Sustainable Blood Supply Research Articles

An ecosystem of interconnected technologies to increase efficiencies in blood establishments: The example of the Blood and Tissue Bank of Aragón, Spain.

Blood establishments face environmental, financial, demographic and societal challenges that may impair sustainable blood supply to patients. This study presents the technologies (devices and software) assembled in a global ecosystem implemented by the Blood and Tissue Bank of Aragón (BTBA), Spain, over the last decade to overcome these challenges. Descriptive yearly activity data (2013-2023) of BTBA were retrospectively collected to evaluate the impact of different technologies on blood processing efficiency, focusing on the production of blood components (red blood cell concentrates [RCCs], platelet concentrates [PCs]) and plasma. Operator satisfaction about the technologies introduced in daily routine work was also monitored. Between 2013 and 2023, the annual production decreased by 16.0% for RCCs and increased by 13.3% for PCs. From 2020, all PCs were treated with pathogen reduction technology, and no inventory stock-out was reported. The lowest PC expiry rate (0.2%) was observed after the implementation of the software for blood processing and PC stock management. The deployment of this software also improved plasma recovery: on average, an extra plasma volume of 9 mL was collected per donation in 2023 compared to 2015. A survey confirmed staff satisfaction. The progressive implementation of automated and software-based solutions was key to increasing efficiencies in BTBA. This enabled the optimization of blood processing by maximizing productivity, enhancing traceability, reducing overproduction and wastage and increasing the yield of recovered plasma, while ensuring blood product safety and staff satisfaction.

Dare To Donate Application (An E-Blood Bank System)

Dare To Donate application is a comprehensive online platform aimed at optimizing blood donation processes by prioritizing the referral of active blood donors and conducting thorough analyses of donor data. This system focuses on improving the efficiency of blood donation networks to ensure a consistent and sustainable blood supply for healthcare institutions. Its key feature involves a user-friendly interface allowing potential donors to register and create profiles, providing essential information on blood type, availability, and willingness to donate. Intelligent algorithms match donor profiles with real-time blood demand, facilitating targeted referral notifications. The system also integrates advanced analytics tools to comprehensively analyse donor data, including tracking donation histories, identifying supply and demand trends, and generating insights into active donor demographics. These analytical capabilities empower blood banks and healthcare authorities to make informed decisions, strategize donation campaigns, and optimize resource allocation for better emergency preparedness. In summary, the E-Blood Bank System serves as a platform for connecting active blood donors with those in need, offering critical insights through data analysis to enhance the efficiency and sustainability of blood donation networks, ultimately contributing to saving lives and improving healthcare outcomes. This collaborative approach enhances coordination during emergencies and enables a swift response to fluctuating blood demands, thereby saving valuable time and potentially lives. In conclusion, the E-Blood Bank System represents a paradigm shift in blood donation management, harnessing the power of technology and data analytics to revolutionize the way blood supply is managed. By fostering a culture of continuous improvement and innovation, it promises to address the evolving challenges faced by blood banks and contribute significantly to the advancement of healthcare delivery systems worldwide. Key Words: blood donation, demographics, active donors, analytics, sustainability, healthcare outcomes, evolving challenges, blood supply.

Blood Donation Pattern and Characteristics of Blood Donors in Saudi Arabia

Background: Blood donation rates in Saudi Arabia are relatively low compared to other countries. Understanding the patterns and characteristics of blood donors is crucial for improving donation rates and ensuring a sustainable blood supply. This Study utilizes data from the Wateen App to examine blood donation patterns in Saudi Arabia.Methods: A cross-sectional study was conducted using data from individuals who registered on the Wateen App. The Study analyzed demographic information, donation frequency, blood group distribution, regional variations, temporal trends, and user satisfaction with the App. Statistical analyses were performed to identify significant findings.Results: The Study found that the majority of registered donors were male, with a higher proportion in the 25-35 age group. Most donors had donated once, while a small percentage had multiple donations. O+ blood group donors constituted the most significant proportion, followed by A+ and B+. The Eastern province had the highest incidence of registered donors. Over the years, there has been a gradual increase in the number of donors. There was no significant correlation between donation numbers and different months, seasons, or Ramadan.Conclusion: This Study provides insights into blood donation patterns in Saudi Arabia. Efforts should be made to address gender disparities, engage a wider age range of donors, promote donations among individuals with less common blood types, and improve donation infrastructure in regions with lower donation rates. The Wateen App has shown positive outcomes in enhancing donor engagement. Further research and collaborative efforts are necessary to improve the blood donation system in Saudi Arabia.

