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Blood bank audit 2016

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Blood Bank Audit 2016

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Blood bank audit 2016

  1. 1. Blood Bank Audit January 2016-December 2016 Dr S Arulselvi, Dr Sulekha Karjee, Dr Vedanand Arya Presenter : Dr Bankim Das (Senior Resident)
  2. 2. DONATION PATTERN TYPE OF DONOR GENDER TOTAL MALE FEMALE VOLUNTARY 1561 82 1643 REPLACEMENT 6183 75 6258 TOTAL 7744 157 7901
  3. 3. BLOOD DONATION PATTERN 21% 79% TYPE OF DONOR VOLUNTARY REPLACEMENT MALE 98% FEMALE 2% GENDER OF DONORS
  4. 4. WARD WISE MONTHLY REPLACEMENT DONATIONS MONTH ED TC1 TC2 TC3 TC4 TC5 TC6 TC7 OT Jan 13 8 95 184 83 35 126 78 Nil Feb 28 23 102 174 78 36 116 88 1 Mar 14 52 103 174 73 30 113 91 Nil Apr 30 21 120 180 65 30 93 56 Nil May Nil 20 119 246 80 42 80 48 Nil June 4 29 69 194 91 43 72 55 Nil July 7 31 135 176 64 42 104 93 7 Aug 11 42 142 228 102 41 92 77 4 Sept 5 28 84 148 76 36 96 52 8 Oct 8 36 92 140 102 64 76 98 8 Nov 21 36 116 150 100 44 136 72 12 Dec 25 32 105 147 70 28 101 79 19 Total 166 358 1282 2141 984 471 1205 887 59
  5. 5. WARD WISE YEARLY REPLACEMENT DONATIONS 166 358 1282 2141 984 471 1205 887 59 0 500 1000 1500 2000 2500 ED TC1 TC2 TC3 TC4 TC5 TC6 TC7 OT NO.OFBLOODUNITSDONATED
  6. 6. BLOOD DONATION LAST THREE YEARS 6544 6575 6258 2415 1696 1643 8959 8271 7901 0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000 2014 2015 2016 Replacement Voluntary Total
  7. 7. AUTOLOGOUS DONATIONS 0 5 10 15 20 AUTOLOGOUS DONATION 19
  8. 8. COMPONENT PREPARATION JANUARY2016-DECEMBER2016 7900 7346 6995 436 2016 PRBC FFP PRC Cryo
  9. 9. COMPONENT PREPARATION: 3 YEAR COMPARISON 8959 8239 79007502 7161 73466590 6893 6995 1147 916 436 24198 23209 22677 0 5000 10000 15000 20000 25000 30000 2014 2015 2016 PRBC FFP PRC Cryo TOTAL
  10. 10. TTI REACTIVITY FOR THE YEAR 2016 7868 7757 7844 7867 7887 19 130 43 20 0 7650 7700 7750 7800 7850 7900 HIV HBsAg HCV VDRL MP REACTIVE NONREACTIVE
  11. 11. TTI REACTIVITY IN PERCENTAGE 8% 64% 20% 8% 0% REACTIVITY PERCENTAGE HIV HBsAg HCV VDRL MP
  12. 12. TTI REACTIVITY IN PERCENTAGE: COMPARISON TO PREVIOUS YEAR 0.26 1.44 0.57 0.21 0.03 0.2 1.6 0.5 0.2 0 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 HIV HBsAg HCV VDRL MP 2015 2016
  13. 13. DONOR COUNSELING AND NOTIFICATION • Donor Counseling and notification for blood donors who tested positive for the TTI was started in June 2009. • Of 7901 blood donors, who had donated in JPNATC blood bank. • 212 blood donors were found to be reactive for various TTI markers. • Accordingly all 212 blood donors were notified & called for counseling. • Out of which 55 donors reported and were counseled for their respective infectious status.
  14. 14. • After a repeat test of these donors they were referred to the ICTC (Integrated Counselling and Testing Centre) for HIV  Gastroenterology for HBsAg and HCV Skin and VD for Syphilis.
