For those facilities who perform plateletpheresis do you have an RN or MT do the aphresis? Does anyone have any SOPs that they can share on QC and collection procedures? My facility is looking into starting this and I am trying to get some information on the requirements. Thanks.

Kristine

For platelet collections we have pheresis techs (not MT's), MT's and sometimes RN's.

As for the SOPs, there are a lot of them, and most are being revised, I will try and post some later today.

We used to have only RNs do platelet apheresis. I finally convinced everyone that our phlebotomists, with good training and supervision, can also collect routine single donor platelets. Since we often have 3 or 4 donors going at a time, it has been quite helpful to the RNs to have a trained phlebotomist to help with the collections.

Bob Currie, MT

BTW, Kristine,

The U.S. Army has trained MLTs to do platelet apheresis in Iraq. They absolutely have to have a local supply of platelet donations in the field of operations. RBCs and plasma were just not doing the job for soldiers wounded by IEDs. The program is going quite well.

BC

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.

Thanks for the information Bob. I do know what the military is doing in Iraq as I am in the military but in Iraq there are a lot of things they do that will make a blood bankers hair curl so I don't want to take what they do as the standard as they don't have to worry about the inspection agencies that a regular hospital has to deal with.

Kristine

I know what you mean, Kristine, as I attend meetings at Ft. Hood's blood center all the time. We had a presentation at our last meeting on platelet apheresis performed at field hospitals in Iraq. All the donor testing is performed long after the platelets have been transfused. They do try to collect from soldiers who have donated previously and tested negative for viral markers, though. Even so, the field collection program using MLTs to perform the apheresis is quite successful.

BC

We use a combination of RNs, LPNs, and donor room technicians (DRTs)to collect apheresis platelets. We have been crosstraining the whole blood staff, since we've combined the apheresis and whole blood donor rooms, and as we've expanded collections to our branches and mobiles. The DRTs do a great job.

I always enjoyed the patient contact when doing TPEs. It was very rewarding to be doing something that directly helped the patient. Drawing venous or arterial blood samples just doesn't do as much for me. It is hard for my institution to attract RNs to do apheresis because of the difference in pay that direct care nurses have. The apheresis nurses give up $10,000 a year because they don't care for patients 75% of the time. So, we are crosstraining phlebotomists, and that is working out quite well.

BC

In the blood banks I have worked for in Illinois, it is not required that an apheresis technician be an R.N.. It is, however, required that the apheresis technician have access to an M.D. and have CPR training. Apheresis using non-medical personnel usually works best when there are explicit Operating Procedures. We didn't have many problems unless something went drastically wrong with the procedure or the donor.

The ASCP has a certification test that a person with a high school diploma (or equivalency) can take after one full year of donor apheresis experience under the guidance of a Medical Director. Additionally, ASCP has a certification maintenance program that requires people with certification to maintain proficiency in their area. It may be something you want to look into if you are concerned with the proficiency/knowledge of non-medical staff performing these procedures.

I feel that a medically trained individual should perform apheresis. It is a simple enough procedure if proper instruction and supervision is provided to a non-medical individual, but only a medically trained technician can recognize undiagnosed conditions that may arise during this or any large phlebotomy procedure. AABB, in the STANDARDS FOR PERIOPERATIVE AUTOLOGOUS BLOOD COLLECTION AND ADMINISTRATION 2nd Edition covers this in Section 2.