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"Blood transfusion is a life-saving intervention that has an essential role in patient management within health care systems. All Member States of the World Health Organization (WHO) endorsed World Health Assembly resolutions WHA28.72 (1) in 1975 and WHA58.13 (2) in 2005. These commit them to the provision of adequate supplies of safe blood and blood products that are accessible to all patients who require transfusion either to save their lives or promote their continuing or improving health." --Preface.
"External quality assessment (EQA) is an important component of quality systems for blood transfusion services. EQA is the external assessment of a laboratory's overall performance in testing exercise material of known, but undisclosed, content and comparison with the performance of other laboratories that have tested the same material. In laboratories that screen donated blood for transfusion-transmitted infections (TTI), participation in EQA helps to monitor and raise standards of performance. Information generated by EQA provides an opportunity for continual quality improvement through the identification of laboratory errors and the implementation of measures to prevent their recurrence. Thus EQA plays a vital role in making blood safer. The World Health Organization (WHO) plays an advocacy role in promoting the establishment of national EQA programmes and encourages participation by TTI screening laboratories in these programmes. National health authorities are urged to recognize the importance of EQA and support the implementation of these programmes throughout a country's TTI screening network. Professional bodies are encouraged to endorse and support the establishment of EQA programmes. Establishing external quality assessment programmes for screening of donated blood for transfusion-transmissible infections: implementation guide aims to support WHO Member States in establishing and operating EQA programmes for screening donated blood for TTI. The guide has been designed for use by national health authorities and EQA organizing institutions in the development of EQA programmes that can be implemented at national, state, provincial and district levels. It will also give participating laboratories an insight into the organization of EQA programmes for TTI screening and an understanding of the benefits of participation."--Page 1.
A comprehensive guide to each component of a quality assurance program for blood transfusion services, whether established in a small hospital blood bank or a large transfusion centre. Measures described are intended to ensure the maximum safety of all procedures for donors, recipients, and the staff themselves. Arguing that a system of quality assurance should be implemented in all transfusion services and blood banks, the book emphasizes the vital importance of strict quality control procedures at each stage of each procedure. The first chapter explains the importance of meticulous records and documents. Chapter two outlines nine elements that must be included in all standard operating procedures and sets out requirements for their implementation. Subsequent chapters describe measures for quality assurance in donor selection and blood collection. A chapter focused on the responsibilities of laboratories sets out, in tabular form, specific requirements for the quality control of ABO grouping, Rh(D) blood group reagents, HBsAg testing, anti-HIV testing and syphilis testing. The remaining chapters cover the testing and quality assurance of blood components and describe the roles of transfusion committees and audits.
The establishment of systems to ensure that all donated blood is screened for transfusion-transmissible infections is a core component of every national blood program. Globally, however, there are significant variations in the extent to which donated blood is screened, the screening strategies adopted and the overall quality and effectiveness of the blood screening process. As a result, in many countries the recipients of blood and blood products remain at unacceptable risk of acquiring life-threatening infections that could easily be prevented. These recommendations are designed to support countries in establishing effective national programs to ensure 100% quality-assured screening of donated blood for transfusion-transmissible infections. In countries where systems are not yet fully in place, the recommendations will be helpful in instituting a step-wise process to implement them.
The WHO guidelines on assessing donor suitability for blood donation have been developed to assist blood transfusion services in countries that are establishing or strengthening national systems for the selection of blood donors. They are designed for use by policy makers in national blood programmes in ministries of health, national advisory bodies such as national blood commissions or councils, and blood transfusion services.
Individuals who donate their blood provide a unique and precious gift in an act of human solidarity. In order to donate blood, prospective donors should be in good health and free from any infections that can be transmitted through transfusion. Most blood donors perceive themselves to be healthy, but some are unsuitable to donate blood due to the potential risk of compromising or worsening their own health or the risk of transmission of infections to patients. Blood transfusion services (BTS) have a duty of care towards blood donors as well as to the recipients of transfusion. This duty of care extends to prospective donors who are deferred from donation--whether on a temporary or permanent basis--as well as those who donate blood and are subsequently found to have unusual or abnormal test results. BTS have a responsibility to confirm test results and provide information, counseling and support to enable these individuals to understand and respond to unexpected information about their health or risk status. Counseling is part of the spectrum of care that a BTS should be able to provide to blood donors--including referral to medical practitioners or specialist clinical services. Pre-donation counseling was recognized as one element of the strategy to reduce and, if possible, prevent the donation of blood by individuals who might be at risk for HIV and other TTI including hepatitis B and C viruses as well as to inform the donor of the donation process and testing of blood for HIV. Post-donation counseling was acknowledged to be a necessary element of donor management as an adjunct to informing donors of unusual or abnormal test results. Blood donor counseling by trained specialist staff is now considered to be a key component of the blood system in most countries with a well-developed blood transfusion service. It may be required at a number of stages in the blood donation process or following blood screening and should be available at any point at which the BTS has an interface with donors. In many countries, however, blood donor counseling is not yet available in a structured way. Blood Donor Counselling: Implementation Guidelines has therefore been developed to provide guidance to blood transfusion services that have not yet established donor counseling programs.