Quality Assurance in Blood Banking and Its Clinical Impact: Proceedings of the Seventh Annual Symposium on Blood Transfusion, Groningen 1982, organized by the Red Cross Blood Bank Groningen-Drenthe

245 Pages·1984·7.31 MB·English

by  J. Leikola (auth.)

QQUUAALLIITTYY AASSSSUURRAANNCCEE IINN BBLLOOOODD BBAANNKKIINNGG AANNDD IITTSS CCLLIINNIICCAALL
IIMMPPAACCTT
DEVELOPMENTS IN HEMATOLOGY AND IMMUNOLOGY
Already published in this series:
Lijnen, H.R., Collen, D. and Verstraete, M., eds: Synthetic Substrates in Clinical Blood
Coagulation Assays. 1980. ISBN 90-247-2409-0
Smit Sibinga, C.Th., Das, P.C. and Farfar, J.O., eds: Paediatrics and Blood Transfusion.
1982. ISBN 90-247-2619-0
Fabris, N., ed: Immunology and Ageing. 1982. ISBN 90-247-2640-9
Homstra, G.: Dietary Fats, Prostanoids and Arterial Thrombosis. 1982.
ISBN 90-247-2667-0
Smit Sibinga, C.Th., Das, P.C. and Loghem, van J.J., eds: Blood Transfusion and Prob
lems of Bleeding. 1982. ISBN 90-247-3058-9
Dormandy, J., ed: Red Cell Deformability and Filterability. 1983. ISBN 0-89838-578-4
Quality Assurance in Blood Banking
and Its Clinical Impact
Proceedings of the Seventh Annual Symposium on Blood Transfusion,
Groningen 1982, organized by the Red Cross Blood Bank Groningen-Drenthe
edited by
C Th Smit Sibinga, P C Das
Red Cross Blood Bank Groningen-Drenthe, The Netherlands
H F Taswell
Mayo Clinic Blood Bank, Rochester MN, USA
1984 MARTINUS NIJHOFF PUBLISHERS
a member of the KLUWER ACADEMIC PUBLISHERS GROUP
BOSTON / THE HAGUE / DORDRECHT / LANCASTER
Distributors
for the United States and Canada: Kluwer Boston, Inc., 190 Old Derby Street,
Hingham, MA 02043, USA
for all other countries: Kluwer Academic Publishers Group, Distribution Center,
P.O.Box 322, 3300 AH Dordrecht, The Netherlands
Library of Congress Cataloging in Publication Data
Symposium on Blood Transfusion (7th : 1982 :
Groningen, Netherlands)
Quality assurance in blood banking and its clinical
impact.
(Developments in hematology and immunology)
1. Blood-banks--Quality control--Congresses. 2. Blood
--Transfusion--Safety measures--Congresses. I. Smit
Sibinga, C. Th. II. Das, P. C. III. Taswell, Howard F.
IV. Stichting Rode Kruis Bloedbank GroningenjDrente.
V. Title. VI. Series.
RM172.S96 1982 362.1'784 83-23665
ISBN-13: 978-1-4612-9791-8 e-ISBN-13: 978-1-4613-2835-3
DOl: 10.1007/978-1-4613-2835-3
Copyright
---
© 1984 by Martinus Nijhoff Publishers, Boston.
Softcover reprint of the hardcover 1s t edition 1984
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form or by any means, mechanical,
photocopying, recording, or otherwise, without the prior written permission of
the publishers,
Martinus Nijhoff Publishers, 190 Old Derby Street, Hingham, MA 02043, USA.
m
TRAVENOL
Acknowledgement
This publication has been made possible through the support
of Travenol, which is gratefully acknowledged.
VII
CONTENTS
Invited speakers IX
Foreword XI
Opening address XV
1. Principles and organization of quality assurance
International organization of quality assurance
(J. Leikola) 3
A national framework of bloodtransfusion organization
(J . W. Dorpema) 7
Bloodtransfusion practice in hospitals: A topic for quality
assurance
(A.F. Gasparie) 13
Discussion 21
II. Systems and procedures
Principles and practices of quality control
(F. Bonanni) 29
Blood bank standards and procedure manuals
(P.J. Schmidt) 43
Administrative procedures and a machine-readable system
to assure quality control within a blood bank
(2. Smit, H. Smalbil, G.Th. Smit Sibinga) 55
Quality assurance of serological reagents
(W.L. Marsh) 69
Quality control of equipment
(R.E. Klein) 77
Quality control of blood components
(C.Th. Smit Sibinga) 83
VIII
Immunoglobulin production: Organization and quality control
of source material
(R.J. Crawford) 89
Bacterial surveyance in a blood bank
(P.C. Das, C.Th. Smit Sibinga, J. Dankert) 95
Discussion 103
III. Personnel
Job descriptions, competency testing and selection of
personnel
(H. v.d. Meulen) 115
Training programs for blood bank personnel
(B. A. Myhre) 121
Continuous education in blood banking and bloodtrans
fusion practice
(S.R. Hollan) 129
Discussion l37
IV. Clinical efficacy
Transfusion practice: Aspects of safety related to clinical
efficacy
(H. de Beus, C. Th. Smit Sibinga) 147
Transfusion reactions
(K. Sintnicolaas) 157
Transmittable diseases and bloodt ransfusion
(H. W. Reesink) 167
Platelet transfusion: Quality control
(Ch.A. Schiffer) 177
Clinical efficacy and safety of Factor VIII concentrate
(J-P. Allain) 187
The use of indium-labeled granulocytes to help assess
the clinical efficacy of granulocyte transfusions
