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RAFAT MOHEBBI FAR, FATEMEH SAMIEE RAD, ZAHRA ABDOLAZIMI, MOHAMAD MEHDI DANESHI KOHAN�QAZVIN UNIVERSITY OF MEDICAL SCIENCES, �DEPARTMENT OF HEALTH MANAGEMENT, �METABOLIC RESEARCH CENTER, DEPARTMENT OF PATHOLOGY, �MASTER OF HEALTH MANAGEMENT�DEPARTMENT OF LABORATORY, �PUBLISH 2014

Determination of Rate and Causes of Wastage of�Blood and Blood Products in

Iranian Hospitals

AHMAD ZA’IM BIN AZIZ

JURUTEKNOLOGI MAKMAL PERUBATAN U29

MAKMAL TRANSFUSI KLINIKAL,HTA

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SOCIAL BACKGROUND QAZWIN�*Located in 150 km northwest of Tehran, �*it is at an altitude of about 1,800 m (5,900 ft) above sea level. �*The climate is cold but dry, �*The majority of the people of the city of Qazvin are Persians�*Area City 64.132 km² �* Population: 402,748 (2016) �

WHERE QAZWIN, IRAN

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INTRODUCTION

Blood transfusion is an essential part in patient treatment.

Increase life expectency and advances in medical technology are several factors involved in the continuing need for blood and blood product.

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INTRODUCTION cont.

The only source of blood products are from human which has been steadily declining in term of the numbers of donor.

The reasons is in increase of donors’ age, stricter parameters for the acceptance of donors and many more.

Thus, realising this challenges, maintaining and utilizing this precious resources is very important on doing so.

All this is in the confinement of financial, material resources and realistic plan of action based on actual description and analysis of existing conditions in each country.

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OBJECTIVE

The purpose of this study is to determine the rate and wastage of blood and blood products(packed red cells, plasma, platelets, and cryoprecipitate)

Location: hospitals in qazvin, iran. 12 hospitals(5 teaching hospitals, 3 private hospitals, 2 social welfare hospitals, 1 charity hospital, and 1 military hospital)

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MATERIALS AND METHODS (1/3)

Cross-sectional, analytical-descriptive studybased on the statistical data available from hospitals’ bloodbanks.
Data about blood and blood component wastage for the year 2010
The research instrument was a 2-part questionnaire.
The first part was related to demographic characteristics of the hospitals and the second part elicited information about blood and blood component wastage;

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MATERIALS AND METHOD (2/3)

the data were taken from detailed forms of unused blood and blood components, categorized into 6 sections:

*type of blood product,

* blood groups,

*number of requested units,

*number of blood transfusion units,

* number of wasted blood units,

*reason for wastage.

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MATERIALS AND METHOD (3/3)

Thus, the evaluation was retrospective. In order to complete the questionnaire, data were gathered by contacting the blood banks of the hospitals under study, conducting interviews with the people in charge of those departments, and studying the patients’ documents.
The collected data were then analyzed using descriptive statistical methods and SPSS 11.5.

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TOTAL NUMBER OF BLOOD RECEIVED IN ALL HOSPITALS OF QAZVIN PROVINCE : 30913 UNIT.

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Blood	Unit
Used	27865
Discard	3048

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Hospitals	Teaching	Private	Social welfare	Charity	Military
Transfused	18 203	6 152	4 885	990	587
Discard	1 777	607	482	98	58

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FINDINGS

Blood and blood product wastage due to:

Expiration of the usability period
The patient’s lack of need for these products
Blood medically and surgically ordered but not used
Stock time expired (overweight blood bag – doe 14 days)
Hemolysis
Miscellaneous reasons

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CONCLUSION

Wastage at all hospitals averaged 9.8% among 30193 issued blood products.

The blood transfusion system has made significant advancement is areas such as

Storage of blood
Cross-matching
Rational use of blood
Distribution.

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CONCLUSION cont.

In order to improve the standards of blood bank and blood tranfusion service in iran, comprehensive standards have been formulated.

To ensure better quality control in collection, storage, testing, and distribution of blood and its components for the identified major factors affecting blood product wastage.

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DATA FROM CTD

Discarded Blood Bags : By reasons
Discarded Blood Bags : By Component Product
5 mains reasons of discarded : By Components

Expired
Unsuitable for reuse
Broken / Leaking
Expired – Irradiated
Contains foreign particles

*Data From Teknikal Meeting CTD September 2021

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Discarded Blood Bags : By reasons JAN –SEP 2021

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Discarded Blood Bags by Component Product:� Jan. – Sep. 2021

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5 mains reasons of discarded : �By components JAN – SEP 2021

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5 mains reasons of discarded : �By components JAN – SEPT 2021

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5 mains reasons of discarded : �By components JAN – SEPT 2021

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Price for Private Hospital

GXM 2 pint RM135

Blood Bag RM30/Bag

Reagent RM 75 for 2 pint packed cell (ABO grouping,Antibody Screening,Crossmatching)

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1)Case Study Crossmatch :Transfused Ratio (C:T)

If 1 pint blood bag can recrossmatching 6 time
So C:T Ratio is 6:1
5 time crossmatching is wastage( cost and man power)
If costing crossmatching equal RM 75(Reagent,Antisera,Gel Card)
Mean CTD wastage 5 x Rm75 = Rm375

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CTD BLOOD SUPPLY AND BLOOD RETURN JAN – OCT 2021

*PERCENTAGE BLOOD RETURN 34%

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Convert Total Blood Bag Return to �Ringgit Malaysia(RM)

If 19251 blood bag return
Costing gxm for 1 patient used 2 pint blood rm135
Exclude blood bag cost rm30/bag = rm75
Average 1 patient used 2 pint bag
If 19251 /2 bag = 9626 patient used
9626 patient x RM75 = RM721 952.00 wastage cost
Equal 3 Bitcoin

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2)Case Study Of Blood Bag Return Because �RN Not Tally

Example

A&E department using TEMPORARY RN
After patient allow to admit ward
Patient will registered at “Unit Pendaftaran Kemasukan Wad”
Patient will get new RN

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Reason blood return not used

BEFORE ADMIT WAD

AFTER ADMIT WAD

CHECKING LIST BEFORE TRANSFUSED BLOOD

NAME ✔
IC NUMBER ✔
RN NUMBER X

✔