sanguis

AUGUST 2021

sanguis BLOOD SPEAKS

RULES ARE MADE TO BE FOLLOWED

s t n e t n co pg. 4.

pg. 3. breadth of view foreword

Blood Bank Act and National Blood Service Act

pg. 6.

Administrative Order 2008-008 pg. 8.

Administrative Order 2010-0002

pg. 5.

Administrative Order No. 9 s. 1995 pg. 7.

Administrative Order 2010-0001 pg. 9.

Local Blood Council pg. 10-11.

Department Circular 2010 - 0013 pg. 12.

References // Sources

laws, regulations, and acts regarding blood banking.

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BREADTH OF VIEW FOREWORD

Humans cannot live without blood running through their veins. It is the substance that carries oxygen throughout the body as well as nutrients that nourish the growth of the different body systems. But, people could sometimes lack blood which could bring them to critical conditions. This is where blood banking comes in.

Blood banking has been around as early as 1936. The first blood bank opened on March 15, 1937, at Cook County Hospital, and it facilitated 1,354 blood transfusions in its first year of existence. Many people donate their blood through the blood banking process so that it can help others with similar blood types but experiencing more severe predicaments than the average person. The process mainly involves typing the blood for transfusion and testing for infectious diseases.

In patient care, blood banking allows for identification and proper management of different types of blood to ensure that transfusion-related accidents will not happen and cause complications to a person's life. According to Red Cross, nearly 5 million people are receiving blood transfusions every single year. All of these people are potential victims of bad transfusion procedures that may cost them

their lives. That is why, a blood bank would be ideal as it allows to counteract these harmful situations through tactical or strategical planning while also making sure that everything is in check before the medical procedures are in action.

As such, various rules, regulations, and laws are implemented to further emphasize the vitalness of safety in blood banking and clearly explain what can happen due to it, the impact it has on the people involved, and the necessary steps taken if certain occurrences commence.

This issue is dedicated to the different laws and regulations about blood banking and what situations connote or what do they mean in actuality.

RA 1517 (1956)

BLOOD BANK ACT An act regulating the collection, processing, and sale of

human blood, and establishment and operation of blood banks and blood processing laboratories secretary of Health is The blood bank and blood The responsible for strictly enforcing the processing labs should: and issue rules and regulations, Operate with a licensed act such as: physician maximum ceilings for handling Operate on a non-profit The charges of blood basis for its collection, Obtain a license from the (charges storage, DOH provided that they processing, and sale) establish and operate transportation, allowance for spoilage, following accepted Reasonable part of the cost of blood scientific standards Violations for the provision of this act shall be punished by: Imprisonment for not less than one month and not more than one year fine of not less than one hundred pesos and not more than one thousand pesos Both such fine and imprisonment at the discretion of the court

RA 7719 (1994)

KEY FEATURES

An act that promotes voluntary blood donation, ensures sufficient supply of safe blood, regulates blood banks, and enacts sanctions for noncompliance.

Goals of the National Voluntary Blood Services Program (NVBSP): To develop a fully voluntary blood donation system To strengthen a national network of BSF to boost efficiency through centralized blood testing and processing; To implement a quality management system, which includes Good Manufacturing Practice (GMPs) and a Management Information System (MIS); To achieve maximum blood utilization through the use of blood products and component therapy; and To establish a strong, practical, and long-term management and funding strategy for the national blood network.

National Voluntary Blood Services Program: established to meet the needs for blood transfusion in all regions of the country.

Promotion of Voluntary Blood Donation: to ensure adequate supply of human blood, voluntary blood donation shall be promoted through: Public Education Establishment of Blood Promotion in Schools Services Network Professional Education Walking Blood Donors

NATIONAL BLOOD SERVICE ACT

ADMINISTRATIVE ORDER NO. 9 S. 1995 Rules and Regulations Implementing Republic Act o. 7719 otherwise known as National Blood Services Act of 1994

RATIONALE These Rules and regulations are adopted prescribing the principles, guidelines, procedures and standards for the implementation of R.A. 7719 to facilitate compliance therewith and achieve the objective thereof.

