Preliminary ResultsSummary of the Survey of

Blood Transfusion Practice in Indiana

2006Indiana State Association of Blood Banks Education Committee

Presented by Jayanna Slayten, MS, MT(ASCP)SBBISABB Education Committee

These are the preliminary findings

of the 2006 Survey.

A complete analysis of the 2006 data and comparison to

previous surveys will be summarized by and

forwarded to the participants.

Survey Development• A survey was developed covering

– Blood Product Usage

– Serologic Techniques and Transfusion Protocols

– Transfusion Reactions

– Lab Management

• The survey revised – Demographics updated– Survey has new questions – Survey repeated some questions

Survey• The survey was emailed and faxed to Indiana

Hospital Transfusion Services

• The hospitals were asked to respond

– fax the completed survey (OR)

– Email back the completed survey

• The surveys were accepted for three weeks

– August 10 – September 1, 2006

Results: Survey Response

2001 2002 2003 2004 2005 2006

• Total surveys faxed 126 126 126 126 126 126

• Total completed surveys 60 41 55 60 37 50

• Percent response rate of 47.6 32.5 43.6 47.6 30.1 39.1

– Average response rate over the last 5 surveys = 40.1%

– Results more difficult to assess trends with low response rate

Comparison 2001-2006 : Percentage Response Rates by Year

47.6

32.5

43.6

47.6

30.1

39.6

0

5

10

15

20

25

30

35

40

45

50

Yr 2001 Yr 2002 Yr 2003 Yr 2004 Yr 2005 Yr 2006

Response Group - Location

• What is the make up of the response group?

04-06 Comparison of Response Rate to Survey by Geographic Region

16

18

15

23

65

16

7

23 3

10

17

15

1 1

6

0

2

4

6

8

10

12

14

16

18

20

North South Central East West Out of State

2004 2005 2006

Response Group – Size of Facility

• What size facilities responded to the survey?

2006 - Response Group By Size of Facility

0-7536%

75-20038%

200-50022%

>5004%

Response Rate 03-06 : By Facility Size

0

5

10

15

20

25

30

0-75 75-200 200-500 >500

2003 2004 2005 2006

Lab Type

• New Question for 2005 and Repeated 2006– Question was added with the change of labs from

hospital based to privatization– The response group was asked if the lab is hospital

based or private lab 2005

2006• Hospital Based Lab 94% 88%• Lab Group based in a Hospital 6% 12%

– It is anticipated that this demographic will change within the next 5-10 years.

Red Blood Cell Usage

• Does your facility receive 100%

Leukoreduced units?

– 2006 response

– 2006 compared to 2003 and 2004

2006: Percentage of Facilities Using 100% Leukoreduced Red Cells in Indiana

100% Leuko RBC 92%

Packed Cells Used - 8%

03-06 Percentage of Facilities that Use 100% Leukoreduced Red Cells

2003

2004

2005

2006

0

20

40

60

80

100

120

2003 2004 2005 2006

Yes No

Platelets• Does your facility only order pheresis platelets?

– 2006– 2005 compared to 2003 and 2004

• Do you use Random Platelets when Pheresis

are not available?

• Shortages of pheresis when Bacterial Detection

was implemented?

– What percentage

Does your Facility Only Receive Pheresis Platelets?

23

32

28 40

32

28

9 10

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2003 2004 2005 2006

Yes No

2006 - Shortages of Pheresis Platelets Since Bacterial Detection?

Yes35%

No65%

2006 - Percentage of Time There is a Backorder for Platelets due to Bacterial Detection Testing

<5%70%

5-10%12%

10-25%18%

Cryo

• Question: Does your facility routinely use Cryo?– Yes 29.1%– No 71.9%

Would pre-pooled Cryo be easier?– Yes 66%– No/NA 34%

ISBT

• The majority of respondents were aware of the impending ISBT change.

• Response to ISBT– Aware, but no changes 52%– Looking at updates 26%– Completed Plan 5%– Begun Performing Plan 17%

Serologic Protocols

• What is the primary method of

antibody screening / identification?

