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KENYA BLOOD TRANSFUSION SERVICES

BRIEF
GUIDELINES-DONOR SERVICES

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HANDOUT OF SESSION PREPARATION:

APPROPRIATE/ACCURATE
DONOR EDUCATION MATERIALS:
All medical eligibility questions
should be referred to NBTS staff
(team leader).
Leave for the session not later than time
out (See donor recruiters flowchart)
Obtain/review Donor Session
Worksheet/Timetable:
Contains session/prior
DONOR EVALUATION Mini
session information and
physical examination is
projections; distance;
performed as per SOP. Donor
directions and road
is deferred appropriately as
conditions; site
per sop, and deferral
contacts/description; and any
documentation/ information
completed
Prepare/pack mobile vehicle
according to mobile session
checklist DONOR CONSENT:
Review, master card
followed by signature/date
of donor and date of
donation then evaluate as
per SOP

Upon arrival at mobile site, Donor moves to collection

persons in charge are bed where phlebotomist
contacted by the team leader verifies donor/blood bag
IDs, reviews questionnaire
and any documentation
present as per SOP(s)

Set up collection area according to Team

Leaders assessment/instructions

(JOB AIDE) Phlebotomist selects

vein and prepares the
site appropriately and
performs
The team leader creates rapport with the
donors and address any issue arising VENIPUNCTURE: as
from donor mobilisation by the recruiter. per SOP

DONOR QUESTIONNAIRE: Completed

only by NBTS-trained staff as per SOPs;
Process explained to donor and donor
questions answered and terminologies
explained simply

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CHECKLIST

1. Laboratory Coats/Dust Coats 23. Blood weighing scale

2. Rubber gloves
3. Pair of scissors
4. Beakers (100mls/50mls)
5. Master cards/Donor
Questionnaires
6. Record books/Registers
7. Donor weighing scales
8. Blood pressure machine(s)
9. Copper sulphate
haemoglobin estimation
(working solution)
10. Blood Lancets
11. Capillary tubes
12. Stickers (Labels)
13. Blood bags
14. Vacuitainers 4-7ml
15. Tube racks
16. Gauze
17. Portable plastic chairs and
tables
18. Dry cotton swabs
19. Skin disinfectants
20. Strapping
21. Tourniquets
22. Squeeze balls
24. Pilot tube sealers/strippers
25. Donor beds/donor chairs
26. Phlebotomy trays (contents as
per job aide)
27. Mackintosh
28. Pillows
29. First Aid box
30. Bed sheets
for 31. Mattresses
32. Blankets
33. Fluids for donor refreshment
34. Bottle opener
35. Towel for wiping sodas
36. Snacks for donors
37. Donor awards (if available)
38. Cool boxes
39. Ice packs
40. Max min thermometers
41. Hypochlorite solution
42. Waste baskets and bin liners
43. Sharps containers (Safety box)
44. Rubber bands
45. Bar soap.
46. Water
47. Clips/artery forceps

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PREPARATION OF BLOOD DONATION SITE

1.0 PROCEDURE
1.1 Identify the ideal donation site which should be:
Clean
Spacious
Well lit
Well ventilated
1.2 Identify the donor selection site
1.3 Identify and prepare donor evaluation site.
1.4 Identify and prepare site for hemoglobin estimation
1.5 Identify and prepare site for registration
1.6 Strategically position the waste disposal receptacles (bleeding area, cutting area, refreshment area and Hb
estimation area)
1.7 Assemble and arrange the donor chairs/donor beds
1.8 Set the phlebotomy trays (refer to job aide).
1.9 Set-up a cutting table (refer to job aide).
1.10 Strategically position the sharp disposal tins / safety boxes at hemoglobin estimation site and cutting area.

PRE-DONATION COUNSELING AND DONOR DEFFERAL

SEE ATTACHED QUESTIONAIRE FORM

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HB ESTIMATION BY COPPER SULPHATE METHOD

