An analysis of wastage of blood components in blood bank at tertiary care hospital

Abstract

Wastage of all blood components, including RBCs, platelets (PLT), and plasma, is an important issue for hospitals worldwide. Waste is not limited to blood products and is present throughout the health care system.1 Studies of systemic waste have examined the importance of workflows in the health care environment.2 and have focused on min im iz in g operational sources of waste when issuing a variety of medications. In many of these studies, relatively simple interventions resulted in marked reductions in wastage. The present study is designed to analyze the reason for the extent and wastage of whole blood and different blood components. By that we can minimize or prevent the wastage of blood and supply adequate amount of blood components to the patients whenever required for saving the lives. Aims and Objectives: The basic aim of this study is To understand the extent of wastage of different blood components. To identify various causes of wastage Materials and Methods: This is a retrospective and prospective study carried out in A D Gorwala Blood Bank, Shri Krishna Hospital, Karamsad after HREC approval, from 1st January 2015 to 31st December 2015. All the components, like whole blood unit (WBU), Red Cell Concentrate (RCC), Platelet Concentrate (PC),Fresh Frozen Plasma (FFP),Cryoprecipitate (CP), and Cryopoor plasma (CPP) except Single donor plate lete (SDP), wasted during this study period due to any reasons were included in the study. Statistical Analysis: It is an observational study so descriptive statistics is applied. Results: Age, gender, and blood group wastage of blood components were analysed and it was found that most common wastage was found in male donor between 18 to 30 years of a ge, in " B" Positive blood group. In this study also reason for wastage of different blood components and components wise wastage reason also analysed. Most common component wasted was platelet concentrate due to short shelf life and due to 1st run reactivity in TTI testing. Conclusion: The most component wasted was platelet concentrate due to its short expiry life followed by TTI (transfusion transmitted infection) reactivity after 1st run of ELISA. To avoid wastage of blood components continued training of staff, involved in counseling of donor, phlebotomy and TTI testing along with inventory control regarding the stock position and requirement of different blood group is necessary.  Regular audit of transfusion of blood component by transfusion committee helps in reduction of blood wastage and also promotes its rational use.

Harnessing the potential of data‐driven strategies to optimise transfusion practice

“…From the perspective of donors, there is a recurring expectation that donated blood will be used to full effect and not be wasted. 93 Patients are clear that unnecessary (inappropriate) transfusions should be avoided, and initiatives pursued to address variation in practice. Other relevant PPIE initiatives include reviewing research priorities identified through the activities of two James Lind Priority Setting Partnerships, 94,95 and the 'Choosing Wisely' for blood transfusion campaign.…”

“…PPIE views have driven a novel strand of transfusion research examining how differences in people's geographical location, ethnicity and socio‐economic standing may affect the care they receive. From the perspective of donors, there is a recurring expectation that donated blood will be used to full effect and not be wasted 93 . Patients are clear that unnecessary (inappropriate) transfusions should be avoided, and initiatives pursued to address variation in practice.…”

A Descriptive Cross-Sectional Study on Waste and Costs in the Use of Blood and Blood Products

“…en fazla israf edilen kan ürünlerinin trombosit süspansiyonu (%47,8), eritrosit süspansiyonu (%31) ve taze donmuş plazma (%20,3) olduğunu, Roy ve Pal en fazla israf edilen kan ürünlerinin trombosit süspansiyonu (%32,35), kriyopresipitat (%25) ve eritrosit süspansiyonu (%4,49) olduğunu tespit etmiştir. 23,27 Türkiye'de yapılan bir çalışmada, imha oranı en yüksek kan ürününün eritrosit süspansiyonu olduğu tespit edilmiştir. 7 Literatürde yaşanan bu farklılıkların, hastaların klinik durumu, hastanenin hizmet sunum kapasitesi ve ürünlerin kullanım sürelerinin farklılığına bağlı olabileceği düşünülmektedir.…”

“…%47,1 olarak saptamıştır. 7,8,23,29 Hindistan, İran ve Guyana'da yürütülen araştırmalarda da benzer şekilde en önemli israf nedeninin ürünün son kullanım tarihinin dolması olduğu bulunmuştur. 4,17,25 Stanger ve ark.…”

“…%11,2, Hardwick %26 olarak bulmuştur. 18,23,31 Kan torbalarının hatalı üretilmesi veya kan ürünlerinin toplanması sırasında yanlış kullanılması nedeniyle taşıma veya işleme sırasında kan torbalarının sızdırabileceği belirtilmiştir. 32,33 Mahapatra ve ark.…”