E-Blood Bank System (Referral of Active Blood Donors and Analysis of Donors)

The E-Blood Bank System is a comprehensive online platform aimed at optimizing blood donation processes by prioritizing the referral of active blood donors and conducting thorough analyses of donor data. This system focuses on improving the efficiency of blood donation networks to ensure a consistent and sustainable blood supply for healthcare institutions. Its key feature involves a user-friendly interface allowing potential donors to register and create profiles, providing essential information on blood type, availability, and willingness to donate. Intelligent algorithms match donor profiles with real-time blood demand, facilitating targeted referral notifications. The system also integrates advanced analytics tools to comprehensively analyse donor data, including tracking donation histories, identifying supply and demand trends, and generating insights into active donor demographics. These analytical capabilities empower blood banks and healthcare authorities to make informed decisions, strategize donation campaigns, and optimize resource allocation for better emergency preparedness. In summary, the E-Blood Bank System serves as a platform for connecting active blood donors with those in need, offering critical insights through data analysis to enhance the efficiency and sustainability of blood donation networks, ultimately contributing to saving lives and improving healthcare outcomes. Key Words: blood donation, demographics, active donors, analytics, sustainability, healthcare outcomes.

A mixed-integer linear programming model for sustainable blood supply chain problems with shelf-life time and multiple blood types

The blood supply chain (BSC) is a complex system with optimization challenges, whose activities impact carbon emissions and the environment, especially with regard to the disposal of expired blood bag waste. This study proposes a new mixed-integer linear programming (MILP) model that considers multiple echelons, multiple blood types, transportation and production emissions, and blood bag shelf life to maximize profit in the blood supply chain system. The model is applied to a real-world case study. The research results confirmed that the model could mitigate the BSC challenges. We also conducted sensitivity analysis of patient demand parameters, blood production capacity, selling price, and shelf life to investigate the impact of the key factors affecting the total profit, costs, carbon emissions, and number of obsolete products.

Motivations for blood donation by HIV-positive individuals on antiretrovirals in South Africa: A qualitative study.

We performed a mixed-methods study to explore the motivations associated with blood donation by donors with known, but undisclosed HIV-positive status and ARV use (HIV+/ARV+), seeking potential strategies to reduce such donations and mitigate risk for blood recipients. Here, we report predominantly the qualitative component. A safe and sustainable blood supply is dependent in part, on effective pre-donation donor assessment. We previously described failure by HIV+/ARV+ blood donors to disclose their status. Such donations may lead to transfusion-transmitted HIV. The social ecological model provided the conceptual framework for this study. Previously identified HIV+/ARV+ donors were invited to complete a survey (including a validated stigma scale) and qualitative interview, which underwent inductive and deductive thematic analysis. We uncovered two primary motivational paths to HIV+/ARV+ blood donations: privacy and altruism. The latter included a motivation not previously reported in the literature: donating specifically for other people living with HIV (PLWH). The other primary factor was a lack of privacy. These accounts often included donors encountering donation opportunities when accompanied by people to whom they had not and did not plan to disclose their HIV status. Most were highly confident their donations would be identified as HIV-positive and discarded. We demonstrated a complex interaction between individual, social, cultural, and structural/policy factors in blood donations by PLWH who take ARV. Recommendations to limit HIV + ARV+ donations include: (1) Targeted communication strategies to increase knowledge among PLWH of their deferral from blood donation-without increasing stigma, and (2) development of procedures to assist those who feel unable to opt-out of donation due to privacy concerns.

Transparency on Platelet Transfusion in Routine Cancer Care: The Key for Optimal Blood Usage?

