Esmat Ahmed Sheba

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TTIs &
 Blood Donation and Collection

Years Theoretical Duration Practical Duration

1st year (1) Basic Physiologic Conditions: 2 hr  Module for communication One day(6hr)
 Total blood volume calculations. Skills.
 Plasma volume calculations.  Training on Blood campaign One day(6hr)
 Safe extracorporeal volume. preparations
 Compensation of volume and cellular components  Training on phlebotomy. One day(6hr)
 Rate of donations.  Training on donation format. One day(6hr)
(2) Communications skills: 2 hr
 Tools
 Training
(3) Donation Types: 2hr
 Voluntary donation
 Family replacement
 Directed donation.
 Autologous donations.
 Blood Components
Years Topics Type Duration
1st Year
I - Main constituents and functions of circulating blood
1. Hemopoieses. Theoretical 2 hrs.
2. Red Cells Theoretical 2 hrs.
( formation, function, life span and destruction)
3. White Cells Theoretical 2 hrs.
( formation, function, life span and destruction)
4. Platelets Theoretical 2 hrs.
( formation, function, life span and destruction)
5. Homeostasis physiology of blood coagulation. Theoretical 2 hrs.
II - Blood Components -why should be used? Theoretical 2 hr.
 TTIs & Red Cell serology (Immune-hematology)

Year Lectures Duration Practical Duration

1st Year Blood Group Genetics 4 hours
- Basic genetics
- Patterns of inheritance
- Population genetics
- Blood group nomenclature
Basic Immunology for Blood Bank 6 hours
- Immune response
- Components of immune response,
Immunoglobulins, Complement, Cytokines
- Red cell alloimmunization
- Platelet alloimmunization
- Immune mediated red cell destruction

Hematology

Years Theoretical Duration Practical Duration

1st Year Hematopoiesis 2 hrs BM & Blood counts 4hrs

Hemostasis 2 hrs Hemostasis function tests 4 hrs
Immunity 2 hrs Immuno-assays 4 hrs
 BTS at Clinical Interface

Years Topics Duration Practical Duration

1st Year 1- Homeostasis, hypotension, shock and oxygen carrying 2 hours -
capacity of blood
2- Acid base , electrolyte and water balance 2 hours -
3- Maintenance of blood volume and response to blood loss 2 hours -
4- Microcirculatory changes and tissue hypoxia 2 hours -

Total Quality Management and Safety

Years Topics Duration Practical Duration
1st year  Safety regulations
- Introduction to hygiene & safety ½ hour
- Employers responsibility ½ hour
- Employees responsibility ½ hour
- The safety manual ½ hour
- The safety plan ½ hour
- Hand washing ½ hour
- Work design & exposure prevention ½ hour
- Using personal protective equipment ½ hour
- Housekeeping ½ hour
 Total Quality Management
 Quality Awareness
- What is Quality ½ hour
- Who is customer ½ hour
 Definition of terms
( Quality control, Quality assurance, Quality 1 hour
management, Total quality management)
 Introduction to the quality
- Importance of the quality ½ hour
- The consequences of poor quality ½ hour
- Introducing quality ½ hour
 Quality system
- Quality systems 1 hour
- Process & Procedures 1 hour - Developing a process
- Flowchart as a tool for mapping process 1 hour flowchart 1 hour
 Organizational management
- Management responsibility for quality ½ hour - Developing a quality policy 1 hour
- Organizational structure and the role of
the quality manager 1 hour - Developing an organo gram 1 hour
- Job descriptions, responsibility and 1 hour
delegation
- The cost of quality 1 hour - Writing a job description 1 hour
 Documentation
- Documentation in quality system ½ hour
- Standard operating procedures (SOP) 1 hour - Developing SOP 1 hour
- Validation of SOPs ½ hour - Validating SOP 1 hour
- Document control 1 hour
 General Microbiology

years Lecture Duration Practical Duration

1st Year 1- Introduction to clinical microbiology 2 hours

2- Specimen handling 2 hours
3- Problem- based microbiology 2 hours
4- Blood culture & Bacteremia 2 hours
5- Gram positive organism as pathogens 2 hours
6- Opportunistic microbial pathogens 2 hours
7- Anaerobes 2 hours
8- Medical mycology : classification 2 hours
9- Infection control: Introduction 2 hours
10-Infection control: Slandered precautions 2 hours
11-Antimicrobials 2 hours
12-Neutrophil function 2 hours
13-Viral 2 hours
a) Hepatitis Viruses
A
B+D
C
G
b) Other Viruses
CMV
c) HIV
14-Bacterial 2 hours
15-Parasitic 2 hours
16-Prion 2 hours
 Microbiology Related To Transfusion Medicine

