Work Update

A Quick update on what I’ve been upto at work!

A big part of my role here is help improve the standard of the blood transfusion service at the hospital.  This is a big and ongoing task, but I feel I am making some progress.

In the laboratory, I have already taught Laboratory staff in a better and more reliable technique for performing blood groups, tried to ensure that every unit of blood is cross matched against the patient’s blood before it is given (although this does not always happen), improved labelling of blood units, improved the safety of blood donation collections and viral testing, improved recording of testing performed and the fate of blood units and provided education for the lab staff about the theoretical aspects of blood groups and transfusions.  

I have now started the next phase of my mission, which is to train the clinical and nursing staff in better transfusion practice.  I have given a series of presentations to the doctors and clinical officers about blood transfusion, blood groups, transfusion reactions and transfusion safety and produced protocols to follow in the case of transfusion reactions.  

For the nursing staff, I have produced a protocol (in Kiswahili) to follow when giving a transfusion, and held a series of workshops (again all in Kiswahili) teaching the nurses about theoretical aspects of blood transfusion and safe transfusion practice.  I’m following this up by visiting the wards when they perform a transfusion to ensure that the safe transfusion protocol is being followed.  

Teaching the Doctors

 

For those of you reading my blog that work in Blood Transfusion, some of the things I have seen here will make you cringe and make you reach for the nearest SHOT report! A few examples…

• Ward staff would warm a blood unit before transfusion by placing into a sink of hot water
• A blood unit was taken from the lab fridge to the ward, but the patient was still in theatre so the unit would have been sat on the ward for hours before transfusion
• 2 units collected at the same time from the lab for 2 different patients (you can guess where this is leading)… the nurse was literally about to insert the line into the cannula when I asked her to confirm the name of the patient… surprise surprise.. wrong patient!
• The concept of patient observations before, during and after transfusion was completely new to the nursing staff
• Blood units 1 month past expiry date found in fridge
• Patient ID often consists of surname only - a lot of patients don’t know their date of birth, and the some names are very common here.  You would be amazed how many Saidi Mohammed ‘s there are!
• The fate of a unit of blood that was found to be unsuitable for transfusion after viral testing could not be determined
•  Our Blood bank refrigerator regularly warms up to 15°C during the day (it’s just a domestic fridge, and is about 15 years old!)… if anyone wants to donate a proper blood bank fridge then please get in touch!

I could go on, but it gives you an idea of the challenges I face on a daily basis here!  It has been a lot of work getting to this stage, and it is still on-going as with any changes in the workplace, some people are reluctant to adopt new practices.  Thankfully my Kiswahili is almost good enough to explain why we need to change and how it will benefit the patient.  After all, that’s why we are all here.. Isn’t it????