  15. 15. DONOR NOTIFICATION AND RESPONSE PATTERN DONOR RESPONSE METHOD OF NOTIFICATION TOTAL BY PHONE BY LETTER Responders 48 07 55(26%) Non Responders 48 109 157(74%) TOTAL 96(45%) 116(55%) 212
  16. 16. DONOR NOTIFICATION AND RESPONSE PATTERN 0 20 40 60 80 100 120 By Phone By Letter 48 7 48 109 Non Responders Responders
  17. 17. TTI REFERAL & FOLLOW UP 0 5 10 15 20 25 30 35 HIV HBsAg HCV VDRL MP Lost Referal Cases 3 34 5 3 0 10 HIV HBsAg HCV VDRL MP Lost Referal Cases
  18. 18. TTI FOLOW UP EFFICIENCY 4.70% 74.00% 21.30% EFFICIENCY % = 21.3% LOST CASES NON RESPONDERS FOLLOWED CASES
  19. 19. MONTH NO OF SAMPLES RECEIVED NO OF UNITS CROSS- MATCHED No. of COMPONENTS ISSUED JAN 798 2209 1454 FEB 811 2273 1361 MAR 838 2615 1521 APRL 842 2435 1885 MAY 850 2515 1456 JUN 820 2411 1555 JUL 905 2751 1688 AUG 879 2783 1630 SEPT 928 2773 1708 OCT 979 2955 1832 NOV 1013 3082 1940 DEC 1039 3037 1849 TOTAL 10702 31839 19882 MONTH WISE SAMPLES RECEIVED, CROSS- MATCH DONE AND COMPONENTS ISSUED
  20. 20. SAMPLES RECEIVED : UNITS CROSS-MATCHED & COMPONENTS ISSUED 798 811 838 842 850 820 905 879 928 979 1013 1039 1454 1361 1521 1885 1456 1555 1688 1630 1708 1832 1940 1849 2209 2273 2615 2435 2515 2411 2751 2783 2773 2955 3082 3037 0 500 1000 1500 2000 2500 3000 3500 Jan Feb Mar Aprl May Jun Jul Aug Sept Oct Nov Dec NO. OF SAMPLES RECEIVED NO. OF COMPONENTS ISSUED NO. OF UNITS CROSSMATCHED
  21. 21. PRBCs, PLATELETS ,FFP AND CRYOPRECIPTATE ISSUED 335 611 671 661 675 593 708 709 693 727 741 706 382 431 438 568 396 497 504 411 404 568 497 481 475 314 378 628 381 441 420 480 548 458 635 618 12 5 34 28 4 24 56 30 63 79 67 44 0 500 1000 1500 2000 2500 Jan Feb Mar Aprl May Jun Jul Aug Sept Oct Nov Dec PRBCS PLATELETS FFP CRYOPRECIPITATE
  22. 22. CROSS-MATCH : TRANSFUSION RATIO • Ratio of the number of blood units that are cross-matched for patients to the number of blood units that are actually issued. • Ideal CROSS-MATCH TO TRANSFUSION RATIO is 1:1 • The C:T ratio was 2.9:1 in 2014, 3.7:1 in 2015 and 3.9:1 in 2016. • Any blood unit cross-matched for a patient is kept reserved for that particular patient for 24 hrs or till the time information is not given to the blood bank that the blood unit is no more required for the patient • A high C:T ratio indicates that more blood units are unnecessarily being blocked and lesser free blood units would be available for use
  23. 23. OVER ALL CT RATIO FOR THE LAST 3 YEARS 2.9 3.7 3.9 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 2014 2015 2016 CT ratioIdeal C T ratio
  24. 24. OVER ALL CT RATIO WARD WISE FOR THE YEAR 2016 ED TC1 TC2 TC3 TC4 TC5 TC6 TC7 OT C:T RATIO 4.9 4 2 2 5.6 3.7 3.7 4.9 5.2 4.9 4 2 2 5.6 3.7 3.7 4.9 5.2 0 1 2 3 4 5 6 C:TRATIO Ideal C T ratio
  25. 25. BLOOD COMPONENTS RECIEVED FROM AIIMS & CNC BLOOD BANKS FOR THE YEAR 2016 220 124 0 0 50 100 150 200 250 PRBC PRC FFP PRBC PRC FFP
  26. 26. BLOOD TURN AROUND TIME: QUALITY INDICATOR • Turnaround time (TAT) is a visible and common standard by which clinicians judge the quality of laboratory services. • Physicians are sensitive to the issuance of blood components during those moments of surgical urgency when performance expectations run high. • In order to reduce the time, the blood bank authorities have formulated a time frame for release of blood and blood product.
