1. Infectious Disease Updates
   1. Chagas’ Summary (antibodies to T. cruzi)
   • BloodCenter of WI – implemented June 2007; since testing began over 255,000 donations tested and no confirmed positives
     
   • All US blood centers – As of 10-31-08 (since testing began), 683 confirmed positives; mainly located in CA, TX, FL; few + donors in Chicago.
   2. WNV Summary
   • BloodCenter of WI – one positive donor in Sep 2007 and one positive donor in July 2008; both donors from Watertown
   • All US blood centers – mild season; as of 10/31/08, for 2008 264 presumed viremic donations (of these 169 confirmed positive); positive donors mainly located in southwest (CA) and south (LA and MS); 2 positive donors in WI YTD
     
2. ISBT (uniform labeling system; AABB standards required implementation by May 2008)
   1. BloodCenter of Wisconsin implemented early June 2008; no significant issues to date
   2. Some blood centers, ie. ARC, will not be implementing until 2009
      
3. Blood usage and blood utilization
   1. Depending on the hospital’s patient mix overall blood usage is same or slightly increased
   2. Blood utilization key focus for many transfusion services and hospitals these days. There are some consulting companies that can assist an organization to develop a blood management/utilization program eg. Strategic Blood Management, HemoConcepts
   3. Both BloodCenter of WI and ARC updated blood utilization guidelines for their customers in late 2007 (see attached)
   4. 2007 Autologous Usage Data – BloodCenter of WI (preliminary)
      • Overall 4205 units donated from 3019 patients; 2221 total units transfused
        • Overall usage of PAD = 53
      • Top 3 surgical procedures where PAD ordered:
        • Hip replacement, unilateral
        • Knee replacement, unilateral
        • Ant/Post-Post/Lateral fusion with instruments
      • Reports to individual hospitals by end of year; then biannually
        
4. US Biovigilance Network (USBVN) – coordinated effort betweenAABB and CDC National Healthcare Safety Network
   1. Goal: provide a central, coordinated system for identifying adverse events and near-miss incidents occurring at any point in the collection, processing, distribution, transfusion, or transplantation processes for blood, tissue or cellular products
   2. Hemovigilance module (recipient and transfusion service focused)
      • Pilot for collection of data on adverse transfusion reactions and incidents related to transfusion (eg. mislabeled sample, incorrect product issued, etc.) will begin 2009 at limited number of facilities
      • Baseline data on transfusion reactions for project collected and reported in the 2007 National Blood Collection and Utilization Report (supported by US Department of HHS) – for 2006 transfusion reaction rate was 0.32%, which was on the lower end of the range reported by European countries where they have well-established hemovigilance programs (0.3 – 0.7%).
      • Eventually to be rolled out to all hospital transfusion services – initially voluntary entry of data
        
5. Accreditation Updates
   1. JC
• National Patient Safety Goals for 2009; New addition to Goal Improve the accuracy of patient identification
  • NPSG.01.03.01 Eliminate transfusion errors related to patient misidentification
  • Elements of Performance: Before initiating a blood transfusion, the patient is objectively matched to the blood during a two-person bedside or chair-side verification process.
• Public comment on 19 Blood Management Performance Measures submitted late August 2008
  • Blood Management performance measures project was initiated to identify, develop, and test a set of standardized measures to help assess blood management in the hospital setting. Survey results being reviewed and likely not until 1st half of 2009 will selected measures be piloted.
  • Some examples of the draft PMs: Blood Transfusion Indications; Blood Administration Documentation; Time to Crossmatched Blood Administration; Time to Uncrossmatached Blood Administration; Pre-operative Blood Test; Preoperative Hemoglobin; Transfusion Complications; Red Blood Cell, Plasma, Platelet Administration; DRG Blood Utilization; Blood Product Wastage
• Accreditation having more emphasis on tissue processes and procedures in the hospital to ensure patient safety
2. CAP
   • No new checklist items for 2008 since awaiting CLIA approval for deemed status
3. AABB
   • 25th edition of BB/TS standards went into effect on May 1, 2008.
     • Under 5.18.4 Urgent Requirement for Blood and Components
       • NEW standard 5.18.4.5.1 The transfusion service medical director and the recipient’s physician shall be notified immediately of abnormal test results that may affect patient safety.
   • 2007 National Blood Collection and Utilization Report (US Department of HHS) recently published and is available for downloading on AABB website

For Blood Center of Wisconsin Guidelines: www.bloodcenter.com
For ARC Guidelines: www.redcross.org
Questions regarding the above report: kathy.puca@bcw.edu

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