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NTClinical

UPDATE

The role of nurses in blood


services and donor sessions
Authors Davina Potok, RN, DMS, is nurse anaemia and those with burns. Regular red cell
manager, Bristol Donor Centre; David Chandler, transfusions play a vital role in the treatment of
BA, is communication officer, National Blood patients with sickle cell anaemia and those
Service (NBS). with aplastic anaemia.
Abstract Potok, D., Chandler, D. (2005) The
role of nurses in blood services and donor ses- Platelets
sions. Nursing Times; 101: 23, 24–25. Platelets allow the blood to clot and are essential
On 14 June the National Blood Service (NBS) is for cancer patients who undergo chemotherapy.
hosting World Blood Donor Day (WBDD). The During chemotherapy the bone marrow (which
need for blood is universal and many people makes blood cells) is damaged. If the patient is
know of someone who has required blood to not given regular platelet transfusions, the slight-
save or improve her or his life. The nurse is clini- est knock can be fatal. Patients with burns can also
cally responsible for the donation session, with benefit from platelet transfusions.
the care of donors and the safety of the blood
being their main priority. Plasma
Fresh frozen plasma is used after obstetric loss
On 14 June the National Blood Service (NBS) is of blood (usually in childbirth), during cardiac sur-
hosting World Blood Donor Day (WBDD). The event gery and to reverse any anticoagulant treatment.
commemorates the birth of Karl Landsteiner who It is also used to replace clotting factors following
discovered the ABO blood group system and offers massive transfusions.
an opportunity for blood services across the world
to recognise voluntary, non-remunerated donors Blood collection
for their contribution to saving lives. WBDD is co- The demand for blood never ceases. Last year the
sponsored by four organisations that work for the NBS collected 2.3 million donations of blood from
global provision of safe blood – the World Health just over 1.3 million voluntary donors (National
Organization, the International Federation of Red Blood Service, 2004).
Cross and Red Crescent Societies, the International When donors arrive at a blood donor session
Federation of Blood Donor Organisations and the they are asked to complete a donor health-check
International Society of Blood Transfusion. form, which asks questions on lifestyle, medical
and travel history. New donors and those who
Access have not given blood in the last two years will also
Most of the world’s population does not have ac- talk through the health check in more detail, in a
cess to safe blood. More than 80 million units of confidential area, with a nurse or donor carer.
blood are donated every year around the world Providing the donor is suitable, a test will then
but only 38 per cent is collected in developing be carried out to make sure that she or he is not
countries where 82 per cent of the global popula- anaemic and has a haemoglobin level high enough
tion live (World Health Organization, 2002). to ensure that donating will not result in anaemia.
Haemoglobin levels are checked using a tiny drop
The use of blood of blood taken from the fingertip.
The need for blood is universal and many people Before the donation takes place, a sample of
NT Clinical is an essential know of someone who has required blood to save blood is taken for both blood grouping and viral
or improve her or his life. Blood contains three testing in the laboratory. About 470ml of blood is
resource for extending
main components that are routinely used to treat taken (just under one pint).
your knowledge base. You many different types of patient – red cells, plate- The body usually makes up the fluid from the
can achieve your lets and plasma. donation within a couple of hours but the red cells
continuing professional may take up to two or three months to fully re-
Red cells place (Janetzko et al, 2001). The donation process
development PREP
Red cells are essential for replacing lost blood after can take anything from 5 to 20 minutes and is au-
requirements by reflecting events such as accidents, surgery and childbirth, as tomatically stopped once the blood pack reaches
on these articles. well as for preoperative top-ups for patients with the desired weight.

NT 7 June 2005 Vol 101 No 23 www.nursingtimes.net


keywords n Public health n Blood n Donation

Blood donation facts and figures ing that new and essential policies are put into References
practice. It is important that any changes are man-
l The NBS needs to provide 8,000 units of
aged competently and accurately and with as little Janetzko, K. et al (2001) The effect of
blood every day to the 310 hospitals in moderate hypovolaemia on microcircula-
disruption to blood stocks and the relationship
England and North Wales that it supplies. tion in healthy older blood donors.
with donors as possible.
l Only 6 per cent of the eligible population The testing system plays a very important role in Anaesthesia; 56: 103–107.
are blood donors. ensuring a safe blood supply for patients. Blood is
National Blood Service (2004) National
tested for both blood grouping and for infections
l An average district general hospital uses Blood Service Annual Report. Available
that can be passed from a donor to a patient via
between 6,600 and 9,000 units a year and a at: www.blood.co.uk/pdfdocs/annual_
large hospital uses between 18,000 and blood transfusion. The NBS carries out mandatory report_2004.pdf
30,000 units a year. virology tests for syphilis, hepatitis B, HIV 1 and 2,
hepatitis C, and human T-cell lymphotropic viruses World Health Organization (2004)
l More than 95 per cent of blood collected is (HTLV) 1 and 2. Global Database on Blood Safety
processed into its main components – red Supplementary tests are carried out on selected 2000–2001. Summary Report.
cells, platelets and plasma. Red cells last donations, either because of information provided Geneva: WHO.
only 35 days and platelets only five days.
by the donor or to meet the needs of certain pa-
l There are currently about 1.8 million tients. These tests include malaria testing, sickle
registered blood donors who give about 2.3 haemoglobin screening, more detailed blood
million units of blood each year. grouping and, very occasionally, tests for other rel-
evant proteins in the blood.
l Each unit of blood collected is 470ml – just
The range of blood tests carried out by the NBS
under one pint.
is under regular review and other tests may be
l To become a donor you must be aged from introduced in the future.
17 to 60, weigh over 7st 11lb and be in
general good health. The role of the nurse
l For further information about becoming a The nurse is clinically responsible for the donation
blood donor, call 0845 7 711 711 or visit the session, with the care of the donors and the safety
www.blood.co.uk website. of the blood being their main priority. It is also the
role of the nurses to supervise the donor carers,
who carry out a function similar to that of health
The blood packs contain an anti-coagulant, care assistants in hospitals, and to ensure they de-
which ensures that the blood does not clot once it liver a first-class service.
has left the body. It is then heat-sealed and stored As well as providing clinical leadership for the
at body temperature before being sent along with teams, nurses are also required to provide medical
the sample to an NBS blood centre where it will be assessment expertise and have a critical role to
processed, tested and then issued out to one of play in the care and selection of donors. A donor
the 310 hospitals the centre supplies. carer will assess the suitability of the donor to a
certain level but the nurse will provide advice re-
Screening procedures lating to more complicated medical and travel is-
The focus of all donor selection is safety, both for sues. Making critical medical decisions regarding a
the donor and the recipient. It is often necessary donor’s suitability to donate requires extensive
for donors to discuss intimate health or lifestyle- training and medical knowledge.
related issues to ensure that they are suitable. No NBS nurses also help to educate both nurses
risks can be taken, so if the donor is unsure of any- and medics from hospitals, thus improving their
thing, the NBS will not take a donation. knowledge about blood products and their uses.
It is important to remember that an enthusiastic Informal training like this takes place through
donor will, on occasion, find it difficult to accept building up good links between the NBS centres
that she or he cannot donate. It is the role of the and hospitals.
nurse to be sensitive to donors’ needs and to en- Most NBS nurses work in donation collection.
sure that they are motivated to return at a later However, they also have a number of other critical
date if they can. roles. The NBS employs nurses to support hospitals
If the volunteer cannot return it is important that to ensure blood is used as safely and as appropri-
the nurse clearly communicates the reason for the ately as possible and some NBS nurses are also in
decision and shows appreciation for the effort that a position to be able to directly influence patient This article has been double-blind
the person has made to help others. care. In some regions the NBS provides a thera- peer-reviewed.
Changes are made regularly to the donor selec- peutic apheresis service for their local hospitals. For related articles on this subject
tion guidelines so nurses face the challenge of The NBS also has both tissue bank nurses and re- and links to relevant websites see
keeping up to date with the guidance and ensur- search nurses. n www.nursingtimes.net

NT 7 June 2005 Vol 101 No 23 www.nursingtimes.net 25