Abstract
Background: The safety and efficacy of transfusion depend on systematic quality monitoring. This study evaluated core quality indicators donor adverse reaction rate, donor deferral rate, transfusion reaction rate, component discard rate, transfusion-transmissible infection (TTI) seroreactivity and component quality control together with donor satisfaction, at a hospital-based blood centre in Punjab, India. Methods: A descriptive cross-sectional study was conducted over one year in the Department of Immunohaematology and Blood Transfusion. Records of all donations, components prepared and issued, transfusion reactions and donor feedback were reviewed. Indicators were selected in accordance with International Society of Blood Transfusion guidance and national standards. Donor satisfaction was assessed with a 14-item questionnaire covering accessibility and convenience, technical aspects and interpersonal aspects, adapted from the published Blood Donor Satisfaction Questionnaire, with responses scored 0-4 and totals banded into four categories. Proportions are reported with 95% Wilson confidence intervals. Results: Of 3724 donors, 3624 (97.31%) were male; 1168 (31.36%) were aged 26-35 years, 2751 (73.87%) were repeat donors and 3645 (97.88%) donated voluntarily. The donor adverse reaction rate was 0.48% (18/3724), the deferral rate 7.34% (295/4019) and the transfusion reaction rate 0.19% (15/7971). Discard rates were 5.71% for whole blood (4/70), 4.90% for packed red cells (179/3654), 4.95% for fresh frozen plasma (179/3615) and 45.73% for platelet concentrates (717/1568). TTI seroreactivity was 2.23% for hepatitis C, 1.72% for syphilis, 0.59% for hepatitis B, 0.35% for HIV and nil for malaria. Component quality control met national specifications for almost all parameters assessed. Overall, more than 90% donors were satisfied with technical aspect questions and 1961 respondents (82.06%) were very satisfied and 191 (7.98%) satisfied for other questions, out of total 2395 donors who voluntarily filled the feedback forms. Conclusion: Donor adverse events, transfusion reactions and red cell and plasma wastage were low, and component quality control was consistently within specification. The platelet discard rate of 45.7% is the clear outlier and the principal target for intervention. Donor satisfaction rate was high amongst the 2395/ 3724 donors who filled the feedback form. Sustained monitoring of these indicators, coupled with platelet inventory measures, offers a practical route to further improvement.
Keywords: Quality indicators; Blood transfusion services; Donor satisfaction; Component discard rate; Transfusiontransmissible infections; Quality control; Hemovigilance.