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 centres and others charged with saving lives need 24/7 on-demand access to clean blood 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, especially in the UAE, which sources 100 percent of its blood from voluntary donations. Between the pandemic, a lack of younger donors and the ‘retirement’ of older donors, an imbalance between supply and demand is not unexpected. However, it must not be marginalised.
On the heels of World Blood Donor Day, we must consider ways to mitigate the risk of shortages. I have personally donated blood 79 times, each donation comprising of one unit of plasma and one unit of platelets. But that’s not enough. That’s why I also work with healthcare leaders around the world to help ensure every accepted blood product remains available for its full life cycle.
We can’t allow improper labelling, handling, storage, records, or rotation to prevent donated blood from being distributed to a patient in need.
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 physical location of the draw. 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, everyone collecting blood donations should have a mobile barcode label printer, temperature sensing label and ISEGA-tested blood bag labels. They also need a barcode scanner or mobile computer connected to a patient’s electronic health record (EHR).
This technology combo facilitates positive patient identification (PPID) and helps verify donor eligibility before blood is drawn. If the patient passes the initial screening, a set of barcoded labels containing information about the donor and donation can be immediately printed and a temperature sensing label can be generated to start cold chain monitoring.
With all the labels affixed to sample vials and blood bags 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 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.
This automatic process can be repeated as units continue to move through the supply chain – from the lab to the point of transfusion – instilling widespread confidence that all donations entering the national or local blood bank supply have been properly vetted.
Maintaining accountability and compliance
There is always a risk of blood supply loss due to delayed processing or transfers or a lack of trust in the handling of cross-border donations. 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. Therefore, 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. You can also restrict access to ensure only trained personnel are in areas where blood is collected, tested or stored. Critically, you can monitor and maintain the temperature of blood in storage and 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
The blood supply is fragile in both high- and low-income nations, and the risk of shortages is universal. That’s why investments in automated traceability solutions must be a global priority.
If you’re trying to justify an investment in the technologies I just described, remember that every blood sample test costs approximately €100 (384 dirham) and every blood bag has a value of €125 (481 dirham). 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 (3.85 dirham) per bag in capex and a bit of opex budget on labels enables you to prevent those critical blood – and financial – losses.
Just consider how much the Royal Children’s Hospital improved patient safety by updating its scanning technology and increasing the efficiency of its barcode-based blood scanning process, or 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. It also became much easier for a large blood bank system to preserve blood products after putting temperature indicators on each bag (which it actually estimates to be worth $350 USD/1285 dirham). 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 by 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. Also encourage younger people to donate. They’re born with smartphones in their hands – modernise the blood donor system. Link a person’s blood donation history and blood type to the emergency function on smartphones or allow people to own their medical records and grant access to care providers in an emergency.
We must all do our part to strengthen local, national and international blood supplies and the system as a whole.
To learn more about how technologies can be used to help ensure every donated blood unit is properly tested, handled, stored and distributed click here.
