Guidelines and Principles for Safe Blood Transfusion Practice

1 SafeBloodandBloodProductsGuidelines andPrinciples forSafe BloodTransfusionPracticeIntroductory ModuleSafeBloodandBloodProductsGuideline s andPrinciples forSafe BloodTransfusionPracticeIntroductory ModuleConversion of electronic files for the website edition was supported by Cooperative Agreement Number PS001426 from the Centers for Disease Control and Prevention (CDC), Atlanta, United States of America. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC. World Health Organization, reprinted 2009 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: Requests for permission to reproduce or translate WHO publications whether for sale or for noncommercial distribution should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.))

2 Dotted lines on maps represent approximate border lines for which there may not yet be full mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its TO THE MODULE Learning in Blood Role of Your Role of Your Module.

3 Guidelines and Principles forSafe Blood Transfusion Your Role of Nursing Staff at Blood Donor Role of Technical Staff in Pathology Laboratories of Behaviour and Organizations223 SAFETY for Potential Safety Clothing and Donated Blood from Mobile DonorSessions to the Blood Safe Disposal of Laboratory Procedures344 QUALITY AND QUALITY Need for and Assurance and Quality Operating and for Quality515 SAFE STORAGE AND TRANSPORTATION OF Blood ANDBLOOD Blood Cold of Blood and Blood Blood Storage of Blood and Blood Components666 PREPARING BASIC Sulfate Solutions807 STOCK Check898 ACTION Your Your Action Your Action Plan94 Activity Checklists and Answers99 Answers to Self-Assessment Questions115 Appendix: Examples of Standard Operating Procedures121 AcknowledgementsThe World Health Organization would like to thank many Blood Transfusion medicine specialists for their part inthe development of these ReadersMs Mairi ThorntonMs Mairi ThorntonMs Mairi ThorntonMs Mairi ThorntonMs Mairi Thornton National Donor ProgrammeManager, Scottish National Blood TransfusionService, UKDr John BarbaraDr John BarbaraDr John BarbaraDr John BarbaraDr John Barbara Head of Microbiology,North London Blood Centre, UKMr Robin KnightMr Robin KnightMr Robin KnightMr Robin KnightMr Robin Knight Head of Immunohaematology,North London Blood Centre, UKRegional ReadersDr J.

4 K. AcquayeDr J. K. AcquayeDr J. K. AcquayeDr J. K. AcquayeDr J. K. Acquaye Director, National BloodTransfusion Service, GhanaDr G. DuraisamyDr G. DuraisamyDr G. DuraisamyDr G. DuraisamyDr G. Duraisamy Director, Blood TransfusionService, Kuala Lumpur, MalaysiaDr J. Chaivej NuchprayoonDr J. Chaivej NuchprayoonDr J. Chaivej NuchprayoonDr J. Chaivej NuchprayoonDr J. Chaivej Nuchprayoon Director, NationalBlood Centre, Thai Red Cross Society, Bangkok,ThailandDr Maria de los Angeles RodriguezDr Maria de los Angeles RodriguezDr Maria de los Angeles RodriguezDr Maria de los Angeles RodriguezDr Maria de los Angeles Rodriguez Head of theBlood Bank, Hospital Naval, Vi a del Mar, ChileProfessor A. S. SagoeProfessor A.

5 S. SagoeProfessor A. S. SagoeProfessor A. S. SagoeProfessor A. S. Sagoe Secretary to the StateGovernment, Consultant in Haematology andBlood Transfusion , Lagos State Government,NigeriaDr Elizabeth VinelliDr Elizabeth VinelliDr Elizabeth VinelliDr Elizabeth VinelliDr Elizabeth Vinelli Medical Director, NationalBlood Program, Honduran Red Cross, HondurasDr J. M. YousefDr J. M. YousefDr J. M. YousefDr J. M. YousefDr J. M. Yousef Director, National Blood Bank,Amman, JordanProject DirectorDr Jean C. EmmanuelDr Jean C. EmmanuelDr Jean C. EmmanuelDr Jean C. EmmanuelDr Jean C. Emmanuel Director, Blood Safety andClinical Technology, WHOP roject ManagerMs Jan FordhamMs Jan FordhamMs Jan FordhamMs Jan FordhamMs Jan Fordham Director, Open LearningAssociates, UKProduction ManagerMs Tess Gonet Ms Tess Gonet Ms Tess Gonet Ms Tess Gonet Ms Tess Gonet Production Manager, OpenLearning Associates, UKAuthorsIntroductory ModuleDr Alan KitchenDr Alan KitchenDr Alan KitchenDr Alan KitchenDr Alan Kitchen Head of Microbiology, North-East Thames Regional Blood Transfusion Centre,UKMs Pat CorcoranMs Pat CorcoranMs Pat CorcoranMs Pat CorcoranMs Pat Corcoran Short-term Consultant, WHOMr David A.

