[After Hours Therapeutic Phlebotomy]

We are a hospital based donor and apheresis service. We perform many outpatient phlebotomies during business hours. However, we do not bring our on-call apheresis RN in after hours to perform requested inpatient phlebotomy. We have had several requests lately. Can you share your practices for after hours therapeutic phlebotomy?

[Donor & B12 injection]

We would not defer either as long as it was a sterile injection.

[Annual Training cGMP]

Could someone tell me what this is and where I can find more information about it. I am involved with updating our blood bank compliance and proficiency policies and procedures and would like to utilize all available resources. Thanks for your help.

We use a computer based AABB cGMP module marketed by Knowledge Trak/ Mediware.http://www.mediware.com/solutions/blood-center-technologies/knowledgetrak

It helps us to maintain compliance on an annual basis.

[Whole Blood Collection Through Tattoo]

What is your SOP for sticking through tattoos for autologous whole blood collection? We have always avoided venipuncture directly through the tattoo for all donors and patients. However, we recently had a patient with a sleeve on one arm and a new tattoo- 2 weeks old- on the other arm over the antecubital fossa. Thanks!

[Malaria Risk]

The updated CDC map is a major change re: Mexico. We had many deferrals for travel to Riviera Maya which is no longer a risk area. It's difficult to tell from the map- but are the ruins (Tulum, etc.) still a malaria risk? Our employees are asked to probe for trips outside the resorts.

[Red Cell Loss for Double RBC Donors]

Apheresis RBC donors are deferred for 16 weeks but due to cumulative RBC loss, they cannot get a third collection in (with our calculations) within the 12 month period. Wouldn't it be a lot easier (for us) if AABB/FDA extended the deferral to 18 weeks?

[HCV Reentry]

Does anyway allow reentry of HCV NAT reactive, anti-HCV negative donors? My interpretation of July 2005 FDA draft guidance is that reentry is allowed after six months. Thanks!

[Benchmarks for Double Sticks or Hematomas]

We monitor double venipuncture rates monthly and use a threshold of of 5% which we rarely exceed. We collect both autos and allos and combine both for our QA. We do identify phlebotomist rates as well and will do retraining if necessary. We include hematomas in with our adverse reactions and do not break them out separately.

[Donor Antibody Screening]

John- Thanks for your input. I think our policy was developed based on this standard: "Serum or plasma from donors with a history of transfusion or pregnancy shall be tested for unexpected antibodies to red cell antigens".

[Donor Antibody Screening]

We are a hospital based Donor Center and perform antibody screens only on donors who have ever been pregnant or transfused. We are evaluating this policy and would like to get an idea of other Blood Centers' practices. Do you perform antibody screens on all donors?

[Billing for Apheresis Platelets for NAIT]

I'm looking for billing guidance for apheresis platelet collection from moms for intrauterine transfusion for NAIT. They must be discarded if not used- can we capture the cost of the apheresis collection?

Thanks!

[Productivity Benchmarking Data Needed]

We are a hospital based Donor center that collects allogeneic whole blood and apheresis, autologous whole blood, therapeutic phlebotomy and therapeutic apheresis including large volume stem cell collections. We also make components in our center. We have RNs and technicians and I am looking for any benchmarking data that is being used- most of the donor benchmarking data seems to be related to blood drives only (strictly allogeneic-donors per tech, etc.). Thanks!

[Donor Notification of Testing and Arm Prep]

We added a statement to our Educational Materials that donors must read:

What happens after your donation:

To protect patients, your blood is tested for hepatitis B and C, HIV, certain other viruses, and syphilis. If your blood tests positive it will not be given to a patient. You will be notified about test results that may disqualify you from donating in the future. There are some circumstances in which we cannot perform these tests (such as when we do not collect enough blood or the blood tubes are broken). Please do not donate to get tested for HIV, hepatitis, or any other infections!

I agree with BC that gauze should be used, but never pressed down upon.

[Chagas' Testing]

We're a small hospital donor center that has not starting testing yet. Most of our blood comes from a large supplier (which does test for Chagas'). Doesn't this create a "standard of care" even though it's not required? Any other centers holding out until it's mandated?

[Donor Deferral]

We have the same type of center- we do mostly autos and therapeutics but also allogeneic. We are required by regulatory agencies to enter deferrals for all the reasons you mentioned. It is rare for one of these patients to come back as a donor, but you have to have a system in place to prevent those that should be deferred. We were cited many years ago (FDA, I think) for not deferring auto donors in our computer system from being allogeneic.

[Component Processing of Leukoreduced Units]

We are a small hospital donor center that collects units (mostly auto). We prepare components from about 2,000 allo donors/year. We are going to begin pre-storage leukoreduction soon. I'm preparing a budget and asking for help to determine additional FTEs needed,etc. I have the info on the increased cost of bags, we will be sending QC to our testing facility. Can anyone share their experience? Thanks!

[HPV Vaccine Deferral]

How long should a donor be deferred after receiving HPV vaccine? Since it's recombinant, is deferral necessary? Thanks!

[questions about drawing platelet apheresis]

We always used RNs in the past, but now use pheresis techs under RN supervision. This frees RNs for therapeutics. I'd be glad to share SOPs if you e-mail me with your address.

[Cumulative RBC Loss]

Does anyone use an actual value for determining annual RBC loss? I've seen everything from 1300 ml to 1450 and 1451. We perform whole blood and apheresis plts only- no double red cells- is it sufficient to have policies in place to defer donors for 56 days after whole blood donation or apheresis donation in which RBCs can not be returned? Or is it necessary to calculate the number- if so, what is the number? Thanks for your input!

[Babesiosis and Autologous Donation]

Does anyone have specific criteria to accept or defer autologous donors with a history of Lyme/Babesiosis coinfection? We recently had an autologous donor who was afebrile, asymptomatic, on Ceftin for two years. I could not find any literature to support this either way. This patient is scheduled for a joint replacement.