TraQ Program of the BC PBCO

A resource library - indexed by topic - with articles, tips, downloadable resources, education and training in transfusion medicine. Because topics may overlap, scan the index for related topics.

NOTE: Original authors and institutions retain copyright and intellectual property rights to the contents of resources posted here, which may be used for educational purposes only. If a resources is used in whole or in part for any purpose, credit should be given to the original source.

Also see Links

Index

A Accreditation/Audits/Proficiency Testing Apps - see 'Mobile apps' Automation B Blood Components Blood Management, Alternatives & Conservation Blood Safety Standards Blood Scandals C Cell Salvage Checklists Communication Complications of Transfusion Conference Presentations Continuing Education / Continuing Professional Development D Developing Countries Document Control

E Economics Education, Training and Competency Emergency Planning G Guidelines H Hemovigilance I Immunohematology Information Systems Informed Consent Inventory Management (includes issuing blood) J Job Aids L Lookback/Traceback M Manuals Mistake-proofing and other ways to reduce errors Mobile apps

N Nursing O Occurrence Management P Pretransfusion Testing Process Flow Maps Q Quality Systems R Risk Management T Tips & Resources - Management Transportation of Blood U Utilization Management V Validation

Accreditation / Audits / Proficiency testing

Audits

• Canada: A bedside audit in Ontario (Wendy Owens, CSTM Education Day, 02/03/2013, Kelowna, BC)
• BeST (Australia):Audit tools to assess appropriateness of blood components
• UK: National Comparative Audit of Blood Transfusion 2006-2007 Report
• UK: Milkins C.Zooming in on laboratory errors (60 slide presentation: SHOT / UK proficiency testing program
• Hijji B, Parahoo K, Hossain MM, Barr O, Murray S. Nurses' practice of blood transfusion in the United Arab Emirates: an observational study. J Clin Nurs. 2010 Oct 19. [Epub ahead of print]

Accreditation of Canadian Transfusion Services

• Canadian accreditation resources (TraQ resource)

Automation

• Blood banks join the automation chorus (CAP Today, Oct. 2004)

Blood components

Canadian Blood Services

• Clinical Guide to Transfusion, Clarke G, Blajchman M, eds. Ottawa: Canadian Blood Services, 2006.
• Chamber K, Letendre P, Whitman L.Blood Components
• Buffy coat production method webpage

BC PBCO

• Blood bag spiking procedures. 6-min. video of spiking technique for new blood bags used in buffy coat production (B.C. Blood Coordinating Office)
• CBS buffy coat blood bag implementation. Final report (Aug. 2007)

ORBCoN

• Toolkit for introducing a new blood component (v1, Sept. 2011)

Efficacy of albumin in critically ill patients

• View (Br Med J 2003;326:559-6)

Blood management, alternatives & conservation

• The art and science of perioperative anemia management (presentation by Dr. Kate Chipperfield, Mar. 6, 2007)

Blood Conservation Strategies

• UK National Blood Conservation Strategy (Jan. 2004) (60-page report)

Intraoperative cell salvage

• See Cell salvage below

TraumaCare (Summer 2005): Issue devoted to provoking readers to critically explore their personal and institutional transfusion practices....

• Preface: Kaplan LJ. My Juju's Stronger Than Yours!
• Wagner LW, Elron Wallace E. Why should clinicians be concerned about

UK National Blood Service

• Learn Intra-Operative Cell Salvage (online course)

Links to web resources

• Transfusion alternatives

Royal College of Surgeons of England (2002)

• Code of practice for the surgical management of Jehovah's Witnesses

Jehovah's Witnesses

Transfusion Alternative Strategies - Simple Safe Effective

• A 30-minute video by Jehovah's Witnesses
• E-mail This e-mail address is being protected from spambots. You need JavaScript enabled to view it or phone Zenon Bodnaruk: 1-800-265-0327

Note: One of the aims of good clinical care is to avoid blood transfusion wherever possible. This video is targeted to health professionals and is listed here for information only.