6 MvereMr David A. MvereMr David A. MvereMr David A. MvereMr David A. Mvere Chief Executive Officer,National Blood Transfusion Service, ZimbabweModule 1Mr David A. MvereMr David A. MvereMr David A. MvereMr David A. MvereMr David A. Mvere Chief Executive Officer,National Blood Transfusion Service, ZimbabweModule 2Dr Alan KitchenDr Alan KitchenDr Alan KitchenDr Alan KitchenDr Alan Kitchen Head of Microbiology, North-East Thames Regional Blood Transfusion Centre,UKModule 3Dr W. John LockyerDr W. John LockyerDr W. John LockyerDr W. John LockyerDr W. John Lockyer Short-term Consultant, WHOMr Robin KnightMr Robin KnightMr Robin KnightMr Robin KnightMr Robin Knight Head of Immunohaematology,North London Blood Centre, UKMs Pat CorcoranMs Pat CorcoranMs Pat CorcoranMs Pat CorcoranMs Pat Corcoran Short-term Consultant, WHOP articipants in WHO Informal Consultation to evaluate distancelearning materialMr David AmadeeMr David AmadeeMr David AmadeeMr David AmadeeMr David Amadee SeniorTechnologist, Blood TransfusionService, SeychellesMs Sonia AmayaMs Sonia AmayaMs Sonia AmayaMs Sonia AmayaMs Sonia Amaya Blood Bank,Hospital Naval, Vi a del Mar, ChileDr Kamel BoukefDr Kamel BoukefDr Kamel BoukefDr Kamel BoukefDr Kamel Boukef Director.

7 CentreNational de Transfusion Sanguine,TunisiaMr Shirley Randolph BoyceMr Shirley Randolph BoyceMr Shirley Randolph BoyceMr Shirley Randolph BoyceMr Shirley Randolph Boyce ActingSenior Laboratory Technologist,Queen Elizabeth Hospital,BarbadosMs Judith GoddardMs Judith GoddardMs Judith GoddardMs Judith GoddardMs Judith Goddard Uganda BloodTransfusion Service, NakaseroBlood Bank, Kampala, UgandaDr Nidal Mustafa IrshaidDr Nidal Mustafa IrshaidDr Nidal Mustafa IrshaidDr Nidal Mustafa IrshaidDr Nidal Mustafa Irshaid NationalBlood Bank, Amman, JordanDr Dorothy KyeyuneDr Dorothy KyeyuneDr Dorothy KyeyuneDr Dorothy KyeyuneDr Dorothy Kyeyune DeputyDirector, Nakasero Blood Bank,Kampala, UgandaDr Susan LeongDr Susan LeongDr Susan LeongDr Susan LeongDr Susan Leong Director, BloodTransfusion Service, Hong Kong RedCross Society, Hong KongDr Rachanee O CharoenDr Rachanee O CharoenDr Rachanee O CharoenDr Rachanee O CharoenDr Rachanee O Charoen AssistantDirector, National Blood Centre,Thai Red Cross Society, Bangkok,ThailandMr B.

8 T. SatamMr B. T. SatamMr B. T. SatamMr B. T. SatamMr B. T. Satam Scientist-in-Charge,National Plasma FractionationCentre, Hospital, Bombay,IndiaMs Jayaseeli WeeratungeMs Jayaseeli WeeratungeMs Jayaseeli WeeratungeMs Jayaseeli WeeratungeMs Jayaseeli Weeratunge MedicalLaboratory Technologist, NationalBlood Transfusion Service,Colombo, Sri LankaDr Ong Yong WanDr Ong Yong WanDr Ong Yong WanDr Ong Yong WanDr Ong Yong Wan Director,Singapore Blood TransfusionService, SingaporePrefaceThe human immunodeficiency virus (HIV) has focused attention worldwideon the need for safe Blood and Blood products. While the major route forthe spread of HIV is heterosexual transmission, Blood Transfusion is themost efficient mechanism. It is estimated that the transmission of HIVthrough Blood Transfusion is more than 90% efficient.

9 Preventing thespread of HIV through Blood and Blood products is, however, a goal thatcan be attained by every national Blood developing countries, Blood Transfusion services have traditionallybeen a low priority in health service development. The Blood TransfusionSafety Team in the World Health Organization recognizes the need totrain staff involved in Blood Transfusion systems at national level. It wouldbe impossible, however, to train and update all staff within the short andmedium term, using conventional approaches. Suitable training facilitiesare limited and there is a serious shortage of trainers. Many laboratorytechnical staff and others involved in the collection and processing ofblood work in small hospital Blood banks which are distant from trainingfacilities.

10 Participation in conventional short- or long-term coursesnecessitates technicians leaving their workplace, which is costly andplaces additional demands on other staff or requires the appointment ofreplacement learning materials, Safe Blood and Blood Products, are designedto provide an alternative means of rapidly improving the knowledge andtechnical skills of staff in Blood Transfusion services in developingcountries. They have been designed for use in distance learningprogrammes in Blood safety, although they can also be used forindependent study or as resource materials in conventional trainingcourses and in-service training programmes. They will enable bloodtransfusion services to update and upgrade staff in a practical and cost-effective way and to make effective use of limited training materials have been produced for staff with responsibility for donorrecruitment and retention, and for the collection, testing and issue ofblood for Transfusion .