SCOPE

All hospitals, entities, establishments or institutions, government owned and operated or private, engaged in blood transfusion services in the Philippines, whether full time or part time, local or foreign.

IMPLEMENTATIONS National voluntary blood services program Promotion of voluntary blood donation Blood services network and blood donor recruitment Upgrading of services and facilities Phase–out of commercial blood banks Operation and maintenance of blood service facilities Regulation of blood services Penalties for violations VIOLATIONS SUBJECT TO PENALTIES INCLUDE: Blood Bank Charging Fees Blood Bank without License Contaminated Blood Failure to renew LTO Operation without DOH authorization Other sanctions PENALTIES INCLUDE BUT ARE NOT LIMITED TO: Suspension of LTO or authorization Suspension of professional COR

ADMINISTRATIVE ORDER 2008-008 Rules and Regulations Governing the Regulation of Blood Service Facilities

RATIONALE

The passage of the A. O. 20050002 prompts the identification of new functions and capabilities of blood service facilities; thus, there is a need to revise the provision of A.O. 9.

SCOPE

Applicable to all government and private, hospital-based blood service facilities engage in blood banking and transfusion services

OBJECTIVE

These rules and regulations aim to ensure the availability of licensed blood service facilities around the country with adequate staff, equipment, and resources to perform all the required functions safely, efficiently, and effectively.

CLASSIFICATION OF BLOOD SERVICE FACILITIES

Ownership Government Private, hospital-based Service Capability Blood Station (BS)Unit (BCU) Blood Collection Hospital-based Blood Bank (BB) blood Regional, sub-national, and national centers (BCs) Institutional Character Hospital-based Nonhospital-based LTO/ATO

Licensed blood service facilities have the sole right to collect, test for TTIs following the DOH guidelines and distribute blood and blood products for transfusion.

LTO/ATO of a BSF is only valid for three years Hospital-based facilities are no longer required to obtain separate licenses to operate or authorization from the DOH LTO must be displayed at all times at the premises of the facility LTO/ATO shall be suspended or revoked upon violation of the Blood Services Act and its rules and regulations VIOLATIONS

False statement in the application Misrepresentation of facts and falsification of documents Refusal to make available its records to an authorized BHFS/CHD person Charging of blood services above the maximum fees set by the DOH Collection of blood from a paid donor Refusal to participate in EQAS

ADMINISTRATIVE ORDER 2010-0001 Policies and Guidelines for the Philippine National Blood Services (PNBS) and the Blood Services Networks (BSN)

POLICIES AND GUIDELINES

RATIONALE

Issued in support of the RA 7719 and the A.O. 2008-0023. It prescribes policies and guidelines to guide the operations of PNBS and the BSN. This order is also promulgated to describe the structures and processes that relate to the collection, testing, and use of blood products, as well as the facilities and services that facilitate them. It also specifies the roles and functions of involved parties.

SCOPE

Applicable to all government and private blood service facilities nationwide, as well as all hospitals and other health facilities which administer blood transfusion.

OBJECTIVES

Provide supplementary policies and guidelines in the operationalization of the PNBS and the BSN in the context of health sector reform; Describe the structures, systems and processes in relation to the collection, testing and use of blood products, facilities and services; Define roles and functions of health facilities, health care professionals and other partners in adopting the blood service networks as the key strategy.

National Council for Blood Services. (Puno, A., 2021)

Donor Selection and Pre-Donation Counseling.

Follow the DOH Blood Donor Selection and Counselling Manual.

Blood Collection, Post-Donation Counselling, Donor Care and Retention.

Blood collection from healthy voluntary non-remunerated blood donors only.

Intensify voluntary blood donation, advocacy/campaign and enforce an effective donor care and retention.

Testing and Transfusion.

Blood units for transfusion must test negative for transfusion-transmissible infections (TTIs): Hepatitis B, Syphilis, Malaria, HIV 1 & 2, and Hepatitis C virus.

