NBSCP: The Laboratory Perspective

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► What your laboratory should be doing in response to the NBSCP

► Raise institutional awareness of NBSCP

► Appropriate usage of blood products

► Blood product inventory levels

► Availability of blood products

► Clinical consequences of activation of the NBSCP

 

What your laboratory should be doing in response to the NBSCP

It is important that your laboratory is familiar with the requirements of the NBSCP.

You can download electronic copies of the NBSCP requirements from the NBA web site.


Raise institutional awareness of NBSCP

The healthcare facilities to which you supply blood products must also be aware of the NBSCP and its implications.

Governance of transfusion activities is normally the role of a local hospital transfusion committee (HTC) or another appropriate committee incorporating similar responsibilities, of which the laboratory must be an active participant.

If such a committee does not already exist, one should be convened.

The HTC (or its equivalent) should, therefore, assume responsibility for local implementation of the NBSCP and coordinating organisational preparedness for blood product shortages.

The NBSCP must be considered part of the organisational (or wider area) emergency planning framework and an organisational Emergency Blood Management Plan (EBMP) should be prepared accordingly.

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Appropriate usage of blood products

Maintaining an adequate blood supply requires that the available blood product inventory is used appropriately and not wasted.

Proactive management of blood product stocks by the laboratory rather than a reactive response to shortage should be the primary focus. 

At the organisational level, there should be policies directing appropriate blood product utilisation and minimisation of unnecessary wastage and these should be promoted by the HTC.

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Blood product inventory levels

Details of your laboratory’s blood product stock levels will be required to be submitted daily to the Blood Service.

This should be done as directed by your Inventory & Distribution department. 

It is important that we have accurate daily jurisdictional and national figures showing blood product stocks and how the inventory is distributed between the various institutions and the Blood Service.

This data is used to populate the Blood Service's National Inventory Model on which production and supply decisions, including interstate transfers, are made. 

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Availability of blood products

When blood product stocks are adequate, your institution’s orders will be met with little or no adjustment.

When Blood Service stocks drop below predefined levels, there will be restrictions on what can be supplied and, where necessary, this will be under the direction of Blood Service Medical Officers in consultation with the local clinician. 

If stocks do not improve, the NBA will activate the NBSCP and you will be informed accordingly.

You will be expected to follow the requirements of the plan for managing use of blood products including appropriate prioritisation of transfusions.

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Clinical consequences of activation of the NBSCP

The clinical response to blood product shortages and when the NBSCP has been activated, particularly at the more serious levels, will rely on clinicians and laboratories being able to reduce demand through strong triage and vetting of requests of blood products.

You will liaise with your local clinicians and, where necessary, Blood Service medical staff, as part of the decision making process.

In deciding whether or not to transfuse, clinicians will use their clinical judgement to assess product requirements based on the diagnosis of their patients and knowledge of what products (or alternatives) are available.

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Reference

  1. National Blood Authority. National Blood Supply Contingency Plan (NBSCP) - Australia's Response to Blood Shortages. Australia, 2008.