Blood safety standards

Canadian Society for Transfusion Medicine

• CSTM Standards for Hospital Transfusion Services, v 3

EU Directive

• Overview and relevance to Canada

Final Report - Impact of Draft Standard CSA #Z902

• Courtesy ofNancy Heddle, Director, Transfusion Research Program, McMaster University, Hamilton: Survey of the Impact of Draft Standard #Z902 "Safety of Blood and Blood Components" on Transfusion Medicine Laboratories in Ontario Hospitals

Other

• Letendre P.; CSA Standards Z902-04:implications and issues. Blood Matters 2004 Jul;6(3):1-4.

Blood scandals

Canada

• Backgrounders (inc. Krever report)

USA

• :HIV and the blood supply: an analysis of crisis decision making (1995, Institute of Medicine)

Cell salvage

• Intraoperative cell salvage competency assessment workbook (NSH Blood and Transplant)
• Intraoperative Cell Salvage Action Group: Technical factSheets (UK Better Blood Transfusion Toolkit)
• Clinical guideline: Cell salvage blood (intra-operative), administration in a non theatre setting (UCL Institute of Child Health)
• Grainger H, Jones J, McGee D; UK Cell Salvage Action Group. Education, training and competency assessment for intraoperative cell salvage. J Perioper Pract. 2008 Dec;18(12):536?42.

Types of cell salvage

• Intraoperative cell salvage (noblood.org)
• Intraoperative blood salvage using ultrafiltration (the Hemobag) (video)

Checklists

BloodSafe (Govt. South Australia)

See Safety Resource Files for conditions of use

• Nursing admin checklist (Sept. 2008)
• Red cell transfusion audit checklist for patient's notes (Dec. 2008)
• Transfusion basics - prescribing guide (Dec. 2008)

UK (Royal Brompton & Harefield NHS)

• Pre-operative checklist for all patients who decline treatment using blood components

Communication

• Writing resources (Pat Letendre)
• Presentation tips (Pat Letendre)

Complications of transfusion

Clinical Guide to Transfusion, Clarke G, Blajchman M, eds. Ottawa: Canadian Blood Services, 2006.

• Callum J, Pinkerton P. Adverse reactions
• CBS - transfusiomedicine.ca

Complications reading list

• TraQ clearinghouse

Public Health Agency of Canada

• TTISS User's Manual (Updated Feb. 2008)

Other

• Transfusion Ontario TTISS/ TESS Transfusion Reaction Charts
• Heading home after a transfusion (Transfusion Ontario)

Conference Presentations

Australia

• Presentations - iTransfuse 'Transfusion Update 2010'

UK

• Presentations - 2011 SHOT meeting

Continuing Education/Continuing Professional Development

Resources maintained by TraQ

• CE clearinghouse (inc. quality systems education & training & transfusion medicine forums and mailing lists)

Pat Letendre website

• TM education resources

BBTS

• 2005 ASM: Education sessions (CPD scheme, Specialist Certificate, Higher Specialist training)

Developing countries

• Transfusion medicine in developing countries (TraQ literature clearinghouse)

Document control

Document Development and Control

• 47-slide presentation presented by Kate Gagliardi, Hamilton Health Sciences Centre, at the 2003 Canadian Society for Transfusion Medicine Annual Meeting View

Economics

Literature and news on the economics of blood transfusion

• TraQ clearinghouse

Education, training and competency

• TraQ case studies
  • including Severe hemolytic transfusion reaction involving a student
• TM Refresher for technologists in a core lab or wishing refresher on basics (Hamilton Regional Laboratory Medicine Program & Niagara Health System, Ontario, Canada)

British Medical Journal series: ABC of learning and teaching

• Learning and teaching in the clinical environment (Br Med J 2003 Mar 15;326:591-4)
• Educational environment (Br Med J 2003 Apr 12;326:810-2)
• Web based learning (Br Med J 2003 Apr 19;326:870-3)
• Creating teaching materials (Br Med J 2003 Apr 26;326:921-3)