Introduction: In Germany, up to 75% of platelet concentrates (PCs) are administered to haematological and oncological patients. Only limited transparency exists on the characteristics of haematological/oncological patients receiving PC transfusions, treatment patterns, and guideline adherence in daily clinical routine care. This information would be key for managing platelet supply and optimal platelet usage strategies. This study aimed to analyse data from clinical routine transfusions to fill the aforementioned information gaps and to create an inventory as a blueprint for electronic data capturing systems that allow simplified, recurring analyses. Methods: Prospective open-label, single-centre, observational study in a German tertiary teaching haematological/oncological setting. All inpatients who received any transfusion of PCs (pathogen-inactivated or conventional) in routine use over a period of 3 months (March 2015–May 2015) were consecutively included. Except for age (≥18 years), no exclusion criteria were applied. For guideline adherence, the Cross-Sectional Guidelines for Therapy with Blood Components and Plasma Derivatives – amended edition 2020 were used. An inventory blueprint was created through a narrative literature review and the data collected in this study. Results: Ninety-four patients received 942 PCs. The mean (±SD) age was 54.6 (±13.9) years, 68% were male and 86% were diagnosed with a haematological disease. Thirteen patients received 42% of all transfused PCs. The mean ± SD number of transfused PC per patient was 10.81 ± 9.24. Five (0.5% per transfusion) minor adverse events were documented. Approximately 19% of PCs were not administered according to existing guidelines. The mean transfusion interval was 1.71 ± 1.1 days, and the mean increment was 12.62 ± 14.7 G/L. The inventory showed which platelet transfusion-specific data should be documented for answering questions in terms of quality, effectiveness, and management of PC transfusions. Conclusions: Platelet transfusions in a haematological/oncological setting are highly individual in terms of the total number of transfusions and transfusion intervals. The majority of all PC transfusions were given to only a small group of patients. Continuous, structured real-world data collection/evaluation and benchmarking with data from more centres seems essential in determining specific needs in this vulnerable patient group, assessing the quality of transfusion practices, determining effectiveness, and anticipating future demand for platelets and a sustainable blood supply. So far, not all relevant data are collected routinely. The advancing digitalization of health systems offers opportunities to collect and link data and thus make them more accessible and evaluable.

Towards an Optimized and Sustainable Blood Supply Chain Network under Uncertainty: A Literature Review

Blood Supply Chain (BSC) is a challenging subset of the healthcare industry. It treats the blood flow from donor to patient guaranteeing the patient’s needs. Considering the scarcity of blood products, the shortage and wastage are undesirable. As consequence, postponed surgeries, untreated patients, and even deaths should be avoided. Thus, designing and sustainably optimizing the BSC processes is vital. The paper develops a literature review focusing on translating sustainability into the BSC. It captures insights to develop a framework related to the design of a sustainable BSC under an uncertain environment. Studies from, essentially, the last 10 years are analyzed addressing the following aspects: (1) BSC phases characterization, (2) relevant models published according to the strategic-tactical and the operational-tactical perspectives, and (3) capturing the sustainability dimensions treated in previous studies — that rarely are explored together in literature. The authors filtered the initial sample of papers, achieving 90 studies that were reviewed and deeply explored. During the reviewing process, 3 papers concentrated on the strategic-tactical approach were selected as the most comprehensive on the topic — exploring each sustainable pillar. A similar approach was adopted for the operational-tactical perspective, resulting in the examination of 2 studies. The main contributions are: (1) a comprehensive literature revision connected with sustainability goals; (2) capturing insights to answer different questions — that until now have not yet been answered and (3) identifying challenges related to modeling aspects, risk, uncertainty, complexities, solution methods, and regulatory aspects. These contributions will be fruitful to develop directions to future research, adding sustainability insight directly to BSC.