Issuance/Provision of Blood Units.

Blood unit request and issuance should be directly between requesting hospital/end-user health facility and the authorized Blood Supply, Storage and Distribution.

Appropriate cold storage equipment must be present in all blood service facilities licensed/authorized to transport and store blood.

Community Mobilization through Local Blood Councils.

Establish Local Blood Council in every area.

Blood Donor Panels/Registry.

Establish a Blood Donor Panel in each barangay; a Blood Donor Registry in every Blood Bank/Blood Center or Blood Collection Unit; and National Directory of Blood Donor Registries.

Operations of the Blood Services Network.

Safe and quality blood and blood products/components must always be free and available.

DOH Licensing and Authorization.

DOH-BHFS for blood center licensing.

DOH-CHD for hospital-based blood banks licensing.

DOH-CHI for Blood Collecting Units and Blood Stations authorization.

BLOOD BANKING LAWS

ADMINISTRATIVE ORDER 2010-0002 Policies and and Guidelines pertinent to the Establishment and Operation of Local Blood Councils to Support the Implementation of the National Voluntary Blood Services Program for Blood Safety and Adequacy, Quality Care and Patient Safety.

Rationale: Prescribe policies and guidelines for the establishment and operation of Local Blood Council that will support the Regional Blood Services Network, and spearhead the Local Blood Donation Programs, as well as community participation in blood donation.

Scope: Applicable to all community-based organizations established and operated to promote voluntary blood donation and support the National Blood Services Program.

Objectives: Guide the establishment and operation of Local Blood Council pursuant to RA 7719 and its revised IRR Supplement the following Guidelines for the Philippine National Blood Services (PNBS) and its Blood Services Network Operational Guidelines for Blood Services Network (BSN) Quality Care and Patient Safety National Policy on Patient Safety

THE LOCAL BLOOD COUNCIL

Membership: Representative of various community sectors such as Local Government Units (LGU) National Government Agencies in the localities Local Health Services, Hospitals PNRC and Dugong Pinoy Chapters Military and Police establishments Health Professional Associations Schools, etc.

Presence in every region, province and highly urbanized city for public education, donor recruitment, and support for blood donation.

Objectives: Plan and coordinate implementation of Local Voluntary Blood Donation Program Ensure Adequate supply of blood Mobilize human resource, facilities and financial support Organize mobile blood donations Community partnership Assist local blood services network in public education and support for blood donation activities

PHILIPPINES

Committees Executive committee Committee on Public Education Committee on Donor Recruitment Committee on Mobile Blood Donation Committee on Ways and Means Functions Participate in the formulation of the Local Blood Donation Program Promote voluntary blood donation Organize mobile blood collection activities Spearheads/assists in fund-sourcing/fundraising Strengthens the linkages of the health facilities with blood centers Coordinates and monitors the implementation of the Local Blood Donation Program

Strategies for Local Blood Donation Program Implementation of public education, recruitment of blood donors, mobile blood donations Coordinate and assist in the implementation of blood services network Recognition of Blood Donors Policies for the Local Blood Donation Program For the Local Blood Council Motivate healthy donors to give blood; potential blood donor may opt to self-defer Collection of blood from voluntary nonremunerated donors only; Ensure no fees are charged to the donors Blood donation activities shall be conducted in authorized strategic locations Establish efficient networking among hospitals and the Blood Center The Local Blood Donation Program must be included in the LGU’s Work Financial Plan All blood product requests and issuances must be coordinated by the hospital's BSF or Clinical Laboratory and the Blood Center.

Maintain a registry of blood donors with rare blood types Financing sources Allocation from the Regional Blood Center, NVBSP, LGU Contributions from the Business sector, PNRC National Blood Services, NGOs, and Mass media (in kind) Fundraising activities, Grants from Donor agencies and government financial institutions Subsidy from hospitals

LOCAL BLOOD COUNCIL

DEPARTMENT Operational CIRCULAR Guidelines for Blood Services Network 2010 - 0013 RATIONALE

The blood services network is established to ensure efficient distribution, wide availability, and maximize safe use of voluntarily donated blood to augment the blood needs of different regions of the country. It also supports the centralization of testing and processing blood and its components.

