Rakta Kranti Annual Report 2013-14

The Rakta Kranti team of Sankalp looks to organize safe and high quality blood donation drives all through the year. Back in March 2007, when this was started the aim was to create a movement to push Karnataka towards 100% voluntary blood donation. Here we bring to you what direction was taken up by Sankalp in the last 1 year for Rakta Kranti.

Rakta Kranti aims at organizing efficient and well-managed donation drives with standards that are comparable to the best in the world. We bring to the donor all the information relating to blood donation that makes him/her absolutely comfortable and confident about the process.

There were 2 broad level goals set for the project.

• First is to work towards an increased number of blood donation drives in periods of extreme shortage summer months from May to July and again during the winters. This ensures that supply of safe blood is not hit during peak requirements. In terms of statistics, the aim was to bring in 100 or more blood donation drives and target a collection of 10,000 units.
• Second is to build a framework for better quality in blood donation drives better pre donation and medical screening techniques, better management of complications, an eye towards non compliance of teams, more training programs etc.

BRINGING A PROGRAM COORDINATOR ON BOARD

Blood donation drives over the years have changed. Today many donors are well aware of the processes and their concern towards hygiene and quality is high. Donor retention is a challenge anyone would like to come back to donate in subsequent drives only if the current donation process is smooth and hassle free. Last year, for Rakta Kranti apart from aiming for 10,000+ units to be collected there was a significant amount of effort channelized towards improving the overall quality of blood donation drives.

A step taken up in this direction was to have onboard a full time program coordinator for Rakta Kranti. The person has the dual responsibility of visiting and convincing more organizations to conduct voluntary blood donation drives and also attend every drive to ensure that there are no compromises in quality. This person joined us on 1 September 2013.

THE NUMBERS FOR LAST YEAR

1. A total of 139 blood donation drives were organized with 11,318 units of blood collected from 13,843 willing donors. This was a 35% increase in count compared to the previous years figures. Also there were 35 more drives than previous year.
2. Blood donation drives were organised in 75 institutions. 41% (31) were first time drives and 59% (44) were retentions or repeat drives. Of this, atleast 29 organisations were such that drives were organized for the first time at their premises.
3. 5369 (47.5%) units of blood were collected by Government blood banks, 4906 (43.3%) units were collected by voluntary blood banks, 1043 (9.2%) by hospital based blood banks.
4. In line with the goal to have more drives in specific months, the team worked to bring in 5400+ units in 4 summer months from April - July 2013 and 2800+ units in 3 winter months from mid November to mid February.
5. More than 120 new organizations were visited with a view to align them to the blood donation program.

EFFORTS TOWARDS BETTER MANAGEMENT OF ADVERSE EVENTS

A total of 440 adverse events were recorded last year in our blood donation drives. This means about 3.9% of donors who donated had one or more problem post donation that needed attention and management. Of these 274 donors had a vasovagal syncope (delayed or immediate), 122 donors had a delayed bleeding instance from the site of phlebotomy, 22 donors developed a hematoma/pain in the arm and 6 others had different conditions including headache, stomach ache, pain behind the year etc. Although statistically speaking these numbers show a sharp increase compared to previous years, it is only for the first time that a dedicated effort was put in place to identify all types of adverse events and record them.

Already we focus on very strict compliance to policies and standards laid down in the Drug Controller Gazette and National Blood Policy. A few more changes were brought in with a view to arrest the rate of adverse reactions. These include:

• It was seen that when donors are suggested to have 200ml or more quantity of water immediately before donation, the chances of vasovagal syncope reduces significantly. Now, in our drives this has become a common routine.
• It was also realized that if a strong adhesive tape/plaster is used to hold the needle in place during phlebotomy, the chances of the donor having an arm injury or hematoma. This too is being strictly enforced now.
• Only well trained and selected technicans /staff nurse are involved in bleeding donors. This means that the person who is closest to the donor is well aware of the problems and the solutions in case of adverse events.
• Effective mechanism to capture intricate details of complications. A special form that is used for hemovigilance on donor side by some international institutions is in use.
• Every donor who has an adverse reaction gets a follow up call from our volunteer to check his/her well being. This ensures that any complications after leaving the donation area are also recorded.

BUILDING COMPLIANCE TOWARDS QUALITY NORMS

Sankalp Rakta Kranti has been promising organizations that there shall be a great concern towards hygiene and quality in every aspect of the drive. A discussion on similar lines have been held several times with blood bank medical officers. In order to understand the gap between promises made and the ground realities, non compliance on quality parameters have been recorded for our blood donation drives.

Occurrence

These have been discussed in detail with blood banks and volunteer teams. Efforts are in place to align them to build a standard working practice to have a safe and quality compliant blood donation drive.

OTHER WORK AREAS OF LAST YEAR

I. Technology usage

Sankalp uses a customised web portal that was used to track blood donation drives. This was upgraded with several enhancements leading to easier management of blood donation drives. This has also helped in designing customized reports for blood banks and camp organizers. An application for registration of donors in blood donation drives was also designed and launched last year.

II. Focus on IEC campaign

It was seen that in most small institutions, the turnout was really good. This can be attributed to the fact that efforts were put in place to speak to potential donors before the drive and motivate them. However, in many big institutions, specially corporate organizations this has been quite difficult. Special efforts are now being put in place to have more effective IEC campaigns in such organizations. Increased awareness is also planned in repeat drives as we saw a decline in turnout in repeat drives.

III. Paper on Non Compliance

A paper on non compliance against established norms was also published by the team. It goes on to show how poor compliance to standard norms can affect the overall ambience and quality in blood donation drives.

IV. Adverse Donor Reaction Handling Protocol

After a lot of research and consultation with experts a protocol to handle adverse reactions was developed. A training program to build compliance to this protocol was also planned. This protocol has been published in a series of articles in the Patrika over the last 6 months making it open for all.

The plans have already been drawn for the new year. We do realize the responsibility of making safe blood available at all times of the year. As we set our sights towards 16,000 units of blood to be collected this year, we also believe that a lot of ground work needs to be done to reduce the rate of reactions from 3.9% to 3% or below, we also believe that non compliance must be reduced from 1.68 per camp to 1.2 or below. The road ahead is very hard, but we need to take this path as this is the only way Rakta Kranti take the state towards 100% voluntary blood donation.