years Lecture Duration Practical Duration

1st Year Basic bacteriology related to transfusion medicine 2 hours

- Classification of bacteria
- Normal bacterial flora
- Bacteria that could infect blood bags or platelets and
methods of identification
- Methods of sterilization & disinfection
4 hours
Basic virology related to transfusion medicine
- Classification of viruses
- Transfusion transmitted viruses
2 hours
Non viral infection related to transfusion medicine
- Syphilis, malaria, chaggas', toxoplasme
- Prions
 Equipment and Supplies
Years Topics Type Duration
1st
Year Types & Principles of Laboratory Equipment used in Blood Bank Laboratory
1. Glass Ware Theoretical & Practical 1 hr.
2. Plastic ware Theoretical & Practical 2 hrs.
3. Volumetric equipments Theoretical & Practical 2 hrs.
(Pipettes, Flasks & Beakers)
4. Balances and weighing Scales Theoretical & Practical 1 hr.
5. Water Bath Theoretical & Practical 1 hr.
6. Autoclave Theoretical & Practical 2 hrs.
7. Automatic Cell Counter Theoretical & Practical 2 hrs.
8. Laminar flow Theoretical & Practical 2 hrs.
9. Microscopes Theoretical & Practical 1 hr.
 Topics covered during the second year:
Blood Donation and Collection

Years Theoretical Duration Practical Duration

2nd Year 1) Donor Registration: manual or electronic systems. 2hr  Training on donor 6 hr
registration
2) Criteria for donor selection (questionnaire): 4hr  Training on donor 6 hr
 Medical History: questions to protect donor and questionnaire filling and
questions to protect recipient: confidentiality
o Infections: acute or chronic  Training on medical
o Surgeries: major or minor examination
o Medications  Training on educational
o Diseases: congenital or chronic disease material of the informed
o High risk behavior consent
o Vaccination: live attenuated or killed
 Medical Examination: BP, pulse, temperature
,weight and Hb level
 Informed consent.

3) Donor Recruitment and recall: 4 hr Training on recruitment and donor 4 hr

Policy, methodology and documentation. recall
 Blood Components

Years Theoretical Topics Duration Practical Topics Duration

2nd Year Blood Bags System 1 hr. The open System and devices for sterile connections 1 hr.
The open System and devices for sterile 1 hr. Incoming Blood from Donation 1 hr.
connections
Anticoagulants and preservatives 2 hrs. Red Blood Cells 3 hrs.
(types, preparation, Storage and quality monitoring)
Incoming Blood from Donation 1 hr. Plasma Components 3 hrs.
(types, preparation, freezing, thawing, Storage and
quality monitoring)
Principles of components preparation 1 hr. Platelets (PRP) 3 hrs.
(types, preparation, Storage and quality monitoring)
Red Blood Cells 3 hrs. Platelets (BC) 2 hrs.
(types, preparation, Storage and quality (types, preparation, Storage and quality monitoring)
monitoring)
Plasma Components 2 hrs.
(types, preparation, freezing, thawing,
Storage and quality monitoring)
Platelets (PRP) 2 hrs.
(types, preparation, Storage and quality
monitoring)
Platelets (BC) 2 hrs.
(types, preparation, Storage and quality
monitoring)
Granulocytes (preparation, Storage) 1 hr.
 TTIs & Red Cell Serology (Immune-hematology)

Year Lectures Duration Practical Duration

2nd Year  Red cell typing methods, slide , tube 6 hours

Red Cell Antigen – Antibody Reaction & their 4 hours & CAT
detection  ABO/Rh D typing
 Weak D testing

ABO, H, Lewis blood groups & structurally 4 hours  Discrepancies in red cell typing 6 hours
related Antigens (I/i and P blood groups)

