Safe Blood Starts with Me - libdoc.who.int - World Health Organization

should define the measures that willbe taken to meet the transfusionrequirements of the patientpopulation, equitably and whenrequired, at minimum cost, withminimum wastage and with optimumsafety and efficacy.The policy should include anappropriate regulatory and legislativeframework, including thedevelopment of new legislation orregulations, where necessary. Itshould also define national principlesin relation to:— quality systems and initial andongoing training— the selection of blood donors— screening for transfusiontransmissibleinfections— red cell serology testing— the preparation of bloodcomponents and plasmaderivatives— the clinical use of blood— records and information systems.The national blood plan should definethe functions, organization andmanagement of a national bloodtransfusion service (BTS) and thedelegation of responsibilities, whereappropriate, to institutions, hospitalsand non-profit, non-governmentalorganizations, such as the nationalRed Cross or Red Crescent Society orblood donor organizations.The policy should define the role andmembership of a National BloodTransfusion Service ExecutiveCommittee, including taking executivedecisions within the mandate of thenational blood policy and takingoverall responsibility for themanagement of the BTS inaccordance with the national bloodplan.Nationally-coordinatedblood transfusion serviceIn 1975, Resolution WHA 28.72 of theTwenty-eighth World Health Assemblyurged Member States to promote thedevelopment of national bloodservices based on voluntary nonremuneratedblood donation. Becauseof a lack of national coordination andthe fragmentation of services, only35% of the 192 Member States havea national blood policy, relevantlegislation and one specificorganization responsible for thenational blood programme.The national coordination of the bloodprogramme remains an essentialcomponent of the WHO strategy forblood safety because it is aprerequisite for the preparation ofblood and blood products to optimalstandards of quality and safety,including:— the implementation of a nationalquality system for all aspects ofthe transfusion process— the collection of blood only fromvoluntary non-remunerated blooddonors from low-risk populations— the screening of all donated bloodfor transfusion-transmissibleinfections, including HIV, hepatitisviruses, syphilis and otherinfectious agents, such as Chagasdisease and malaria— good laboratory practice in bloodgrouping, compatibility testing,component preparation and thestorage and transportation ofblood products.A nationally-organized or coordinatedblood transfusion service requiresformal government commitment,support and recognition as aseparate, identifiable programme. Italso requires a budgeting and financesystem that can ensure a sustainableblood programme through costrecovery and/or annual budgetallocation.A well-organized blood transfusionservice is safer and more costeffectivethan a hospital-basedsystem. The coordination of servicespromotes adherence to qualitystandards, minimizes duplication andachieves economies of scale throughnational systems for blood donorrecruitment, blood screening andprocessing, and the central bulkpurchasing of essential consumablesand other supplies.A national programme for theeducation, motivation, recruitmentand retention of low-risk blooddonors, for instance, can achievesubstantial cost savings in thecollection and screening of bloodcompared with systems of family/replacement or paid donation. This isbecause a significantly lowerproportion of donated blood fromregular voluntary non-remunerateddonors needs to be discarded becauseof evidence of transfusiontransmissibleinfection.The appropriate clinicaluse of bloodResponsibility for the decision totransfuse ultimately rests withindividual clinicians, but prescribersof blood do not work in isolation.A reduction in unnecessarytransfusions is dependent on theavailability of simple alternatives totransfusion, including intravenous129 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME