Blood Bank Audit 2016

1. Blood Bank Audit
January 2016-December 2016
Dr S Arulselvi, Dr Sulekha Karjee, Dr Vedanand Arya
Presenter : Dr Bankim Das (Senior Resident)

2. DONATION PATTERN
TYPE OF DONOR
GENDER
TOTAL
MALE FEMALE
VOLUNTARY 1561 82 1643
REPLACEMENT 6183 75 6258
TOTAL 7744 157 7901

3. BLOOD DONATION PATTERN
21%
79%
TYPE OF DONOR
VOLUNTARY REPLACEMENT
MALE
98%
FEMALE
2%
GENDER OF DONORS

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. 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. 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. AUTOLOGOUS DONATIONS
0
5
10
15
20
AUTOLOGOUS DONATION
19

9. COMPONENT PREPARATION
JANUARY2016-DECEMBER2016
7900
7346
6995
436
2016
PRBC FFP PRC Cryo

10. 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

12. 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

13. TTI REACTIVITY IN PERCENTAGE
8%
64%
20%
8% 0%
REACTIVITY PERCENTAGE
HIV
HBsAg
HCV
VDRL
MP

14. 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

15. 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.

16. • 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.

17. 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

18. DONOR NOTIFICATION AND RESPONSE
PATTERN
0
20
40
60
80
100
120
By Phone By Letter
48
7
48
109
Non Responders
Responders

19. 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

20. TTI FOLOW UP EFFICIENCY
4.70%
74.00%
21.30%
EFFICIENCY % = 21.3%
LOST CASES
NON RESPONDERS
FOLLOWED CASES

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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

28. 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

29. 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.

30. 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

31. 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

32. 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

33. 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

34. 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

35. 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

36. 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

37. 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

38. 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

39. 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

40. 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

41. Thank you
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