Regional
Quality Systems in Taiz Blood Transfusion Center and Hospital Blood Banks
Ahmed Abdullah Mansoor Ahmed
National Blood Transfusion Center Taiz, Yemen
Hani Abdulsalam Mulhi
Thraia Abdulrazzaq Alshibani
National Blood Transfusion Center Taiz, Yemen
Blood Regulation
The Yemeni blood transfusion service started as hospital blood bank linked to the laboratory. In May 2005 the National Blood Transfusion and Research Centre (NBTRC) was established by a presidential decree. The official opening was in June 2006.
The first legislation and official organization of blood transfusion services was promulgated and it concerns the establishment of the blood transfusion services. Blood Transfusion Services are under the responsibility of the Ministry of Health and Population (MOHP) and the NBTRC carries the responsibility for upgrading, organizing and regulating the blood transfusion services all over the country. The NBTRC has the authority of technical supervision of all Yemeni blood banks (including blood banks within the military and private hospitals). A MOHP Ministry directive, promulgated in 2007, defines the organizational scheme of the blood transfusion services.
Despite the legal text describing the role of the National Blood Transfusion Services in Yemen, the necessary authority and resources are not provided to ensure best practices in blood collection, processing, and administration are applied throughout the country.
Infrastructure
The NBTRC in Taiz governorate is operating since 2014 in a new separate parts in the National Central Laboratory building which is clean and the staff follow up the hygiene rules in all the departments of the center.
Hospital blood banks, on the other hand, do not always have the physical space or dedicated staff to perform the blood banking or transfusion laboratory tasks. These usually fall within the responsibility of the main hospital laboratory.
Human Resources
The NBTRC does not have an adequate number of staff. There is no medical doctor appointed. The following table indicates the categories of staff working in the NBTRC.
Quality assurance
The NBTRC has so far implemented many guidelines for the whole transfusion process and the work instructions are followed by all staff. The quality system in place comprises work instructions, organogram, job description, list of personnel, list of equipment and maintenance, quality control of the products and records of all the NBTRC activities.
Some of the Staff of National Blood Transfusion Center in Taiz
An analyzer for screening donated blood for infectious diseases
Blood donation
NBTRC relies on voluntary non remunerated blood donors and family replacement donors to provide an adequate blood supply. Hospital blood banks also rely on these types of donors but some of them accept paid donors too. In the NBTRC, a donor’s recruitment programme has been established based on a production of guidelines for blood collection activities which cover donor’s selection criteria with the introduction of donor’s privacy and confidentiality of donor’s data. Donor history is evaluated using a donor history questionnaire.
Blood processing
Although physicians continue to request whole blood for transfusion, great effort has been made to phase it out. The NBTRC Taiz produces the following blood components: Red cells concentrate, fresh frozen plasma, platelets concentrate and cryoprecipitate. Storage and transportation
In NBTRC, storage equipment for blood components and reagents are separate and the temperatures are monitored. Blood donor testing
The NBTRC applied the Presidential decree’s recommendations concerning HIV 1,2 HBs,HBcTotal, HCV and Malaria and syphilis testing by device card. WHO supply of reagents is always available. The NBTRC uses an automated analyzer (cobas e 411) for viral screening. Direct and reverse ABO and Rh grouping using manual tube system are performed in all the collected units. Testing for transfusion-transmitted infections in some hospitals is limited to rapid testing, and ABO and Rh typing is performed using the direct slide method. Future directions
Blood banks in Yemen require further standardization and improvement in availability of resources. Both the NBTRC and hospital blood banks must work on establishing an adverse event reporting system to pave the road for a hemovigilance system. External quality control must also be implemented. It seems necessary to provide training about laboratory quality management to blood banks staff, and transfusion medicine education to clinicians.
Agitators used for platelet storage