Rh System 4 hours

Other blood groups 4 hours

- MNS
- Kell
- Duffy
- Kidd
- Other systems
- High frequency antigens
- Low frequency antigens
 Hematology
2ND Year Nutritional anemia 2 hrs Investigations 4hrs
Membrane defects & 2 hrs Investigation 4 hrs
enzymopathies
Hemoglobinopathies 2 hrs Investigation 4 hrs
Decreased & defective 2 hrs Investigation 2 hrs
erythropoiesis

BTS at Clinical Interface

2nd Year 1- Clinical indications and dose / response for transfusion : 2 hrs Case study 2 hrs
of Packed red blood cells
2- of FFP and cryoppt 2 hrs Case study 2 hrs
3- of platelets and granulocytes 2 hrs Case study 2 hrs
4- of coagulation factors 2 hrs Case study 2 hrs
5- of blood products (fractionation products) 2 hrs Case study2 2 hrs
6- Massive bleeding and estimating blood loss 2 hrs Case study 2 hrs
7- The hematology of newborn 2 hrs - -
 Total Quality Management and Safety
2nd year  Safety
o Fire safety
- Fire response plan ½ hour
- Evacuation plan ½ hour
o Equipment safety 1 hour - Design a maintenance and 1 hour
calibration plan
o Office safety 1 hour
o Safety during storage 1 hour
o Safety inside the building 1 hour
 Total Quality Management
o Egyptian national standards 1 hour
o Assessment within quality system
- Validation 1 hour Preparing a validation plan 1 hour
- Quality monitoring tools 1 hour
- Error management 1 hour Preparing an SOP on error 1 hour
- Audit and auditing 1 hour reporting
- Audit process 1 hour Developing an audit plan 1 hour
 Microbiology

years Lecture Duration Practical Duration

2nd Year Principles of some laboratory techniques related to transfusion 2 hours Particle agglutination assays 6 hours
medicine:
Screening assays:
- EIA
- Particle agglutination assays
- Simple rapid assays
Enzyme Immuno linked Assays 3 hours ELISA assays (different types) 18 hors
- Antiglobulin EIA
- Competitive
- Sandwich
- Ab. Capture
- Combination Ag/Ab assays
Other screening assays 2 hours
- Microparticle assays
- System assays
- Chemiluminescence assay
- Blots/Line assays
 Equipment and Supplies

Years Topic Type Duration

2nd Year
Types &Principles of Laboratory Equipment used in Blood Bank Laboratory

Centrifuges Theoretical 2 hrs.

(Types, Principle, Uses, Specification &
Maintenance)
Maintenance & Calibration of Centrifuge Practical 2 hrs.
Blood Bank Refrigerators & Freezers Theoretical & Practical 2 hrs.
Agitator Theoretical & Practical 1 hr.
Incubator & Ovens Theoretical & Practical 1 hr.
Data Logger & Thermometer Theoretical & Practical 1 hr.
Blood Sample Collection Devices Theoretical & Practical 2 hrs.
Spectrophotometer Theoretical & Practical 2 hrs.
 Topics covered during the third year:
Blood Donation and Collection

Years Theoretical Duration Practical Duration

3rd Year (1)Donor selection and blood collection 12 hr  Training on Egyptian donor 4 hr
 Review of questionnaire and informed consent selection criteria.
 Confidentiality, self deferral, education and  Training on sample 4 hr
opportunities collection 4 hr
 Preparation of materials and instruments before  Arm inspection, preparation
collection and phlebotomy 4 hr
 Blood container selection (single , double or triple)  Training on blood
and tubes for sample collection, labeling, sealing, 2 hr
 Sample Identification and collection transportation and storage
 Arm inspection and antiseptic measures for  Management of donor
phlebotomy site adverse reactions.
 Balance adjustment
 Blood collection, labeling, sealing and storage of bags
& samples.
 Care of donor before, during and after donation.
 Adverse donor reaction management.
 Documentation.
2) Regular phenotyped donations arrangement for phenotyped  Arrangement for regular donor
appointments for a phenotyped 4 hr
patients.
patients needs
 Blood Components

Years Theoretical Topics Duration Practical Topics Duration

3rd Year Cold Chain and Storage Lesions 2 hrs. Basic Care & Preventive Maintenance of Blood Cold 2 hrs.
Chain Equipments
Basic Care & Preventive Maintenance 1 hr. Quarantine and Release 6 hrs.
of Blood Cold Chain Equipments
Quarantine and Release 2 hrs. Labeling 2 hrs.
Biohazards & Discarded Components 2 hrs. Biohazards & Discarded Components 6 hrs.
Evaluation & Validation of blood Packs 2 hrs. Evaluation & Validation of blood Packs 3 hrs.
Validation of new process 2 hrs.
 TTIs & Red Cell Serology (Immune-hematology)
Year Lectures Duration Practical Duration
3rd Year Pre transfusion Testing 2 hours Immediate spin & antihuman globulin test 6 hours
- Transfusion requests (tube method)
- Blood sample
- Blood serology testing (blood grouping, Ab.
Screening, crossmatch.
- Enhancement techniques
- Detection of Ag-Ab reaction (AHG test & other
methods)
- Selection of units
- Interpretation of antibody screening &
crossmatch
- Electronic crossmatch
- Issuing of blood units
Detection and identification of alloantibodies to
Red Cell Antigens Crossmatching using CAT 6 hours
4 hours
Hemolytic disease of Newborn
- Pre- and post-natal evaluation
- Intrauterine blood transfusion
Immune Hemolytic Anemia
- Direct Antiglobulin Test 4 hours Saline replacement & pre-warming 6 hours
- Auto-immune techniques
- Allo-immune Enzyme technique 6 hours
- Drug – induced
Antibody screening 6 hours
Direct antiglobulin test 6 hours
Antibody identification 6 hours
Antibody Titration 12 hours
Adsorption technique 6 hours
Elution technique 6 hours
 Hematology
3rd Year Platelet disorders 4 hrs Investigations 2 hrs

Coagulopathies 2 hrs Investigations 2 hrs

Thrombophilia 2 hr Investigations 2 hrs

Plasma for Fractionation 4 hrs Practical 4 hrs

BTS at Clinical Interface

Years Topics Duration Practical Duration

3rd Year 1- Handling of blood components in hospitals (storage, 2 Bedside transfusion 6 days x 6
transportation, administration, thawing, warming, practice hours
monitoring)
2- Hemolytic anemias 2 Case study 2
3- Blood alternatives 2 Case study 2
4- Hospital Transfusion committee 2 Review activities of HTC 2
5- Stem cell transplantation 2 Attend session 1 day x 6 hours
6- Estimation of needs and management of blood 2 Exercise 2
inventory
 Total Quality Management and Safety
Years Topics Duration Practical Duration
3rd year  Safety
o First Aid 1 hour First Aid One day / 7hours
o Accident management and accident reporting 2 hour
o Biological and chemical safety 1 hour
o Safety and minimizing risks 1 hour
o Transportation for bio hazardous material 1 hour
o Waste management and Waste reduction 1 hour
 Total Quality Management
o Basic statistics
-Mean , mode , median, range , standard deviation, 3 hours
descriptive statistics, histogram, Normal
distribution curve
o QC 1 hour
o Internal and External Quality assessment schemes 1 hour

Microbiology
3rd year Confirmatory testing 2 hours Confirmatory testing 12 hours
Neutralization 2 hours Neutralization 12 hours
Western blot 2 hours Western blot 12 hours
NAT 2 hours
 Equipment and Supplies

Years Topics Type Duration

3rd Year
Types & Principles of Laboratory Equipment used in Blood Bank Laboratory
Blood Serology Testing Equipment Theoretical & Practical 2 hrs.
Automatic Cell Washer Theoretical & Practical 1 hr.
Automatic Blood Groupers Theoretical & Practical 2 hrs.
Blood Group Gel Theoretical & Practical 1 hr.
Blood Group capture Theoretical & Practical 1 hr.
Blood Warmer & Pump Theoretical 1 hr.
Cell Savers Theoretical 2 hrs.
Cell Separator Theoretical 2 hrs.
Cell Separator Practical 2 hrs.
 Topics covered during the fourth year
Blood Donation and Collection

Years Theoretical Duration Practical Duration

4th Year (1) Special donation categories: 4 hr  Training on Apheresis 2 hr

 Apheresis donation. donation.
o Separation techniques: centrifugation,  Training on different types 6 hr
membrane filtration and adsorption. of Autologus donations
o Component collection, labeling and  Training on notification of 6 hr
storage. blood donation results and
 Types of products collected by apheresis: counseling
PRBCs, plasma, granulocytes, hematopoietic
progenitor stem cells.

(2) Autologous donation: 4 hr

 Preoperative
 Normovolemic hemodilution
 Postoperative
(3) Counseling seropositive donors 4 hr
 Blood Components
4th Year Leuco depletion of blood components 2 hrs. Leuco depletion of blood components 2 hrs.
with Demonstration
Irradiation of blood components 1 hr. Quality monitoring of leukodepleted units 2 hrs.
Washing of Red Cells 30 min Irradiation of blood components 1 hr.
Splitting & Pooling 30 min Washing of Red Cells 1 hr.
Methylene blue Treatment 1 hr. Splitting & Pooling 1 hr.
Documentation & Traceability in Blood 1 hr. Documentation & Traceability in Blood Components 2 hrs.
Components
Fractionation of plasma 2 hrs.
Problem Solving (Discussions) 2 hrs.
Fibrin glue preparation – storage

TTIs & Red Cell Serology (Immune-hematology)

Year Lectures Duration Practical Time

Platelets & Granulocyte antigens and 2 hours Cases of transfusion reaction 6 hours
antibodies
Alloimmunization to platelet Ags & prevention
HLA System, function, genes, antigens, 2 hours Evaluation & validation of immune- 12
antibodies and tissue grafting hematological reagents hours
4th Year
Poly agglutination 2 hours
Investigation of transfusion reaction 2 hours
New technology in transfusion medicine 2 hours
Immunofluorescence
Platelet cross matching
 Hematology

Years Theoretical Duration Practical Duration

Myeloproliferative disorders 6 hrs Investigations 2 hrs

Lymphoproliferative 6 hrs Investigations 2 hrs
disorders
Bone Marrow 4 hrs 2 hrs
4th Year Transplantation
Investigations

B.M Films 4 hrs

Slides of Hematology cases 4 hrs

 BTS at Clinical Interface
4th Year 1- Adverse transfusion reactions 2 hrs Investigation of adverse 2 days
reactions
2- Hemovigilance 2 hrs Adverse reactions reporting 2 days
system
3- Therapeutic apheresis 2 hrs Attend session 1 day x 6 hours
Transfusion therapy in selected clinical conditions : 2 hrs Review and evaluate blood 2 days
request form
4- in pediatrics and neonates 2 hrs Case study 2 days
5- in coagulopathies and hemoglobinopathies 2 hrs Case study 2 days
6- in organ transplantation 2 hrs Case study 2 days
7- in liver and renal diseases 2 hrs Case study 2 days
8- in obstetrics 2 hrs Case study 2 days
9- in oncology and marrow failure 2 hrs Case study 2 days
 Total Quality Management and Safety
o Estimation of needs ½ hour
o Stock management 1 hour
o Role of regulatory agencies 1 hour
o Risk Management 1 hour
o Selection of indicators 1 hour
4th year
o QC charts 1 hour
o Variability 1 hour
o Types of data 1 hour
o Drawing simple control chart 1 hour
o Determine the process status 1 hour

Microbiology
Selecting screening assay 2 hours
- Sensitivity
- Specificity
4th year Evaluation & validation of assays 2 hours Evaluation & validation of 18
assays hours
PCR 2 hours
Cultures
 IT Applications in transfusion medicine

Years Theoretical Duration Practical Duration

4th year  Overview 1 hours  Basic skills enhancement (for those

 IT & medical applications
 BMS snapshot
 International BTS web sites
who don’t have ICDL certificate)
 Word processing
 Database
 Presentations
 Internet
 Networking
30 min  Practical training
Accessing, data entry, report generation,
backup and restore of:
 Donation system
 Issuing system
 Hospital blood banks system
 Statistics and daily report system
 Therapeutic unit system
30 min  Navigating through web site
15 min

 NBTS workflow 15 min

 IT organization in NBTC & 15 min

RBTC’s
 IT responsibilities 15 min
 SW applications: 45 min
 Donation system
 Issuing system
 Hospital blood banks system
 Warehouse system
 Statistics and daily report system
 Therapeutic unit system
 Medical equipment repair and
calibration system
 Bar code system
 NBTS WAN & RBTC LAN’s 30 min

 Security policy 15 min

 Disaster recovery plan 15 min

 Quality assurance 15 min

- Procedures
- Forms
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