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Hospitals and laboratories can implement a number of strategies to reduce avoidable wastage of blood components and products.
“My fridge has never failed” is not a plan.
We regularly receive reports of refrigeration failures resulting in the loss of entire inventories of blood and blood products.
This not only leaves the laboratory or hospital without the ability to respond to an emergency request for blood but wastes substantial numbers of precious donations each year.
A plan should consider:
How alarms are monitored particularly outside normal working hours
Immediate actions to be taken in the event of an alarm
Who should be notified and when (include contact numbers)
How long your fridge will maintain its temperature if it fails
If there is an alternative refrigerator available to store blood in case of catastrophic failure
Hospitals and laboratories with small inventories of blood components may have higher wastage rates due to time expiry, especially of precious Group O RhD negative red cells.
These organisations should consider approaching larger organisations, either within their own network or geographically proximal, with a view to entering into an agreement to transfer short-dated components to the larger organisation where they may be more likely to be used before expiry.
Agreements should cover such things as storage and transport conditions and the age of components at the time of transfer.
All blood components should be maintained in a controlled temperature environment until they are to be administered.
Handling of refrigerated components outside of refrigeration should be kept to a minimum to ensure that specified storage temperatures are not exceeded.
Red cell components must not remain out of the refrigerator for more than 30 minutes on any one occasion.
In order to allow the return of blood components that have been issued to the ward but not used, the time of issue and the time of return to the laboratory should be recorded.
If the red cells have been out of the refrigerator for less than 30 minutes they may be returned to inventory at the discretion of the transfusion service provider.
If red cells have been out of the refrigerator for longer than 30 minutes they should be discarded unless the transfusion can be completed within 4 hours from the initial issue time.(1)
The ideal inventory of blood components will balance the requirement to have sufficient numbers of the appropriate components in the correct groups to meet clinical needs, with minimising the potential to waste blood through expiry and the cost of excessive deliveries.
The ideal inventory level will vary from organisation to organisation and will depend on a number of factors, including:
Time to resupply in an emergency
Distance from the blood supplier and the frequency of deliveries
The predictability of use: eg, level one trauma centre vs Thalassemia treatment centre
The number, type and complexity of activities undertaken in the hospital, eg, trauma, obstetrics, surgery
In a number of cases inventory levels have evolved over the years and not arrived at through any evidence-based system.
We recommend that you regularly review your inventory levels and discuss with your State or Territory Medical, Transplantation and Quality Services who will be pleased to offer advice.