Motivating trainees

• Tips on how to motivate trainees by Pat Letendre

Emergency Planning

National Advisory Committee on Blood and Blood Products (Canada)

• National Plan for the Management of Shortages of Labile Blood Components | Also see Provincial Simulation Reports

BC PBCO (Canada)

• BC Blood Contingency Plan and Toolkit (Oct. 30, 2009)
• BC Blood Contingency Plan (Updated 21 Dec. 2009: UM.CONT.0001 Ver 2.0)

California Blood Bank Society

• CBBS Today; 2012, Vol. XXX, No. 2 - 1^st of 3 Special Issues (free to all) to commemorate anniversary of disastrous earthquake & tsunami that struck Japan on March 11, 2011

Transfusion Ontario (Canada)

• Emergency blood management

Guidelines

• Canadian guidelines
• International guidelines

Hemovigilance

Error Surveillance - The Hospital Perspective - Ann Wilson (Presentation at CSTM Education Day, 02/03/2013, Kelowna, BC)

Hemovigilance around the globe

• TM Blog: Only in UK and Down Under? Pity! (Musings on hemovigilance)
• Canada: TTISS
• International Haemovigilance Networks
• NZ: Haemovigilance reports
• UK: SHOT
  • 2011 SHOT Report - Summary | Full Report | Key recommendations feature 'Back to Basics'
• USA Biovigilance website
• USA: MERS-TM
• USA: CDC releases forms for hemovigilance module of National Healthcare Safety Network (Jan. 2010)

Immunohematology

 

Presentations:  CSTM Education Day (02/03/2013, Kelowna, BC)

Interesting Serological Case Studies - Julia Hendry

How Often Should We Repeat Antibody Investigations - Dr. Gwen Clarke

 

Schonewille H.; Red blood cell alloimmunization after blood transfusion (Leiden University Press, 2008) 176 p. thesis - it's a gem

NCBI: Blood groups and red cell antigens (free online textbook)

Armstrong B. Special issue: Introduction to Blood Transfusion Technology. ISBT Science Series 2008 June;3(2).

• 300-page textbook from South Africa targetted to medical laboratory technologists. Every chapter is full free text. Choose PDF versions & then save.

Molecular typing of blood groups - Just found these informative free text articles:

• Reid ME. The Rh antigen D: a review for clinicians. Blood Bulletin 2008 Apr; 10(1).
• Reid ME. Transfusion in the age of molecular diagnostics. Hematology 2009.
• Seltsama A, Doescherb A. Sequence-based typing of human blood groups. Transfus Med Hemother. 2009; 36(3): 204?212. Published online 2009 May 14.
• Westhoff CM, Sloan SR. Molecular genotyping in transfusion medicine. Clin Chem 2008;54(12): 1948?50.

TraQ's case studies

• Level A (advanced)
• Level B (basic)
• Other (adapted from other sources)

Other

• Judd's Methods in Immunohematology, 3rd ed., with CD

Drugs causing immune hemolytic anemia and/or positive DATs

Drugs/compounds reported to cause hemolytic anemias and/or positive DATs (Posted March 2008, courtesy of Maureen Wyatt)

Based in part on a contribution by George Garratty, PhD, FRCPath View (September 2004)

• Also see Petz LD, Garratty G. Immune Hemolytic Anemias, 2nd ed. 2004

HDFN

• UK: Promoting awareness of RhD haemolytic disease of the newborn (HDN) - Advances in prevention and treatment (many resources)

Information systems

Blood Bank Information Systems (System Review Series, CAP Today, Oct. 2007) FDA: Draft Guidance for Industry: Blood Establishment Computer System Validation in the User's Facility

Implementation of the Mak Progesa label system in BC hospitals (2003)

Method to store daily reagent quality control in Meditech

• Contributed by Gail Sharpe, Laboratory Quality Coordinator, Hematology/Transfusion, Eastern Health, Health Sciences Centre, St. John's, NL