Diagnostic and prognostic utility of brain collaterals in acute ischaemic stroke: Current knowledge and insights on treatment decision-making

Stroke is a leading cause of death and disability worldwide. The advent of acute reperfusion therapy, intravenous thrombolysis and endovascular thrombectomy, has revolutionized the field of stroke medicine, and neurology in general. Recent studies have implicated a major role of cerebral collaterals in the trajectory of acute ischemic stroke patients receiving reperfusion therapy. Collaterals sustain blood supply to the tissue in the setting of acute ischemia which prevents further expansion of the hypo perfused tissue, playing an important role in determining outcomes after acute ischemic stroke. The use of collateral assessment in routine practice in acute ischemic stroke, let alone in reperfusion therapy, is far from universal and limited. Future work in embedding collateral assessment in standards of care in acute stroke and management is warranted. This article provides a comprehensive update on the diagnostic and prognostic utility of collaterals in acute ischemic stroke and recommendations on collateral-based decision making in acute stroke and steps that can be taken for its rapid uptake in clinical practice.

Designing and Solving Location-Routing-Allocation Problems in a Sustainable Blood Supply Chain Network of Blood Transport in Uncertainty Conditions

Purpose: In this paper, a location-routing-allocation problem in a multi-objective blood supply chain network was designed to reduce the total cost of the supply chain network, the maximum unmet demand from distribution of goods, and decline greenhouse gas emissions due to the transport of goods among different levels of the network. The network levels considered for modeling include blood donation clusters, permanent and temporary blood transfusion centers, major laboratory centers and blood supply points. Other objectives included determining the optimal number and location of potential facilities, optimal allocation of the flow of goods between the selected facilities and determining the most suitable transport route to distribute the goods to customer areas in uncertainty conditions. Methodology: Given that the model was NP-hard, the NSGA II and MOPSO algorithms were used to solve the model with a priority-based solution. Findings: The results of the design of the experiments showed the high efficiency of the NSGA II algorithm in comparison with the MOPSO algorithm in finding efficient solutions. Originality/Value: This study addresses the issue of blood perishability from blood sampling to distribution to customer demand areas.

Donor orientation and service quality: Key factors in active blood donors' satisfaction and loyalty.

Faced with the increasing demand for blood and greater restrictions on ensuring the safety of transfusions, voluntary donation is currently the only and best alternative for the health system to have a sustainable and safe blood supply. In this context, one of the primary strategies of blood transfusion centres is to increase the satisfaction of their active donors so that they maintain their intention to donate in the future and, in turn, make the necessary recommendations so that third parties can become new donors. That is why this paper raises a question for research concerning, what should the premises be to guide the management of blood transfusion centres to maintain and even increase the satisfaction and loyalty of their active donors? In order to respond to this issue, a change in paradigm is proposed based on a management model supported by donor orientation and service quality as basic pillars, as well as on the development of a number of key social capital resources that explain this orientation toward the donor. In both approaches, the donor becomes the cornerstone of decision-making, moving away from the traditional model which is focused more on achieving targets related to the collection of blood bags. Through the empirical analysis of a sample of 126 employees from various transfusion centres and 26,833 active donors in nine Spanish autonomous communities, we have been able to validate this proposed management model as a useful tool to blood promotion agents in their decision-making processes.

Assessment of Knowledge, Attitude and Practice Regarding Blood Donation among Paramedical Personnel in a Teaching Hospital, Hassan, Karnataka

Background: Voluntary, non - remunerated blood donation is the foundation for safe and sustainable bloodsupply. Health care providers, especially non physician personnel or paramedical personnel, play an importantrole in motivating and promoting blood donation as they come more in contact with public as representativesof the health system and hence need to possess a comprehensive and accurate knowledge regarding blooddonation. Methodology: A Cross–sectional study was conducted to assess the knowledge of blood donationamong 285 paramedical personnel working in Hassan institute of medical sciences, Karnataka which isa tertiary care teaching hospital. A pretested Questionnaire regarding blood donation KAP (knowledge,attitude and practice) were administered to all the paramedical personnel who consented to take part in thestudy after adequate sample size estimation. Results: More than 90% of staff had good knowledge regardingthe blood groups and the eligibility criteria. 253 (88.8%) respondents considered blood donation as good and205(71.9%) believed it was safe to donate blood but in practice only 116(40.7%) had ever donated blood.Male workers were more likely to donate blood (p<0.0001) Conclusion : It was observed that although thereis a reasonably good level of knowledge and positive attitude among the paramedical personnel, the practiceof donating blood was not adequate, especially that of regular voluntary donation. Hence it is important toconduct sensitization programs to improve practice of blood donation and various incentives as suggestedby the staff themselves and several international bodies maybe considered to promote blood donation amongthem.