– Tube: All methods are currently being used

– Tubeless: Only Ortho Gel

2006 - Tube Methods Used

3

7

3

1

0 1 2 3 4 5 6 7 8

LISS-AHG

PEG-AHG

37-AHG

Alubmin-AHG

2006 - Tube Method vs. Gel and Automation

Tube29%

Gel67%

Automated 4%

Serologic ProtocolsAHG Reagent Used

• What type of AHG reagents does our facility use?

2003 2004 2005 2006• Polyspecific AHG 47% 37% 30% 13%• IgG AHG 53% 63% 65% 87%

• This question continues to demonstrate that more facilities are using IgG-AHG vs. Poly-AHG for AHG testing.

Serologic ProtocolsWeak D Testing

• Does your facility complete the weak D testing on all D- negative recipients / patients?

2003 2004 2005 2006

• Yes, Full Weak D 60% 45% 38% 21%• No, No Weak D 40% 55% 62% 79%

– Fewer Indiana Facilities in 2006 are completing weak D testing

– 2006 survey reconfirms this trend

When to your facility routinely complete weak D testing?

0 5 10 15 20 25 30 35

Prenatal Samples

Labor and Delivery

Cord Cell Testing

Per physician request

other

If a patient is confirmed as Weak D Positive,does your facility give a Weak D positive

patient Rh Negative Products?

Yes62%

No38%

Transfusion Service Protocols

• Pre-surgical T and S– When are they drawn?– When do you “band” the patient?

When is the Presurgical Sample Drawn ?

3 days before38%

one week before8%any time before

8%

day of surgery17%

other29%

When is the patient "banded" for provision of blood?

0 5 10 15 20 25 30 35 40

pre-surgical sample isdrawn

day of surgery

other

What is the Type of Band Used?

Hollister38%

Tupenex16%

Securline 18%

Fenwal3%

Fisherbrand5%

PD Corp3%

Name & SS #3%

BB/D # & hosp armband

3%

Med Rec #/Name band8%

Home grown system

3%

Transfusion Service Protocols:Compatibility Testing

• What type of crossmatch does your

facility complete for an antibody screen

negative patient sample?

– Immediate Spin

– AHG

– Electronic

What Type of Crossmatch do you use?

Immediate Spin63%

AHG31%

Electronic Crossmatch

6%

Blood Utilization Review

• Do you feel that your facility has adequate blood utilization review?– Yes 66%– No 34%

Has your facility considered a blood utilization management program?

– Yes 54%– No 46%

What percentage is a Regional Reference/Transfsion Service Utilized by your Faciity?

0

2

4

6

8

10

12

14

16

18

20

<5% 5-10% 10-25% 25-50% 50-75% 75-90% 90-100%

What can you forcast concerning the use of a Regional Reference / Transfusion Service ?

12

0

35

0 5 10 15 20 25 30 35 40

Increase

Decrease

stay same

Transfusion Reactions

• Attached for review

Lab Management

• For 2006– This year’s questions focused

• Evening/Nights Coverage• Staffing Strategies• Average salaries for new graduate medical

technologist• Average salary increases in 2005

Staffing of Blood Bank during Evening and Nights ?

Generalist94%

Both2% Dedicated Blood

Bank4%

How are Evening and Night Lab Professionals Compensated ?

Shift Differential47%

Flat Dollar amount45%

other8%

If a Differenital is used for Evening and Nights - What %?

8

3

20

1

0 5 10 15 20 25

2-5%

7%

10-15%

20%

> 20%

What is the starting wage for new MT(ASCP) Lab Professionals in your Lab?

1 12

25

14

1

0

5

10

15

20

25

30

< $15/hr $14-$18/hr $10 to $20/hr $15 to $17/hr $17 to $19/hr > $20/hr

What is the aveage annual salary increase in your laboratory?

No increase

1%

2%3%

4%

>5%

5%

2006 Preliminary Summary

• The final analysis will be correlated and returned by fax and emailed to the facilities

Special Thanks

• Thank to all the facilities that responded!

• Thanks to the ISABB 2006 Survey Reviewers

• Special Thanks to Jane Kimble for the tally