75.8%). The major reason for that high rate was delay in getting the results of transfusion transmitted infection (TTI) tests and some units were expired before released to the blood bank. The total cost for blood wastage was 262,828.3₤ (1,201,125.33 SAR. Conclusion: This study reported the highest wastage rate for all 3 blood components in comparison with other similar studies which urge the need to take an action to reduce these occurrences.

Determination of rate, causes and cost of wastage of blood and its products in two blood donation centers in Riyadh

Determination of rate, causes and cost of wastage of blood and its products in two blood donation centers in Riyadh

Smart Platform for Data Blood Bank Management: Forecasting Demand in Blood Supply Chain Using Machine Learning

Despite the efforts of the World Health Organization, blood transfusions and delivery are still the crucial challenges in blood supply chain management, especially when there is a high demand and not enough blood inventory. Consequently, reducing uncertainty in blood demand, waste, and shortages has become a primary goal. In this paper, we propose a smart platform-oriented approach that will create a robust blood demand and supply chain able to achieve the goals of reducing uncertainty in blood demand by forecasting blood collection/demand, and reducing blood wastage and shortage by balancing blood collection and distribution based on an effective blood inventory management. We use machine learning and time series forecasting models to develop an AI/ML decision support system. It is an effective tool with three main modules that directly and indirectly impact all phases of the blood supply chain: (i) the blood demand forecasting module is designed to forecast blood demand; (ii) blood donor classification helps predict daily unbooked donors thereby enhancing the ability to control the volume of blood collected based on the results of blood demand forecasting; and (iii) scheduling blood donation appointments according to the expected number and type of blood donations, thus improving the quantity of blood by reducing the number of canceled appointments, and indirectly improving the quality and quantity of blood supply by decreasing the number of unqualified donors, thereby reducing the amount of invalid blood after and before preparation. As a result of the system’s improvements, blood shortages and waste can be reduced. The proposed solution provides robust and accurate predictions and identifies important clinical predictors for blood demand forecasting. Compared with the past year’s historical data, our integrated proposed system increased collected blood volume by 11%, decreased inventory wastage by 20%, and had a low incidence of shortages.