1.0 PURPOSE-To provide a procedure on how to determine hemoglobin levels of blood donors using Copper Sulphate
method.
2.0 SCOPE-To ensures the determination of blood donors hemoglobin levels using Copper Sulphate method are performed
correctly.
3.0 REFERENCE
3.1 KNBTS SOPs 1st Edition 2003
4.0 DEFINITION-HB: Haemoglobin.
5.0 RESPONSIBLE PERSON-Laboratory Technologist/Technician
6.0 EQUIPEMENT-
7.0 PROCEDURE
7.1 Prepare tray as per job aide. Fill beaker full with Copper Sulphate working solution.
7.2 Explain procedure to donor
7.3 Clean finger.
7.4 Select site for pricking pulp space on top or side of the finger.
7.5 Hold swab and place spirit on it.
7.6 Grip donors middle finger between your thumb and your second third fingers of your left hand or right hand if left
handed.
7.7 Clean the area selected.
7.8 Prick the skin with lancet, squeeze and wipe off the first drop. Do not squeeze repeatedly as this may dilute the
blood and lower Hb.
7.9 Fill the capillary tube full with blood, avoid letting air into the capillary tube.
7.10 Hold the capillary tube straight 1 cm above beaker of copper sulphate and allow a drop of blood onto Copper
sulphate. It is important not to shake the capillary tube to assist the drop. Give the drop no more than 10 seconds
to sink.
7.11 If the drop of blood floats, Hb is inadequate, if the drop sinks, Hb is adequate. Donor with inadequate Hb must be
appropriately deferred.
7.12 Copper sulphate solution should be changed after every 50 tests and every day. (Change copper sulphate solution
after every 50th test if using 100 ml beaker and after every 25th test when using 50 ml beaker).
8.0 DOCUMENTATION-Master Card
DONOR REGISTRATION
1.0 PURPOSE-To provide a procedure for proper registration of donors
2.0 SCOPE-To ensure that donors are registered properly
3.0 REFERENCE
3.1 AABB Technical Manual, 14th Edition
3.2 KNBTS SOPs 1st Edition 2003
DEFINITION-Regular donor: One who donates at least every six months.
4.0 RESPONSIBLE PERSON-Clerk
5.0 EQUIPEMENT-Not applicable
6.0 PROCEDURE
6.1 Clerk fills the venue register accordingly.
6.2 Clerk receives donor after evaluation.
6.3 Clerk records donor demographics in the clinic register.
6.4 Clerk confirms that there is no damage and also confirms the expiry date of the blood bag.
6.5 Clerk sticks the donor labels on the:
6.5.1 Clinic Register
6.5.2 Lab Register
6.5.3 Master Card

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PERFORMING VENEPUNCTURE
1.0 PURPOSE: to provide procedure on how to perform venepuncture
2.0 SCOPE: to ensure venepuncture is performed correctly.
3.0 REFERENCE
3.1 AABB Technical Manual, 14th Edition
3.2KNBTS 1st Edition 2003
5.0 RESPONSIBLE PERSON- Phlebotomist
6.0 PROCEDURE
6.1 Welcome the donor
6.2 Confirm the labels on the vacuitainers, blood bags and master card
6.3 Inspect the bag for any defects and discoloration
6.4 Confirm expiry date on the bag, apply pressure to check for leaks
6.5 Prepare donors arm as follows; Apply tourniquet, identify venipuncture site and clean thoroughly with antiseptic
solution. Cotton swabs are used and wiped inside out in circular movements.
6.6 Position the blood bag below the level of the donors arm; hang on the spring scale at the side of the chair or bed.
6.7 Clip the tubing using the provided clips, remove the needle protection and perform venepuncture with the bevel up,
release the clipping. When the needle position is acceptable and blood is flowing freely into the tubing, tape the
tubing onto the donors arm to hold the needle in place.
6.8 Ask the donor to squeeze the ball slowly every ten to twenty seconds during collection
6.9 Mix blood and anticoagulant gently and periodically (approx. every 45 sec) during collection. Unit should take up to
15 minutes to fill.
6.10 Monitor volume of blood being drawn. Stop bleeding when correct weight is achieved (450mls).
6.11 Clip tubing, remove tourniquet, remove needle from arm, apply pressure over swab and have donor raise arm
over elbow straight and hold swab firmly over phlebotomy site with the other hand.
6.12 Unclip and fill the vacuitainers for blood processing samples without contaminating contents of the bag by
inserting the needles into the vacuitainers one at a time.
6.13 Seal the tube using the hand sealer, cut and discard needle into the biohazard container.
6.14 Place blood unit at an appropriate temp.
6.15 Lower arm and apply pressure dressing.
6.16 Release donor for refreshment and continued post donation care after resting in bed for at least 5 mins.
POST DONATION CARE
1.0 PURPOSE-To provide a procedure for proper post donation care.
2.0 SCOPE-To ensure proper post donation care is given.
3.0 REFERENCE
3.1 AABB Technical Manual, 14th Edition
RESPONSIBLE PERSON -Nurse/Phlebotomist.
4.0 EQUIPEMENT-Not applicable.
5.0 PROCEDURE
5.1 Check arm and apply bandage after bleeding stops.
5.2 Have donor remain reclining on bed or in donor chair for 5-10 minutes under close observation by Phlebotomist.
If the donor gets adverse reaction or faints, refer as per job aide.
5.3 Allow donor to sit up when his/her condition appears satisfactory and monitor as he/she resumes upright
position and walks to refreshment area.
5.4 Allow the donor to sit in a comfortable position for refreshment (fluids).
5.5 Give the donor post donation instruction card before leaving the donation site.
5.6 Thank the donor for an important contribution and encourage him/her to come back after 3-4 months (refer to
SOPs on donor retention).

