Quality Performance Question.

[mdk48]

I was asked to look into our expected values for quality performance for such things as QNS rate, double venipuncture rate, donor adverse reaction rate, apheresis patient adverse reaction rate, and repeatedly reactive transmissible disease tests. Currently we use the following expected rates, to evaluate quality performance:

QNS rate: 2%

Double venipuncture rate: 5%

Donor adverse reaction rate: 5%

Apheresis patient adverse reaction rate: 5%

Repeatedly reactive test results: unknown? (I guess I am just looking for an overall prevelance of RR test results in the blood donor pool to compare our rate to)

I am unaware of where these numbers first came from. What I am wondering is, does anyone know what resource lists expected quality performance numbers for the things listed above? And further, what numbers are used at your facilities as expected quality performance? If anyone has an answers please post or drop me a PM please. Thank you.

p.s. I guess I should add that our donors include both homologous and autologous donors.

[rcurrie]

I seem to remember a CAP Q Probe with such data collected and distributed.

Some blood centers have gone to a "no double stick" policy, with surprisingly good return rate results.

That 2% QNS rate is a pipe dream- be happy if your rate is less than 5%.

The adverse reaction rates seem high. If your rate approaches that rate, then you need to look at programs aimed at reducing the rate. One way to reduce the rate in blood donors is to have the donor drink some water within 30 minutes of donating. Another is to keep the donor's mind occupied. TVs do a good job of this, as do chatty phlebotomists. With your apheresis donors, if your rate is high it could be that you are adding too much citrate or at too fast a rate, or you are not replacing fluids fast enough. Citrate reactions appear to be enhanced when the fluid return rate is not high enough.

RR rates depend on the donor population. You will see rates rise as your first time donor rates rise, especially if you use mobiles and go into a new collection area. If you do not do your own testing, your testing lab should be able to give you some cohort statistics. Sometimes the rise in RRs is due to entering a new collection market with a high percentage of first time donors, but you may also see a rise whenever there is a new lot of testing reagents, indicating a QC problem with the reagents. I have seen this problem occur several times.

Anyway, those are the experiences of this locomotive engineer.

BC