The Most Precious Resource at the New Britain General Blood Bank
New Britain [January 25 2006] -
“We never see the patient, but we never lose sight of the fact that we are responsible for their care.”
The New Britain General Hospital blood bank is a bank only insofar as it is a secure facility to store blood; there the analogy ends. The bank’s assets, while precious, are donated by volunteers from all walks of life. Withdrawals are tightly monitored and regulated, but are given to anyone in need. Strict safeguards are in place 24/7 to protect it, much as if it were gold. To those that need blood, however, it is more valuable than gold.
“I view our role as a caretaker of a precious product donated by volunteers,” says David Krugman, MD, director of the blood bank and associate director of pathology. “It’s our job that those are safely and appropriately given to people in need.”
The New Britain General blood bank is technically referred to as a transfusion service, differentiating it from the Red Cross in Farmington, which collects and distributes blood products. The hospital’s main source of blood products is the Red Cross, which receives the large majority of its blood from donors within Connecticut. The Red Cross will in fact hold a blood drive for hospital staff and volunteers in the next week. (Dr. Krugman proudly notes hospital employees donated close to 90 pints in a recent drive.)
The hospital blood bank manages the transfusion of blood — obtaining the blood products needed, matching it appropriately to patients in need, and getting it to them.
In the past year, the NBGH blood bank transfused more than 10,000 blood products. This means that 10,000 units of blood products were processed through the blood bank’s lab and matched to a patient in need. The blood bank supplies all parts of the hospital (such as the operating room, emergency department, or ambulatory surgery unit) as well as the Hospital for Special Care, and NBGH-affiliated dialysis centers in Newington and Forestville.
Whole blood is rarely given anymore; the exception would be an autologous donation, or donation to oneself. Blood is “fractionated” or broken down into several parts — red cells, white cells, platelets, plasma, cryoprecipitate, and manufactured blood products, such as albumin. Patients are given only the part they need.
All blood and blood products go through extremely rigorous testing, beyond initial quality control imposed by the Red Cross at the time of collection. Blood must be matched for use by a specific patient far beyond simple blood type; blood is tested for antigens and antibodies. Blood products are also treated in some cases depending on the patient’s needs — for instance blood may be irradiated before being given to a chemotherapy patient.
To do this testing, the blood bank has 10 medical technologists, including Blood Bank Supervisor Cynthia Albert: Janet Collins, Jean Dakin, Jody Mills, Rosalind O’Brien, Kristen Olson, Joan Piercey, Dominic Rauti, Orlando Rosario, and Barbara Tanski. They cover all three shifts 365 days a year. There’s a dedicated blood bank technologist on first and second shift; on third shift, there are generalists who also work in other parts of the hospital laboratory.
One of the challenges for the work of the blood bank is to make sure there are adequate products.
“Our job is to provide appropriate blood products that appropriately match the individual.
Red Cross provides blood that has been screened for infectious diseases, including HIV, hepatitis, and others,” says Dr. Krugman. “I feel 100 percent confident that it’s been tested with the most up to date tests available. The risk of disease transmission is very small, but it is not zero. One of the jobs of the blood bank is to minimize the transmission of infectious diseases. That’s why our technologists have to be very good.”
The blood bank recently received its two-year accreditation from the American Association of Blood Banks (AABB). “The AABB’s accreditation procedures are voluntary,” said Cynthia Albert, blood bank supervisor. “It is extremely important to have this accreditation because it tells the public that we are adhering to the highest standards of excellence in dealing with blood products. This is essential to the highest quality of patient care.”
The blood bank, or transfusion service, Albert notes, is also inspected and approved by the State of Connecticut, the Food and Drug Administration, and the Nuclear Regulatory Commission, in addition to meeting the standards of the Red Cross. The blood bank has been continuously accredited by the AABB since 1972.
“One of the biggest challenges for any blood bank — and I think we’re very fortunate — is to have a qualified technical staff – and those that are particularly attracted to blood banking,” says Dr. Krugman.
Cindy Albert emphasizes the responsibility of the staff. “We treat patients. There is a fair amount of stress in ensuring a safe match and getting it to the patient in a timely way.”
“What the technologist does is challenging – there is no machine that makes the final decision. And no one loses sight of the fact that we’re treating patients; whatever we send them is transfused into a patient and would have an immediate affect if it’s not right.
“Our staff is great,” says Albert. “They never lose sight of the fact that we’re caring for patients. In blood bank, we know we have a role in patient care, every day. We don’t see the patient, but we never lose sight of the fact that we have a very important role in their safety and care.”
Albert tells of an elderly woman who the blood bank staff “knew” for two years. They had never seen or met her, but they knew she needed regular transfusions. When the patient died, her family asked that all memorial gifts go to the blood bank. A note came from the patient’s daughter; she wrote, “Thanks to you, we had our mom for two more years.”
“We were all very touched,” Albert says. What makes her proud, she says, even after 34 years with the blood bank, is “seeing that patients receive the care that they need. I am always proud of the work that the staff does every day.”
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