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BLOOD PACKAGING AND TRANSPORTATION

1.0 PURPOSE-To provide an appropriate procedure for packing and transportation of whole blood to the center.
2.0 SCOPE-To ensure that blood units are packed and transported at appropriate temperatures to maintain viability of
components.
3.0 REFERENCE-AABB Technical Manual, 14th Edition
4.0 RESPONSIBLE PERSON-Team Leader.
5.0 PROCEDURE
5.1 Put blood units in a cool box in an upright position allowing room for air circulation.
5.2 Rubber band the minimum and maximum thermometer in between two units of blood (Temperature should be
maintained at between + 2oC - + 10oC.
5.3 Put a piece of carton box on top of units and then place ice packs above avoiding direct contact between the
blood units and ice packs.
5.4 Seal the cool box and transport to the centre within 12 hours of collection.
5.5 Units for Fresh frozen plasma (FFP) preparation to be delivered to the centre within a maximum of 6 hrs. of
collection.
5.6 Units for platelet preparation to be transported in cool boxes without ice packs (between temperatures + 20 - +
24oC) and to be delivered to the centre within a maximum of 6 hrs. of collection.
5.7 Pack the blood into the vehicle and leave the station
5.8 On arrival at the center, unpack the blood and samples from the vehicles
5.8.1 Turn in blood and samples to cold room.
5.8.2 Turn in records to the relevant departments
5.8.3 Turn in supplies and equipment to the store.
5.8.4 Vehicle is packed at the designated packing yard.
6.0 DOCUMENTATION-Temperature Charts

APPENDIX
APPENDIX I
FIRST AID
FAINTING
a. Apply cold compresses to the donors forehead or back of neck.
b. Place donor on their backs and elevate the lower limbs
c. Loosen tight clothing.
d. Be sure donor has an adequate airway
e. Monitor blood pressure, pulse and respiration periodically until donor recovers.
NAUSEA AND VOMITING
a. Make the donor as comfortable as possible.
b. Instruct to breath slowly and deeply.
c. Apply cold compresses to forehead or back of neck.
d. Turn head to side.
e. Provide vomit receptacles.
f. Give water after vomiting has ended to rinse mouth.

TWITCHING AND MUSCULAR SPASMS

a. Divert attention by engaging in conversation.
(To interrupt hyperventilation pattern)
b. Have donor re-breath in paper-bag if symptomatic

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HAEMATOMA
a. Remove tourniquet and needle.
b. Place 3 or 4 gauze squares over the site and apply firm digital pressure for 7-10 minutes with arms raised.
c. Apply ice for five minutes if desired.
NB: Convulsions and cardiac difficulties Try to position donor in recovery position and call for help immediately. (Calm and try to
prevent injury to the donor and yourself; use emergency kit).
1. APPENDIX II

CUTTING TABLE
a. Portable table
b. Mackintosh
c. Test tube rack
d. Pair of scissors
e. Sharps container /Safety box
f. Gauze
g. Dsinfectant e.g. 2% glutaraldehyde, savlon, hypochlorite solution, alcohol, etc.
2. APPENDIX III
PHLEBOTOMY TRAY
a. Skin disinfectant
b. Strapping
c. Squeezing balls
d. Tourniquets
e. Dry cotton swabs
f. Blood weighing scales
g. Clips
h. Gloves
i. Pair of scissors.
j. Gauze pads.
3. APPENDIX IV
ADVERSE REACTION REPORT

DATE:________________ INSTITUTION:___________________________

NO NAME DONOR NO. TYPE OF ACTION REMARKS RESPONSIBLE

REACTION TAKEN OFFICER

1
2
3
4
5

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KENYA NATIONAL BLOOD TRANSFUSION SERVICE-STANDARDS

5.2 Information, Consent and Notification
5.2.1 Donor Identification
Blood collection facilities shall obtain the donors name, date of birth, identification (where
applicable), telephone number (where applicable), and occupation. For repeat donors, the blood
collection facility shall confirm the donors identity and compare current information to existing
records for accuracy.

