People can survive weeks without food and days without water. However, blood loss can be fatal in just five minutes. That’s why first responders, trauma centers and others charged with saving lives need 24/7 on-demand access to clean blood and blood banks must be able to supply units for the eight main blood groups as well as the rare blood types.
Yet, blood and plasma demands chronically outpace donations, and acute donor shortages are threatening longer-term health crises. There is expected to be a 75,000-person shortfall among regular donors in Britain this year alone, and while 37% of people in the U.S. are eligible to donate blood, only 10% come forth annually to donate.
I wish this was a temporary issue we could resolve with worldwide blood drives on World Blood Donor Day. However, you and I both know there is no quick fix to dwindling and unstable supply levels. It’s why you clicked to read this post, isn’t it? You wanted to find out what you can do to stop waste and help ensure every accepted blood product remains available for its full life cycle.
So, let’s consider the most common reasons why donated blood may be disposed of before it can be distributed to a patient in need:
- disqualified sample
- improper handling
- improper storage
- improper records and rotation
Each of these can be avoided if the proper processes and technologies are in place to ensure careful donor screening and close oversight of blood products as they move from the collection point to the lab, then onto the blood bank and eventually the point of transfusion.
Blood Preservation Starts at the Time of Donation
For years, I have talked with phlebotomists, clinicians and healthcare administrators about how important it is to properly label a blood vial at the point of care – the physical location where the blood draw occurs. If the label contains the wrong information, a label is placed on the wrong vial, or a label is missing completely, that blood will be rejected by the lab. Part of the donation testing and acceptance process is correlating the blood with the right patient history.
Therefore, every person collecting blood donations should have the following technologies within reach:
- A mobile barcode label printer
- A barcode scanner
- A mobile computer that allows access to a patient’s electronic health record (EHR) and/or positive patient identification (PPID)
- ISEGA-tested blood bag labels
- A temperature sensing label
This technology combo allows for the patient’s identity to be confirmed, their EHR retrieved, and their donor eligibility verified before any blood is drawn. If the patient passes the initial screening, the phlebotomist can immediately print a set of barcoded labels containing information about the donor and donation. A temperature sensing label can also be generated to start cold chain monitoring.
With all the labels affixed to sample vials and blood bags at the point of donation, in front of the donor, everyone can be confident the blood sample will be accepted by the lab for testing and the full donation can be made available if the sample passes the lab test. The donor and donation have been properly matched.
Once the donation is complete, the phlebotomist can simply scan the barcoded labels again to confirm where each sample was sent and the blood bag units were stored along with the time of those actions. A digital record of each unit can be monitored, and the blood properly managed. This helps ensure no blood is lost in transit, left out on a counter, or left in storage too long.
Speeding Up Testing and Acceptance
When lab technicians receive properly labelled blood vials…
- a quick barcode scan can confirm receipt (to maintain the chain of custody),
- samples can be automatically analysed by the machine, and
- results can be immediately reported in the EHR or messaged to the clinical team managing the blood bank supply or transfusion process.
If the blood sample is deemed safe and acceptable, then the associated blood bags – all donated units – can be labelled to the global ISBT 128 standard. Both the primary and secondary labels put on the bags should include a unique donation identification number (DIN) imprinted to allow for vein-to-vein traceability. Once the labels are affixed, their barcodes can be scanned, parsed, and verified. If you use barcode scanners with the Zebra Blood Bag Parse+ software loaded on, clinicians will be able to scan all codes at once, including the:
- ABO & RhD Blood Group Code
- Collection Date
- Component Code
- Expiration Date
- Special Testing Code
This intake step can be completed quickly and with confidence that all donations entering the national or local blood bank supply have been properly vetted up to that point. As the blood bags continue to move through the supply chain – from the lab to the point of transfusion – this automatic verification process can be easily repeated.