Designing a supply chain network for blood decomposition by utilizing social and environmental factor

Recently, supply chain network design has been a demanding question and attracted great interest in a wide range of fields, including the medical industry. The heart of the entire discipline of the medical industry is the concept of blood management which nowadays brought striking attention among managers and decision-makers. Thus, a bi-objective and sustainable blood supply chain network is introduced in this study by considering both social and environmental factors of blood decomposition. In addition, some aspects of uncertainty are firstly considered to the problem in terms of both the amount of gathered blood from blood transfusion centers and the decomposition ratio in the blood decomposition center. Considering bi-objective programming in the developed network, the problem simultaneously considers optimizing the CO2 emission, balancing the flow of all utilized vehicles, penalty coefficient of non-visited centers, total costs of using all vehicles, and more importantly the social and environmental factors of blood decomposition. Therefore, the total cost is minimized by the first objective function along with the environmental factor of greenhouse gas emission while maximizing the social factor of blood decomposition is done by the second objective function which gathers and produces the maximum amount of blood sub-products for patients using stochastic programming. Several sensitivity analyses are conducted for a better implication of the problem in various conditions. The findings of the study suggest that expecting more social factors convey more costs in most cases. Therefore, blood supply chain managers must adjust their aims and scope to achieve the best-desired results for society.

The development of a legal framework for blood donation and blood safety in China over 24\u2009years

BackgroundThis study analyzes the regulation of and developments in blood donation in China from 1996 to 2019, and demonstrates the government’s efforts to improve blood safety.ResultsSince the implementation of the Blood Donation Law in 1998, the number of blood donors in China increased by 275% from 1998 to 2018 (from 4 million to 15 million). The principle of no-fault liability was proposed and has been applied since 2010 to the tort liability related to blood transfusion malpractice. In 2015, mutual blood donation accounted for 4.2% of the national collection. However, in some provinces of China, the percentage of mutual blood donation increased from 9.3 to 35.6% in 2016. The National Health Commission canceled mutual blood donation in March of 2018. Since 2015, nucleic acid amplification testing has become a routine test item for screening blood.ConclusionsThe Chinese government institutionalized the voluntary non-remunerated donation principle, enacted regulations for the management of blood transfusion, and adopted advanced blood testing technology to sustain blood supply and ensure blood safety. Despite increased blood donation, blood shortages persist. The quality and safety of blood collection can be further improved through the cancellation of mutual blood donation and incentive measures for voluntary non-remunerated donation of blood, which needs facilitation by governmental legislation.

Maintaining adequate donations and a sustainable blood supply: Lessons learned.

BackgroundThe availability of a safe blood supply is a key component of transfusion medicine. A decade of decreased blood use, decreased payment for products, and a dwindling donor base have placed the sustainability of the US blood supply at risk.Study Design and MethodsA literature review was performed for blood center (BC) and hospital disaster management, chronically transfusion‐dependent diseases, and appropriate use of group O‐negative red blood cells (RBCs), and the Choosing Wisely campaign. The aim was to identify current practice and to make recommendations for BC and hospital actions.ResultsWhile BCs are better prepared to handle disasters than after the 9/11 attacks, messaging to the public remains difficult, as donors often do not realize that blood transfused during a disaster was likely collected before the event. BCs and transfusion services should participate in drafting disaster response plans. Hospitals should maintain inventories adequate for patients in the event supply is disrupted. Providing specialty products for transfusion‐dependent patients can strain collections, lead to increased use of group O RBCs, and create logistical inventory challenges for hospitals. The AABB Choosing Wisely initiative addresses overuse of blood components to optimally use this precious resource. Group O‐negative RBCs should be transfused only to patients who truly need them.ConclusionsCollecting and maintaining a blood supply robust enough to handle disasters and transfusion‐dependent patients in need of specialty products is challenging. Collaboration of all parties should help to optimize resources, ensure appropriate collections, improve patient care, and ultimately result in a robust, sustainable blood supply.

