Analysis on discard of blood and its products with suggested possible strategies to reduce its occurrence in a blood bank of tertiary care hospital in Western India

• Main Authors: Ashishkumar Nathabhai Kanani, Jitendra H Vachhani, Spruha K Dholakiya, Shweta B Upadhyay
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2017-01-01
• Series: Global Journal of Transfusion Medicine
• Subjects: Blood component; blood transfusion service; discard rate; education; training; whole blood
• Online Access: http://www.gjtmonline.com/article.asp?issn=2468-8398;year=2017;volume=2;issue=2;spage=130;epage=136;aulast=Kanani

Background: Blood is precious and should be utilized judiciously with minimal wasting. By analyzing the data and the reasons for discard, the blood transfusion service can develop plans to evaluate causes that lead to discard of blood and its components and interventions that can be used to optimize their use by training and education. Aim: (1) The aim of the study was to evaluate causes that lead to discard of blood and its components and interventions that can be used to optimize their use by training and education, (2) to introduce possible strategies for minimizing blood wastage, and to observe and compare the discard rate after the implementation of strategies. Materials and Methods: The study of analysis on discard of blood and its products was carried out retrospectively from January 2014 to December 2016 (36-month period), and the data were collected from the blood bank database system using Easy Software in the Department of Transfusion Medicine, Shri M P Shah Govt. Medical College, Jamnagar in Western India. The results were analyzed using Microsoft Excel 2007 database sheet, percentage calculated and Chi-square test was applied between different variables with P value set a significant when <0.05. Results: A total of 66,255 blood units were collected during the study period of 36 months. Out of 66,255 blood units collected, 44,617 were whole blood (WB) whereas components were prepared from remaining blood units. A total of 21,638 packed red blood cells (PRBCs), 6840 platelet concentrate (PC), and 14,372 fresh frozen plasma (FFP) were prepared. Average discard rate of the present study was 6.95%. Discard rate for WB, PRBC, PC, FFP was 3.15%, 2.26%, 28.39%, and 5.36%, respectively. Conclusion: To minimize wastage of blood, there should be proper implementation of blood transfusion policies and coordination between hospital and blood bank staff. Strict adherence to donor selection criteria, taking proper predonation history and counseling, software to identify transfusion transmitted infection (TTI) positive donors, and deferring suspected professional donors who have been screened previously may help in reducing discard due to TTI positivity. Process improvements such as technical expertise in phlebotomy, prevent red blood cells (RBC) contamination during platelet and FFP preparation, precaution during thawing of FFP to prevent leakage, and increased use of apheresis technique prevent wastage of blood components. Continued medical education for technical staff to maintain self-audit, tracking quality indicators of processing and preparation of the blood components, rational use of blood and components, and review the blood management system will further help in reducing the discard rate.