(M. Clay, J.F. McCullough) 195
Discussion 213
V. Error Analysis
Error analysis: Types of errors in the blood bank
(H.F. Taswell, C.L. Sonnenberg) 227
Error analysis: Methods of detection, analysis and control
(C.L. Sonnenberg, H.F. Taswell) 239
Discussion 247
IX
INVITED SPEAKERS
J-P. Allain - Centre National de Transfusion Sanguine,
Paris, France
H. de Beus - Wilhelmina Hospital, Assen, The Nether
lands
F. Bonanni - Travenol International Services Inc. ,
Brussels, Belgium
A. F. Casparie - Weezenlanden Hospital, Zwolle, The Nether
lands
M. Clay - American Red Cross Blood Services, St.
Paul, MN, USA
R.J. Crawford - Glascow and West of Scotland Blood Trans
fusion Service, Glasgow, UK
P.C. Das - Red Cross Blood Bank Groningen-Drenthe,
(moderator) Groningen, The Netherlands
J.A. van der Does - Red Cross Blood Bank's Gravenhage,
(moderator) The Netherlands
J . W. Dorpema - State Control Laboratory, National Institute
(moderator) of Health, Bilthoven, The Netherlands
M.R. Halie - Dept. of International Medicine, University
( moderator) of Groningen, Groningen, The Netherlands
A . M. Holburn - Blood Group Reference Laboratory, Oxford,
(on behalf of WHO) UK
S.R. Holan - National Institute of Haematology and
Blood Transfusion, Budapest, Hungary
R.E. Klein - National Committee on I & A, AABB, Arling
(moderator) ton, VA, USA
J. Leikola - League of Red Cross Societies, Geneva,
Switzerland
W.L. Marsh - The New York Blood Center, New York,
NY, USA
x
H. van der Meulen - University of Groningen, Groningen, The
Netherlands
B.A. Myhre - University of California, Los Angeles, CA,
(moderator) USA
H . W. Reesink - Amsterdam Medical Centre, Amsterdam,
The Netherlands
Ch. A. Shiffer - University of Maryland Cancer Center,
(moderator) Baltimore, MD, USA
P.J. Schmidt - Southwest Florida Blood Bank, Tampa,
FL, USA
K. Sintnicolaas - Daniel den Hoed Clinic, Rotterdam, The
Netherlands
Z. Smit - Red Cross Blood Bank Groningen-Drenthe,
Groningen, The Netherlands
C.Th. Smit Sibinga - Red Cross Blood Bank Groningen-Drenthe,
(moderator) Groningen, The Netherlands
Ch.L. Sonnenberg - Mayo Clinic Blood Bank, Rochester, MN,
(moderator) USA
H. F. Taswell - Mayo Clinic Blood Bank, Rochester, MN,
(chairman) USA
XI
FOREWORD
THE PHILOSOPHY OF QUALITY ASSURANCE IN THE BLOOD BANK
H. F. Taswell
One year before this symposium, Cees Smit Sibinga and I began
to discuss an approach to quality assurance in the blood bank
which we felt would be both important and practical and could
serve as the basis for the choice of subjects to be presented in
the symposium. As an introduction to this book, I would like to
outline our approach, the subjects chosen and the rationale behind
our choice.
What is the fundamental purpose of a blood bank and trans
fusion service? Simply stated, the purpose of a blood bank and
transfusion service and of a quality assurance program in blood
banking is, for the one to provide and, the other to assure safe
and effective transfusion therapy. This objective is in contrast to
that of other clinical laboratories. The objective in a clinical
chemistry laboratory is to produce accurate test results which will
be meaningful to the clinician taking care of his patient. In most
clinical laboratories, therefore, the goals of a quality assurance
program are largely quantitative, that is, to assure accurate
numerical test results. In contrast, in the blood bank, the goals
of quality assurance are primarily qualitative, that is, to assure
safe and effective transfusion. As a result, two somewhat different
approaches to quality assurance are necessary.
How are we to assure quality in the blood bank? Safe and
effective transfusion can be achieved to a large degree by preven
tion of error. Blood bank procedures are repetitive and relatively
simple and straight forward. Since the morbidity and mortality
associated with transfusion arises primarily from errors, one of
the primary goals of quality assurance in the blood bank should
be the prevention of errors.
What is an error? An error can be defined for the purpose of
this introduction as an "inadvertent or unauthorized deviation
from standard procedure". If one accepts that errors are the
primary cause of transfusion morbidity and mortality and that an
error is a deviation from standard procedure, then the necessary
elements of a quality assurance program in the blood bank are
readily apparent. These same elements will provide both a means
of error control and an efficient management system.
What are the necessary elements? The first and most important
element needed for a quality assurance program is a standardized