Using Meditech's taskbatches for equipment maintenance

• Contributed by Gail Sharpe, Laboratory Quality Coordinator, Hematology/Transfusion, Eastern Health, Health Sciences Centre, St. John's, NL

Informed consent

Informed consent for blood and blood products

• Literature
  • Friedman M, Arja W, Batra R, Daniel S, Hoehn D, Paniz AM, et al. Informed consent for blood transfusion: what do medicine residents tell? What do patients understand? Am J Clin Pathol. 2012 Oct;138(4):559-65.
    • Full free text
• Canada
  • Alberta Health Services: Consent to blood transfusion
  • BC Provincial Blood Coordinating Office: Informed consent & refusal of consent Transfusion Medicine Medical Policy Manual)
  • CBS: Informed consent
  • ORBCoN / Bloody Easy: Informed consent to transfusion card

Australia - Royal Children's Hospital

• Blood transfusion, consent & documentation (29/09/2006)

Australia / New Zealand

• ANZSBT survey of documentation of consent for transfusion (2 Sept. 2010)

Informed consent forms

• Australia - Govt. of Queensland:Blood & blood products transfusion consent (Rev. 06/2010, V3.0)
• Capital Health, Edmonton, Alberta: Informed consent, documentation of transfusion
• USA - Univ. Virginia health System: Blood transfusion consent or refusalal (Rev 10/09)

Inventory Management (inc. issuing blood)

CBS: Blood Inventory Management Best Practices Guide (2007)

• Pereira A.Blood inventory management in the type and screen era. Vox sang 2005;89(4):245-50.

A Receiving Hospital's Perspective on Redistribution of Red Cells in British Columbia, Canada

• Article by Sheila de Groot View

Blood Stocks Management Scheme (BSMS)

National scheme to manage blood stocks in the United Kingdom

• BSMS website
• Inventory Practice Survey 2006 Report: "Stock Control & Training"
  • Other inventory practice surveys

Issuing Blood

• Mock-Up of blood component issue-administration record (form) (Chinook Health Region, Alberta, Canada)

Job Aids

• ARC: Visual inspection reference guide (recommended by Kathleen Eckert)
• CBS: Visual assessment guide

Lookback / Traceback

1986-1990 Canadian Hepatitis C Class Action Settlements [posted Jan.9, 2003]

View

Recipient Notification Programs (compiled by TraQ)

View

Manuals

TraQ / PBCO Manuals

Overview of laboratory manuals (Please read first)

• Technical Resource Manual & Competency Companion
• Laboratory Quality Manual
• Technical Operations Manual

TM medical policy manual

Other Hospital Customer Service and Technical Manuals (small selection of what is available online)

Mistake-proofing and other ways to reduce errors

• Technology to enhance patient safety (TraQ clearinghouse)
  • Includes mistake-proofing devices such as barcodes, RFID, and barrier systems
• Prevention of transfusion errors at the order entry phase. Improvements after an aggregated root cause analysis (BC Interior Health presentation courtesy of Maureen Wyatt)
• Errors and accidents in blood administration: What can be done to reduce their occurrence? (US HHS Blood Safety Transcript, Jan. 26, 2000
• Also see Occurrence Management

Mobile applications

Canada

• BC PBCO & BC Technical Resource Group: 'Transfusion Bits and Bytes' (6 educational videos for med lab technologists) | Downloadable for iphone
• BC PBCO mobile web apps: BMI (Body Mass Index) Calculator and IVIG Dosing Calculator | Instructions:
  • Android
  • Blackberry
  • iPhone
  • For further info contact Quality and Utilization Management Program Coordinator via PBCO
• ORBCon IVIG Guidelines & Calculator 
  • Downloads: Blackberry | iPhone, iPod touch, iPad

UK

• NHSBT website for platelets indications(acts like an app): Platelet Transfusion Mobile Site | BBT App | BBTS news item

Nursing

• TraQ nursing resources

Occurrence management

Error management: Theory and application in transfusion medicine at a tertiary-care institution

