ACSLM – Graduate Project Webinar – Tues 14th September, 1pm.
Tuesday, 14th September 2021, 1pm
The Academy on behalf of the Transfusion and Transplantation Science Advisory Body presents a webinar on the three topics below on Tuesday, 14th September at 1pm. Booking is essential and is in the usual manner: www.acslm.ie | Members CPD Area | Login | Click Events tab and scroll to the event and book. Non-Members should create a guest account at Login. ACSLM members free, non-members €30.
Each presentation will last approx. 15 mins with time for Q+A between each speaker.
The Evaluation of ROTEM Usage in the National Maternity Hospital
Ashley Hendy, Medical Scientist in the National Maternity Hospital, Blood Transfusion Laboratory
Bio: graduated with a First Class Honoours Degree in Biomedical Science in Technological University Dublin, 2021. In final year, focused studies on Biochemistry, Transfusion and Transplant Immunology. Currently employed by the National Maternity Hospital in the Blood Transfusion Laboratory.
The incorporation of point-of-care analysers, like ROTEM®, to enhance the treatment of major haemorrhage is being recognised internationally. In 2018, ROTEM® was introduced to enhance the treatment of post-partum haemorrhage in the National Maternity Hospital. However, this implementation of ROTEM® required evaluation. The British Society of Haematology provide guidelines for the use of ROTEM® in treatment of major haemorrhage. The use of ROTEM® in NMH was evaluated in comparison to these guidelines and a quality improvement initiative was designed to address the downfalls identified.
This study revealed under-utilisation of ROTEM® analysis in NMH. In 2019-2020, 79.6% of patients eligible for ROTEM® analysis were not tested. When incorporating ROTEM®analysis, the massive haemorrhage pathway must be activated, as per the locally verified ROTEM® algorithm. The massive haemorrhage pathway is also potentially under-activated in NMH. In 2019-2020, 60.9% of patients analysed on ROTEM® in NMH satisfied the specified blood loss trigger for ROTEM® analysis, yet 14.7% were treated alongside an active massive haemorrhage pathway. Review of ROTEM® records found no documented training records of staff in ROTEM® analysis and issues with identifying IQC failures.
A survey of ROTEM®-users revealed training was not standardised for ROTEM® in NMH. A ROTEM®-User Training Programme was drafted and participation in an accredited external quality assurance scheme was initiated.
Implementation of National Transfusion Advisory Group (NTAG) Guidelines Regarding Cytomegalovirus (CMV) Negative Blood Components in the Hospital Setting
Chloe Keenor, Medical Scientist, St Vincents University Hospital, Blood Transfusion Laboratory
Bio: Chloe graduated TUDublin in 2021 specialising in Transfusion Science and Clinical Chemistry. Her thesis was focused on the NTAG’s new CMV guidelines published in 2020. As of July 2021, she began work as a medical scientist in blood transfusion in St. Vincent’s University Hospital.
Introduction: Cytomegalovirus (CMV) is a herpes virus that can cause serious issues in foetuses and transplant recipients as it can be transmitted via blood transfusion. Leukodepletion and CMV testing are used to eliminate the risk of CMV from blood products’ National Transfusion Advisory Group (NTAG) created a new national set of guidelines in 2020 regarding the use of CMV negative products.
Method: In this study a liver transplant audit (n = 276) and cost analysis were performed. A haematology audit (n =201), a survey (n = 31) and a non-conformance audit (n = 17) to assess the impact NTAG guidelines would have on the hospital blood bank.
Results: From the survey 74% of hospitals are also changing to NTAG guidelines and foresee challenges such as communication issues, documentation, etc. The cost analysis showed an annual saving of €1,293 if CMV negative units weren’t ordered for liver transplant patients. Data of patient demographic and CMV status were collected.
Discussion: From the results stock management in the hospital would improve as the number of CMV negative products are reduced due to fewer special requirements for patients. There’s a number of barriers that need to be resolved as NTAG guidelines are implemented such as pre-testing for allogeneic transplant recipients, false positives in |CMV testing, and IT issues.
Audit of Neonatal Crossmatching in University Hospital Waterford
Emer Whelan, Medical Scientist, University Hospital Waterford in the microbiology laboratory.
Bio: Medical scientist currently practicing in University hospital Waterford. Attended UCC and MTU from 2016-2020, graduating with a bachelors in Biomedical science. Subsequently, completing nine months of clinical placement in May of this year in the Pathology laboratory in UHW. Currently working in the Containment level 3 Microbiology laboratory in UHW.
Neonatal red cell transfusion is an important procedure in transfusion practice particularly amongst premature infants. The current protocol for issuing blood components in neonatal transfusion involves serologically crossmatching maternal plasma with donor cells. The audit carried out presents findings from a retrospective evaluation of the risks involved in the issue of blood components without manual IAT crossmatching for neonatal transfusions. This study utilised data retrieved from the Laboratory Information Management System (LIMS) in University Hospital Waterford (UHW) which provided information on 117 neonatal transfusions performed in UHW during the period 2013-2020. During this period, 60% of neonatal transfusions carried out were suitable for issue without IAT crossmatching of red cells based on the current proposed eligibility criteria. The presence of maternal antibodies was the main circumstance requiring an IAT crossmatch prior to the issuing of blood components. In conclusion, in relation to the neonatal cases eligible for issuing without an IAT crossmatch there was no significant additional risk of transfusion identified in comparison to performing an IAT crossmatch. The implementation of a standardised procedure for issuing blood components without requirement for manual crossmatch for neonates should be considered due to numerous benefits outlined which include decreased turnaround times, improved patient care and reduced cost of materials consumed.
Booking is essential and is in the usual manner: www.acslm.ie | Members CPD Area | Login | Click Events tab and scroll to the event and book.
Non-Members should create a guest account at Login.
ACSLM members free, non-members €30.
Queries to your CPD Officers: firstname.lastname@example.org