A robust optimization model of the field hospitals in the sustainable blood supply chain in crisis logistics

Crisis management is one of the significant challenges when a disaster occurs. Post disaster operations mainly focus on medical treatments. One of the general requirements of medical treatments of field hospitals in disaster is blood transfusion. This way, configuring a blood transfusion network to handle the appropriate assignments and distribution is proved to influence the type, number and severity of recent crises. Therefore, obtaining effective solutions, containing determining the optimal location of facilities of field hospitals, identifying the optimal capacity of facilities and transportation, blood transfusion routes to reduce costs and injustices in this area in times of crisis is essential. Hence, in this study, we proposed a model, intend for allocating blood types and regarding the lifetime of blood to tackle with field hospitals in the disaster sites. Furthermore, the coverage of the demand for blood types for the establishment of field hospitals and the balanced distribution of blood between these hospitals from the blood collection level to the establishment of field hospitals with optimal routing of blood transfusion at the lowest cost is considered. The proposed model for the crisis response management phase is modelled applying a multi-objective mathematical model under uncertain conditions. To cope with the uncertain data arisen in the disaster condition, the robust optimization approach is applied. Then, to solve the proposed model, a hybrid method based on Genetic Algorithm and Multi-Choice Goal Programming (GAMCGP) under uncertainty is developed. In addition, the proposed model is successfully applied to a real- world blood supply chain in Mazandaran, northern part of Iran, and the results validate the performance of the proposed model. It also proves that the suggested model can be considered as a new approach for blood supply chain tactical management in the crisis logistics.

Proceedings of the AABB blood center executive summit.

AABB hosted the Blood Center Executive Summit on 20 October 2019 during the AABB Annual Meeting in San Antonio, Texas. The session was sponsored by the Commonwealth Transfusion Foundation, a nonprofit, private foundation whose mission is to inspire and champion research and education that optimizes clinical outcomes in transfusion medicine and ensures a safe and sustainable blood supply for the United States. The Summit focused on the intersection of blood centers and plasma centers. Presenters and attendees explored existing and needed data, regulatory requirements, risks and benefits of different donor models, and future direction of the plasma community and blood centers. The Summit also identified priority issues that warrant further investigation and provide opportunities to drive progress. Introductory remarks provided context for the Summit presentations. Debra BenAvram, FASAE, CAE, Chief Executive Officer, AABB (Bethesda, Maryland), noted that during the past year, she and other AABB staff have had many discussions with blood center executives on key issues and challenges. In these talks, many executives requested that AABB provide programming specifically for this member segment. The Summit is a direct result of those requests, and the AABB supports a fruitful discussion as well as important and actionable next steps. Kevin Belanger, DHS, MS, MT(ASCP)SBB, President and Chief Executive Officer of the Shepeard Community Blood Center (Evans, Georgia), observed that he and his colleagues have seen a decrease in the donor base and, at the same time, an increase in plasma centers. He also noted that the resulting discussions about competition and donor compensation have been muted. The Summit provides a forum for a broad, open discussion that can be the start of something important. As chair of the Summit planning committee, he thanked both panelists and audience members for participating. Bob Carden, Chief Executive Officer of the Commonwealth Transfusion Foundation (Richmond, Virginia), who moderated the Summit, joined BenAvram and Belanger in welcoming participants to the day's presentations. He emphasized the need for data and noted that one outcome of the day would be a list of potential research projects that could be pursued and considered for funding.

Coronavirus Threatens Blood Supply: Patient Blood Management Now!

