Fatores intercorrentes na sala de coleta de sangue de doadores, associados ao descarte de sangue total no Serviço de Hemoterapia do INCA

Abstract

Hemotherapy is the science that studies the treatment with blood, its components and derivatives. The shortage of blood donors reduces the production of quality blood components to provide hemotherapy support to patients who need treatment. Complications during donor blood collection leading to the disposal of whole blood units (WBU) before processing further aggravates this picture. The present study aims to identify the intercurrences that lead to the disposal of WBU in the donor collection room (DCR), in order to minimize the discard and optimize viable WBU. A retrospective study was performed on the collected WBU records, discarded and associated intercurrences, in the period from 2012 to 2015. Data were extracted from blood bank computerized systems (SBS and HEMOTE / PLUS). Were included in the study, WBU collected, were excluded collections that did not use bags and those with incomplete data. The statistic was performed through bivariate data analysis in the EXCEL® program. A total of 46,478 (100%) WBU were collected, of which 44,686 (96.14%) were used, 1,792 (3.86%) discarded in the donor collection room (DCR). A total of 14 complications were identified: It was considered discard indicators were: slow flow 576 (32.14%), difficult venous access 438 (24.44%), interrupted flow 293 (16.35%), donor reaction 198 (11.05%) and high volume 142 (7.92%). The other complications were: subjective discard (0.15%), low volume detected at fractionation (0.06%), accident (0.04%), unsuitable in collection (0.03%), technical mistake (0.01%), collection abandonment (0.01%), defect in the bag (0.00%) and defect in the homogenizer (0.00%). About 930 (2%) donors used 2 blood bag supplies (BBS) per punch with waste of 2,722 BBI. A SOP (Standard Operating Procedure) was developed to standardize the handling of homogenizers, and an animation in PowerPoint® program that contains the procedure of handling the homogenizers, that simulates intercurrences related to nonconformities, to be incorporated into the training. The complications recorded throughout the research confirm the need to update the steps inherent in the collection procedure to improve the quality of the hemotherapy service, avoiding economic and social damages and increasing the contingent of WBU available.