Potential Threats And Consequences In Healthcare

The risks associated with inappropriate handling of blood

When one is handling blood they run risks of exposure to blood borne viruses examples of which include the human immunodeficiency virus (HIV) and hepatitis B. (Stainsby & Lilleyman, 2005) Inappropriate handling of blood can also lead to medical errors resulting from wrong decisions. It can also result in to biological risks from genetic differences of blood transfused. (Williamson & Davine, 2013) It can also result in to an internal therapeutic risk as the patients organic equilibrium may be adversely affected by the medical intervention. (Grizzle & Polt, 1988)

Principles of appropriate use of blood and blood products

These include the assumption that all blood and blood products are infectious whether they have been screened or not. Another principle is to minimize or eliminate the likelihood of blood to blood exposure. This principle advocates for safety ware while handling blood so as to protect the personnel handling the blood from the risks they are exposed to in case of this contact. (Milkins et.al, 2013)

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Requirement of traceability between donor and patient

When blood specimens are involved it is often important to have information on the donor .This is because some of the developments on the patient, such as antibody antigen reactions may result from the presence of undetectable antibodies or particular genetic, grafts from the donor. Thus the origin of these developments easily established and dealt with appropriately (Milkins et.al, 2013)

Role of stock management in the efficient handling of blood

Blood is highly perishable and thus it is important to keep an inventory of the stock. The stock management inventory ensures there is sufficient supply to cover the demand. This implies that no lives are lost due to lack of blood. This also ensures that minimum blood is lost as a result of expiry as this is a waste of the precious commodity. (Keeling et.al, 2012)

Role of blood stocks management scheme

The blood stocks management scheme is a joint venture between the National Blood Service in England and North Wales together with hospitals which agreed to participate. Its formation was to monitor the supply chain of blood through developing an innovative data management system which is web based and hence enable collection of data and benchmarking. This has led to a better utilization of donated blood. (Chapman & Cook, 2002)

Method of identifying antibody specificities using BCSH guidance on inclusion

When an antibody is identified during the antibody screening procedure the specificity of the antibody should be determined using British Committee for standards in haemology. This involves the testing of the patient’s plasma against an identification panel which consists of reagent red cells. One must ensure that the panel results are not conflicting with the screen results as this may indicate the manual test has been done on the wrong sample. Blood samples containing red blood cells from the patient may be included as an auto control. This can help to identify an antibody directed against an antigen with high frequency. (Milkins et.al, 2013)

Relevance of red cell phenotyping in antibody identification

Red cell phenotyping refers to the use of red blood cells with homozygous expression of the relevant antigen. This enables exclusion of antibodies such as anti-jka and anti-jkb whose absence or presence is important clinically and whose specificities may have not been determined hence posing a risk of hemolytic transfusion reaction. This also enables the determination of the compatibility of the patient with the alloantibody. Identifies antigens lacking in patient to prevent formation of antibodies in the future and identifies donors whose phenotypes are not common. (Milkins et.al, 2013)

Quality control and external quality assurance procedures

Blood transfusion laboratories must have a quality management which must be operational. These quality management systems must meet the standards of good practice. Equipment, information and test systems used in transfusion laboratories must be validated against requirements that have been validated. Persons must be identified who are supposed to conduct critical steps of the process. The quality control system must offer a platform for audit of the laboratory steps. Security is needed for the critical control points of testing blood before transfusion. Internal audits should be carried out to check compliance with laboratory processes. The laboratory should also take part external quality assessment schemes. Some of the guidelines for the include compliance with ILAC G13:2000 and ISO 17043:2010: (Milkins et.al, 2013)

Demonstrate awareness of local policies and procedures and natural guidelines covering all of the above blood stock management and blood transfusion

There have been many efforts that have been put in place locally to ensure that there is an efficient management of blood stocks and to ensure efficient screening of blood before transfusion to patients. (Sebastian et.al, 2012) Standard operating procedures are instituted in the laboratories and personnel are well trained and are constantly reminded of the need for personal protection while handling blood samples. This is being achieved through constant staff training and seminars. (Stainsby et.al, 2008)

Learning reflection blood stockage and antibody identification

I believe stocking of blood is a very important step in the management of emergency situations such as accidents. It also helps to reduce the time taken by patients to receive treatment. This is because blood can be found at any time it is needful. The alternative would be to ask people to donate blood at the time of need. This kind of set-up may result into problems as the doctors may not have time to perform the necessary screening on the blood or may do it in such a hurry as to overlook important concerns thus resulting into patients developing complications. Having known cases of babies who have suffered from the haemolytic disease of the new borne I believe it is important to carry out antibody identification so that the specificities of all clinically important antibodies be determined to avoid risking the lives of patients who receive blood from donors through antibody- antigen reactions.

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References

  • Evans, M. R., Henderson, D. K., & Bennett, J. E. (1990). Potential for laboratory exposures to biohazardous agents found in blood. American journal of public health, 80(4), 423-427.
  • Grizzle, W. E., & Polt, S. S. (1988). Guidelines to avoid personnel contamination by infective agents in research laboratories that use human tissues. Journal of tissue culture methods, 11(4), 191-199.
  • British Committee for Standards in Haematology, Milkins, C., Berryman, J., Cantwell, C., Elliott, C., Haggas, R., ... & Win, N. (2013). Guidelines for pre‐transfusion compatibility procedures in blood transfusion laboratories. Transfusion Medicine, 23(1), 3-35.
  • Keeling, D., Mackie, I., Moore, G. W., Greer, I. A., Greaves, M., & British Committee for Standards in Haematology. (2012). Guidelines on the investigation and management of antiphospholipid syndrome. British journal of haematology, 157(1), 47-58.
  • Williamson, L. M., & Devine, D. V. (2013). Challenges in the management of the blood supply. the Lancet, 381(9880), 1866-1875.
  • Chapman, J. F., & Cook, R. (2002). The Blood Stocks Management Scheme, a partnership venture between the National Blood Service of England and North Wales and participating hospitals for maximizing blood supply chain management. Vox sanguinis, 83(3), 239-246.
  • Gerrard, R., & Cox, F. (2004). The National Blood Service Supporting Better Blood Transfusion. British Journal of Perioperative Nursing (United Kingdom), 14(5), 215-220.
  • Stainsby, D., Russell, J., Cohen, H., & Lilleyman, J. (2005). Reducing adverse events in blood transfusion. British journal of haematology, 131(1), 8-12.
  • Stainsby, D., Jones, H., Wells, A. W., Gibson, B., Cohen, H., & SHOT Steering Group. (2008). Adverse outcomes of blood transfusion in children: analysis of UK reports to the serious hazards of transfusion scheme 1996–2005. British journal of haematology, 141(1), 73-79.
  • Sebastian H.W. Stanger, Richard Wilding, Nicky Yates, Sue Cotton, (2012) "What drives perishable inventory management performance? Lessons learnt from the UK blood supply chain", Supply Chain Management: An International Journal, Vol. 17 Issue: 2, pp.107-123,

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