This is the extended post discussing the issues in the Quality and the Risk Management in the field of Blood Transfusion

1. QUALITY MANAGEMENTOF BLOOD BANK DR. N. C. DAS

3. Adequate collection of safe blood.

4. Preparation of blood components

5. Laboratory Quality Testing

6. Safe and appropriate use of blood and blood components

7. Good record keeping and documentation, worksheet

8. Use of standard operating procedures

9. Implementation of safety guidelines

10. Skilled, capable manpower DR.N.C.DAS

11. COMPONENTS OF QUALITY MANAGEMENT QUALITY PREPARATION (Effective Component Preparation) QUALITY IN PROCUREMENT (Donor, Material, Reagent) QUALITY MANAGEMENT QUALITY IN SUPPLY (Storage, Transportation, Service) QUALITY IN DESIGN & DEVELOPMENT (Improved Techniques & Procedures) Quality does not happen by chance. Quality needs to be systematically developed.

12. QUALITY MANAGEMENT SYSTEM QUALITY PLANNING QUALITY CONTROL SYSTEM QUALITY IMPROVEMENT QUALITY ASSURANCE DR.N.C.DAS

13. QUALITY PLANNING POLICY STATEMENT ON QUALITY BLOOD SAFETY PLANNING RECORDS AND DOCUMENTATION QUALITY MANUAL WORK INSTRUCTION OR WORK SHEET SOP DR.N.C.DAS

14. QUALITY CONTROL

15. QUALITY ASSURANCE Quality assurance provides information regarding levels of performance that can be used in setting priorities for process improvement.

16. QUALITY IMPROVEMENT PRODUCT IMPROVEMENT PEOPLES IMPROVEMENT Quality Blood Bags Sterile procedure for collection Storage Environment Proper maintenance of records Component separation Use of latest technique for separation Motivation & leadership In service training & skill developments. 3. Awards & recognition 4. Seminar & work shops 5. Empowerment of people QUALITY IMPROVEMENT PROCESS IMPROVEMENT Improve technique of collection Donor Comfort Donor Refreshment Highly skilled manpower to handle Internal & External Quality Control

17. QUALITY ASSESMENT TOOLS VALIDATION CALIBRATIONAND STANDARDISATION To measure what suppose to measure in the sample QAT AUDIT DRUG CONTROLLER ERRORMANAGEMENT QUALITY ASSESMENT SCHEMES INTERNAL QAS EXTERNAL QAS

19. Senior/supervisory staff must take note of reports and follow the procedure for formal notification and investigation

20. Formal logging of errors, results of investigation, action taken to be recorded.

22. POLICY STATEMENT LEGAL REQUIREMENT & LICENSING GUIDELINES OF FUNCTIONING (Manpower, equipments, Procedures) TYPE OF RECORDS POLICY STATEMENT TRAINING & SUPERVISION MATERIAL MANAGEMENT & MAINTENANCE SPECIFICATION OF ALL BLOOD PRODUCTS METHOD OF SUPERVISION & AUDITING

23. QUALITY MANAGEMENT INDICATORS IN BLOOD BANK BLOOD BANK QUALITY CONTROL QUALITY ASSURANCE Equipment Maintenance Regular Calibration Use of quality Reagent Materials Standardization Blood grouping & cross matching Screening of donor Preparation of SOP Blood Safety Proper labeling Maintenance of log book QUALITY IMPROVEMENT DR.N.C.DAS

24. TRANSFUSION REACTION

25. TRANSFUSION REACTION SEVERE REACTION MOSTLY OCCURS WITHIN FIRST 15 MINUTES OF TRANSFUSION. TRANSFUSIONREACTION RISK Risk of Transfusion Transmitted Infections Risk of immune related problems Risk of Transfusion related complications

26. TRASFUSION TRANSMITTED

27. TRANSFUSION RELATED

29. ABO incompatibility still remains the major cause of transfusion associated mortality.

32. Keep IV line open

33. Notify the physician and blood bank

34. Give IV anti histamines

35. If reaction is severe give IV steroid

36. Keep monitoring the vitals of the patient every 15 mts.

38. Blood sample in EDTA

39. Blood sample in Plain Vial

40. First Urine sample after the transfusion reaction