The outbreak of the SARS-CoV-2 pandemic has led to shortage of blood supply in health-care systems around the world. During the SARS epidemic in 2002–2003 severely affected cities experienced a dramatic decrease by 90% in blood donations, which fortunately could be compensated by importing blood units from less affected regions.1 According to the national blood transfusion services, the numbers of blood donations have already dropped dramatically in the current pandemic.2 To sustain blood supply, multiple countermeasures must be pursued. Hospitals around the world have to postpone elective surgery to preserve resources and to decrease the demand for blood units. However, there are still (emergency) patients who require allogeneic blood transfusions, for example, in trauma, obstetrics, and so on. Transfusion services desperately ask for donations and highlight, that there is no evidence for blood-related transmission of SARS-CoV-2 so far. However, shortfalls are already in existence and the overall numbers of blood donations are likely to remain at a very low level. Attempts to reduce the demand on allogeneic blood units are imperative in the present situation. Therefore, the authors encourage health care workers around the world to implement patient blood management (PBM) as soon as possible. PBM is an evidence-based multimodal approach to improve patient outcome. It is based on 3 main pillars: diagnosis and treatment of anemia, minimizing (iatrogenic) blood loss, rationale (restrictive) use of blood units. In detail, PBM comprises over 100 measures and recommendations3,4 whose implementation requires a stepwise and locally adjusted process. Nevertheless, the most important components may be adopted without much effort and can be implemented even in a busy clinical environment: - Preoperative intravenous iron substitution (anemia approx. 40% due to iron deficiency) - Intraoperative tranexamic acid (eg, 1 g for 10 minutes before incision in high risk surgery or if bleeding is apparent) - Maintaining physiological conditions: normothermia, pH > 7.2, calcium >1.1 mmol/L - Cell salvage and re-transfusion of processed blood - Single-unit policy (reassessment after each blood unit) - Rational numbers of diagnostic blood samples - If close hemoglobin measurements are needed, noninvasive hemoglobin measurement - Correct coagulation anomalies as early as possible (via conventional laboratory tests or point of care testing) Adherence to at least some of these measures will significantly reduce the demand for blood units. A meta-analysis revealed that the implementation of PBM leads to an overall decrease in transfusion demand by 39% (55% in orthopedic surgery; 50% heart surgery) and results in reduced morbidity, namely acute renal failure and thrombotic events, which reduce by about 25%, respectively. Additionally, reduced mortality rates by 11%, shorter hospitalization, and even cost savings can be achieved.5 In these times, it is of utmost importance to acknowledge these findings. After all, PBM makes a virtue of necessity and must be considered imperative in view of the current crisis.

Obstetric anaemia in Africa in the time of COVID‐19: a call to action

As we face the COVID‐19 pandemic, shortages of blood and components are a global concern. Yet Africa has struggled to maintain a sustainable safe blood supply prior to the pandemic. The impact of COVID‐19 on an already fragile blood supply could result in devastating consequences for obstetric patients, adding to the burden of maternal mortality on the African continent. Application of the principles of patient blood management in the obstetric population has previously been recommended. In the light of the COVID‐19 pandemic, these cost‐effective and safe principles should be applied with urgency in Africa in an attempt to reduce maternal mortality in the wake of the pandemic.

The effect of the video and brochure via donor recruitment on fear, anxiety and intention: Randomized controlled trial

Although voluntary blood donation is important in terms of sustainable blood supply, voluntary blood donation rates in the world and in our country are behind the desired target. University students are an important group in achieving the goal.The study was planned among 551 university students between 19–21 March 2018.It was planned as a single-blind randomized controlled study in order to evaluate the factors affecting students' blood donation decision and the effect of brochure and video information on fear, anxiety and intention. The data obtained by using Blood Donation Questionnaire and State Anxiety Scale and p ≤ 0.05 was accepted as significant.As a result of the study, 37.9 % of the students reported that they did not give blood due to health reasons, 26 % insecurity and 24.1 % fear. The increase in after the intervention knowledge level was mostly in the group of videos and improved brochures (p < 0.001).There was no difference between the groups in terms of the State Anxiety Scale mean scores p> 0.05). In after the intervention, those who intend to give blood have higher knowledge and their fear and anxiety scores less than those not intend to give blood (p < 0.05). There was no difference between the groups in terms of intention to give blood after the intervention (p> 0.05).As a result, it was found that the information given through the developed brochures and videos increased the level of knowledge, had no effect on the anxiety level and it can be said that the improved brochure has positive effects on intent and fear.