• Arch Pathol Lab Med 2003;127(11):1517?22View paper

Root cause analysis in investigation of errors

• Presented by Margaret O'Donovan at SHOT 2003 meeting View (31 slides)

The Strange Case of Penny Allison Video highlighting the most common causes of error in blood transfusion

Available from UK National Blood Service

• Details and order form

Pretransfusion testing

Pretransfusion Reading List

• TraQ clearinghouse

Process flow maps

UK National Blood Service

Overview - Electronic Clinical Transfusion Management System

• Flow charts: Maps below are in same document
• Simple Blood Transfusion Process Map (Figure 2)
• Blood Transfusion Process Map for Special Requirements (Figure 3)
• Emergency Issue of Blood - Transfusion Process Map (Figure 4)
• Returned and unused Blood Process Map (Figure 5)

Quality Systems

UK Office of Government Commerce

• How to write a business case
• How to manage a project

Quality System - TraQ

• Education & training clearinghouse
• QS literature
• QS links

Risk management

Risk management literature

PubMed search results

Tips & resources - management

UK DOH: Workforce planning in pathology toolkit (31 Oct. 2008)

http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_089905
• Multiple documents, inc. spreadsheets - Aim is to log what the workforce currently does and help managers to model changes when
  • demand for tests varies
  • work is redesigned, or the competence required to do it is reassessed
  • improvements in productivity are achieved

Management - General

• Tips on how to deal with conflict by Pat Letendre
• Tips on how to make meetings more efficient (Pat Letendre)
• Networking - Overcoming your hesitation (Article for information professionals, but relevant to all)

Transportation of blood

BC PBCO

• Technical Operations Manual
• See TMP 0017 (Redistribution Shipment) & TMP 0019 (Transfer Product With Patient)

Utilization management

BC PBCO

King W-S, Roland K, Selin S, Kate M. Chipperfield KM, Morrison D. Introduction of guidelines for the use of albumin and the effect on albumin prescribing practices in British Columbia. BCMJ 2012 Jan, Feb; 54(1): 34-8.

Utilization management (inc. red cells, platelets, plasma, IVIG, coagulation products, albumin)

IVIG Utilization Management Program Guidelines (June 2009)

AABB

• 2005 nationwide blood collection & utilization survey

USA

• National Blood Collection and Utilization Surveys

Canadian Agency for Drugs and Technologies in Health

• Octaplas compared to fresh frozen plasma to reduce the risk of transmitting lipid-enveloped viruses: an economic analysis and budget impact analysis

IVIG utilization

PBCO IVIG utilization

Asia Pacific Immunoglobulins in Immunology Expert Group

Australian National Blood Authority

Criteria for the clinical use of IVIG in Australia (3 March 2008)

A systematic literature review and report on the efficacy of intravenous immunoglobulin therapy and its risks (September, 2004)

Canadian Agency for Drugs and Technologies in Health

Intravenous immunoglobulin for the treatment of chronic inflammatory demyelinating polyneuropathy (Mar. 2009)

Subcutaneous versus intravenous immunoglobulin for primary immunodeficiencies: systematic review and economic evaluation (Jan. 2008)

Capital Health, Edmonton, Alberta, Canada

IVIG Request Form (Feb 2004)

IVIG Administration Protocol (Client Resource A

Initial (or over 8 wks since last) IVIG Infusion (Client Resource B)

Less Than 8 wks Since Last IVIG Infusion(Client Resource C)

Transfusion of Blood Products - Commonly asked questions

UK

DOH: Clinical guidelines for immunoglobulin use, ed. 2 update (July 2011) | Summary poster

NHS: National demand management programme for immunoglobulin

rFVIIa (NiaStase^®/NovoSeven^®)

• Moltzan CJ, Anderson DA, Callum J, Fremes S, Hume H, Mazer CD, Poon MC, Rivard G, Rizoli S, Robinson S. The evidence for the use of recombinant factor VIIa in massive bleeding: development of a transfusion policy framework. Transfus Med. 2008 Apr;18(2):112?20.

Validation

TraQ case study

• Method validation in the transfusion service