5.2.2 Donor Education

The blood bank or NBTS shall have procedures to ensure that the following requirements are met
for all prospective donors:
1) Donors are given educational information regarding, donor selection criteria, the donation
process, and infectious diseases transmitted by blood transfusion.
2) Donors acknowledge that the educational information has been received and understood.

5.2.3 Donor Consent

The blood bank shall ensure that donors understand the donation process and agree in writing to
the donation process prior to donation. The following issues shall be addressed in the agreement:
1) What tests will be performed on their donated blood;
2) Under what circumstances they will be informed of test results;
3) Donor specific information shall not be shared with third parties without appropriate consent.
4) Donors shall be provided with appropriate post-donation advice, care, and information about
possible donor adverse events.

5.2.4 Donor Notification of Abnormal Test Results

Donors shall be informed of any medically significant abnormality detected during pre-collection
evaluation or as a result of laboratory testing. Donors shall be entitled to receive testing results
which shall be ready within 30 days of donation.

5.2.4.1 The blood bank shall provide counseling or referral for a

donor who has any positive or confirmed reactive infectious disease marker.

5.2.5 Donor Test Results

Donor test results shall be maintained in a confidential manner and in conformance with the laws
of Kenya.
5.2.6 Information About Donors
The blood bank or transfusion unit shall have a process for managing post-donation information
received from the donor or a third party about a donors suitability.

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5.3 Care of Donors

5.3.1 The collection facility shall have a policy to ensure that the donor qualification process is private
and confidential.
5.3.2 The donor shall be observed closely during the donation and for no less than 20 minutes
thereafter.
5.3.2.1 The collection facility shall have a process for the management of donor adverse events
and the provision for availing emergency medical care, as necessary. Immediate assistance
and the necessary equipment and supplies shall be available.
5.4 Donor Qualification
On the day of donation and before collection, the prospective donors history shall be evaluated and the
donor examined to minimize the risk of harm to the donor and the potential recipient. The prospective
donor shall meet all donor qualification criteria. Additional donor qualification procedures (such as those
in the Policy Guidelines on Blood Transfusion in Kenya, 2001) may be incorporated by reference.
5.4.1 Donors shall attest that they have provided accurate information.
5.5 Blood Collection
5.5.1 Methods
Blood shall be collected into a sterile closed system.
5.5.2 Protection against contamination
The venipuncture site shall be prepared so as to minimize risk of bacterial contamination.
5.5.2.1 Every collection site shall have a sharps disposal container.
5.5.3 Samples for Laboratory Tests
At the time of collection or component preparation, the integral donor tubing shall be filled with
anticoagulated blood and sealed in such a manner that it shall be available for subsequent
compatibility testing.
5.5.3.1 The integral donor tubing segments shall be separable from the container without breaking
the sterility of the container.
5.5.3.2 At the time of collection, additional blood may be collected for laboratory tests.
Containers shall be properly labeled at the time of collection, shall accompany the blood
bag and, shall be re-identified with the blood bag immediately after filling.
5.5.3.2 Storage of samples before testing shall meet the requirements stated in the manufacturers
written instructions for the test being performed.
5.5.3.3 Donated blood sample aliquots shall be stored in a stable and retrievable manner for at
least one year to facilitate look-back.
5.5.4 Ratio of Blood to Anticoagulant/Preservative
The volume of blood to be drawn shall be proportional to the amount of
anticoagulant/preservative solution in the collection bag, in accordance with manufacturers
instructions.
5.5.5 Temperature during Transport
If blood is to be transported from the collection site to the component processing laboratory, it
shall be placed in a blood transport box having sufficient refrigeration capacity to cool the blood
continuously toward a temperature range of 2-10o C until it arrives at the processing laboratory.
5.5.5.1 Blood intended for preparation of platelets, shall be transported and stored in a manner
intended to maintain the blood at a temperature range of 20- 24o C. Separation shall be
completed within 6 hours of collection.
5.5.6 Quarantine of Donated Blood
5.5.7 All blood and blood products shall remain quarantined until all laboratory tests have been completed.

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