  27. 27. TURN AROUND TIME: SALINE CROSS-MATCH 752 228 26 2220 0 100 200 300 400 500 600 700 800 ISSUED TO ED ISSUED TO WARD & OT 15 min 15-20 min 20-60 min SALINE CROSS-MATCH
  28. 28. TURNAROUND TIME : AHG CROSS-MACTH 361 625 1937 2283 0 1716 ISSUED TO CASUALITY ISSUED TO WARD/ OT 45-60 min 1hr- 6hr >6 hrs
  29. 29. TURN AROUND TIME: SALINE CROSS-MATCH JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 15 min 48 50 85 52 41 51 80 87 79 57 80 42 15-20 min 4 2 0 0 2 2 0 6 2 2 2 4 20-60 min 4 0 2 0 2 0 0 0 6 6 0 0 0 10 20 30 40 50 60 70 80 90 100 NOOFUNITSISSUED SALINE CROSS-MATCH: MONTH WISE ISSUED TO CASUALITY
  30. 30. TURN AROUND TIME: AHG CROSS-MATCH JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 45-60 min 33 25 34 24 34 31 28 42 43 25 28 14 1 hr- 6hrs 166 149 193 157 175 152 172 183 133 156 160 141 0 50 100 150 200 250 NO.OFUNITSISSUED AHG CROSS-MATCH: MONTH WISE ISSUED TO CASUALITY
  31. 31. TURN AROUND TIME: SALINE CROSS-MATCH JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 15 min 16 10 21 27 18 12 25 13 22 32 13 19 15-20 min 0 0 0 8 4 0 0 2 2 2 0 4 0 5 10 15 20 25 30 35 NOOFUNITSISSUED SALINE CROSS-MATCH: MONTH WISE ISSUED TO WARDS/ OT
  32. 32. TURNAROUND TIME: AHG CROSS-MATCH JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 45-60 min 38 43 47 67 51 54 47 42 55 67 66 48 1hr-6hrs 123 186 183 178 183 165 188 203 218 190 220 246 >6hrs 163 120 113 159 143 123 144 138 135 167 136 175 0 50 100 150 200 250 300 Noofunitsissued AHG CROSS-MATCH: MONTH WISE ISSUED WARDS/ OT
  33. 33. CAUSES OF DELAY IN RELEASING OF BLOOD • Delay/ non receipt of requesting cross-matched component • Wrong sample, labeling errors, incorrectly filled requisition forms • Delay in obtaining consent for saline cross-match, alternate blood group • Forward-reverse blood group discrepancies in sample
  34. 34. CAUSES FOR DELAY IN SALINE CROSS-MATCH CAUSE ED WARD/OT TOTAL PATIENT BLOOD GROUP DISCREPANCY Nil Nil Nil PATIENT BLOOD GROUP NOT AVAILABLE Nil Nil Nil MULTIPLE SALINE CROSSMATCH DEMANDS RECEIVED TOGETHER 10 8 18 REQUISITION INTIALLY RECEIVED AS ROUTINE 28 16 44 SALINE CONSENT NOT GIVEN/NOT SIGNED 6 Nil 6 TC NO OR NAME OF PATIENT NOT TALLYING ON FORM & SAMPLE TUBE Nil Nil Nil HEMOLYSED SAMPLE Nil Nil Nil TOTAL 44 24 68
  35. 35. CAUSES FOR DELAY IN SALINE CROSS-MATCH 0 5 10 15 20 25 30 35 40 45 ED WARDS/OT 10 8 28 16 6 CONSENT NOT GIVEN/DOCUMENTED INTIALLY AS ROUTINE MULTIPLE REQUESTS
  36. 36. STATS FOR SAMPLING ERRORS MONTH DATE WARD ERROR FEB 16 14.2.16 TC 1 SAMPLES INTERCHANGED MAR 16 11.3.16 TC 4 WRONG SAMPLE SENT MAR 16 15.3.16 TC 4 WRONG SAMPLE SENT JUL 16 2.7.16 TC 4 WRONG SAMPLE SENT JUL 16 3.7.16 TC 3 WRONG SAMPLE SENT JUL 16 15.7.16 TC 6 WRONG SAMPLE SENT JUL 16 27.7.16 TC 6 WRONG SAMPLE SENT
  37. 37. RECENT DEVELOPMENT IN BLOOD BANK • Chemiluminescence for TTI Lab – Fully automated – Short incubation time – Quick result – Stat sample loading facility • Automated Immunohematology analyzer – Fully automated – 96 sample loading – Provision for antibody screening and antibody identification. – Stat sample loading facility
  38. 38. Thank you DONATE BLOOD SAVE LIFE

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