Maintaining Accountability and Compliance
There is always a risk of blood supply loss due to delayed processing or transfers. If a blood bag is left unattended or exposed to temperatures that could compromise safety and quality, someone is going to question the unit’s continued efficacy. And if there’s any doubt about the blood’s viability, it’s quite possible it will be rendered unusable and go to waste. However, the more we can automate traceability, the easier it becomes to prevent mistakes that would make blood unusable. Plus, blood transfusions are considered medical treatments. Anything that compromises the accuracy of lab results or blood identification could increase the risk of ineffective treatment and associated costs to both the patient and healthcare provider.
In other words, we must create secure, trustworthy collection, testing, processing, storage, distribution, and administration systems.
With electronic dispensing and bag collection systems, you can:
- print crossmatch labels that help verify the right blood component is being sent to the right blood bank or hospital location at the right time and being put in the right fridge.
- restrict access to ensure only trained personnel are in areas where blood is collected, tested or stored.
- monitor and maintain the temperature of blood in storage.
- ensure the right blood component and unit quantity reaches the right location at the right time when a patient need is confirmed.
You can also confirm each blood bag label matches the patient data embedded in their barcoded wristband using a quick scan at the point of care, in compliance with ISBT vein-to-vein requirement. This initiates a new information chain specific to patient safety monitoring and healthcare management pre- and post-transfusion. All data from the blood bag can be added to the patient EHR with a single scan, and patient vitals and adverse reactions can be reported immediately via a wristband scan correlating the patient to the EHR.
Building the Business Case for Technology in the Blood Supply Chain of Custody
If you’re struggling to justify the cost of technology to decision-makers, remind them that every two seconds, blood is needed by a patient in the U.S. undergoing surgery or cancer treatment or experiencing chronic illness or a traumatic injury. Or that countries like India have reported being short nearly 41 million units in recent years. The blood supply is fragile in both high- and low-income nations.
The only way to ensure blood is available every second of every day for every patient is by ensuring the right blood is matched to the right donor in the first mile and the right patient in the last mile.
- The point-of-draw labelling process initiates the chain of custody – and accountability – for every donation.
- Label parsing at the lab and continuing through the last mile makes it easy to verify where the donation has been and where it should go.
- Crossmatching blood bag labels with fridge labels or patient wristbands instills confidence that the right patient is receiving the right blood component.
- Temperature indicators give you control over the cold chain and help eliminate waste due to uncertainty. You can return unused products to the supply knowing a temperature excursion didn’t occur or decide not to use a product when you know an excursion did occur.
For those most inspired by financial impacts, figure every blood sample test costs approximately €100 and every blood bag has a value of €125. If a single donated unit must be removed from the supply at any point of time because there isn’t technology in place to monitor the product’s core temperature or maintain accountability during transfers, that money is lost. And every unit wasted due to mishandling, mislabelling or inadequate oversight increases the risk that clean, safe blood won’t be available for a patient when they need it. Whereas spending €1 per bag in capex and a bit of opex budget on labels enables you to prevent those critical blood – and financial – losses.
- how simple it was for Sanquin, a Dutch blood bank, to create a fail-safe solution for labelling blood products. The investment was primarily in a printer upgrade.
- how easy it became for this blood bank system to preserve blood products after putting temperature indicators on each bag (which it actually estimates to be worth $350 USD). I know you can’t put a price tag on life, but you can see the qualitative and quantitative value of technology investments when you consider how they help preserve precious blood supplies and protect patient safety.
So, if you work at a local donation centre, blood bank, hospital or emergency response agency, see if the processes and tools I described above are being used. If they’re not, bring awareness to them to sharing this information with influencers and decision-makers. Donate your time to this cause so that, together, we can help ensure every blood donation received and accepted around the world is properly handled, stored and distributed and that every patient who needs blood can receive it.
And, if you can donate blood, please do.
We must all do our part to strengthen local, national and international blood supplies. We can’t wait on regulators to find a solution.
Did You Know?
Wayne is an A- blood group and has donated 79 times, each donation comprising of one unit of plasma and one unit of platelets.
To learn more about the current blood shortage or read more facts about how blood is collected, processed and distributed, click here. You can also learn more about how and where to donate blood here.