OBJECTIVES

This department circular aim to provide comprehensive guidelines governing the operation of Blood Service Network in all the region in the country; specifically, to: ensure an adequate supply of blood and its components through voluntary blood donation establish an equitable means of blood distribution Establish a high- standard of screening donated blood Establish an efficient referral system among blood service facilities Ensure an organized data and information sharing and storage among blood service facilities through the Integrated Blood Bank Information System.

GUIDELINES FOR THE OPERATION OF BLOOD SERVICE NETWORK

Donor Recruitment Units of Blood Establishment of an operational plan for Testing Testing using a DOH-prescribed education and marketing campaign to methodology and reagents in either of the promote blood donation following establishments: Voluntary donor recruitment shall target - Philippine Blood Center low-risk groups - Sub-national Blood Centers Local Blood Donor Program shall endeavor - Regional Blood Centers under the to recruit 2% of the total population Philippine National Blood Services Continuous education program for Donor Recruitment Officers/Teams Transfusion Transmissible Infections (TTIs) Donor Screening, Counselling, and · Hepatitis B Collection of Blood · Syphilis Voluntary donors shall undergo a medical · Malaria interview, pre-donation counseling, and · HIV 1 & 2 physical examination following standards on · Hepatitis C Donor Screening, with personnel who has sufficient training in screening and collecting blood Blood collection in the premises of the blood service facility Mobile blood donation shall be regularly and properly organized and conducted in schools, government or private facilities, shopping malls, churches, and among others

Donated blood reactive to any TTIs above must be screened again twice using the same test format.

The National Reference Laboratory receives donated blood that remains reactive after two retests for confirmation.

A person who donated blood with a confirmed positive result must be contacted again for counseling and referral to the appropriate medical service Forward and reverse blood typing, as well as antibody screen, is carried out All units of blood issued by Blood Centers need to be retested for TTIs by hospitals or other health facilities that receive them Handling of Blood Components Maintain sterile aseptic condition during all steps of handling of blood and blood products.

Hospital and Bedside transfusion Practice Follow the guidelines set by the Hospital Transfusion Committee or the General Guidelines for Appropriate Blood Administration.

Appropriate Use of Blood and Blood Conservation Request and Transfusion shall only occur when medically indicated and consistent with the Philippine Clinical Practice Guidelines Alternative strategies to reduce the use of allogenic blood should be considered Periodic orientation of all staff regarding rational blood use.

Storage and Transport of Blood Components

Rejection and Return of Units of Blood Probable Causes of Rejection and Return of Unit of Blood by End User Health Facility: Mislabeled blood type Wrong component issued Improper storage of blood unit during transport Defects in the blood bag Incompatible crossmatch The end user health facility shall notify Blood center before shipping the blood unit back The blood center must verify inconsistency and immediately replaced the returned unit.

Provision of Blood in case of Emergency

Reporting and Investigation of Blood Transfusion Reaction End user health facilities shall formulate a standard operating policy for the detection and reporting of results of blood transfusion reaction.

Hospital Blood Transfusion Committee (HBTC) shall conduct an official investigation and analysis of suspected transfusion reactions.

References // Sources

Blood Bank Act, R.A. 1517. (1956). https://www.lawphil.net/statutes/repacts/ra1956/ra_1517 _1956.html Design Shack. (2014). 50 Outstanding Free Design Textures.

Retrieved from https://www.pinterest.ph/ pin/ 257831147391355768/ MT Lectures. (2010). Department Circular No. 2010-0013.

Retrieved from https://mtlectures.blogspot.com/2017/08/department -circular-no-2010-0013.html MT Lectures. (1995). Administrative Order No. 9 s. 1995.

Retrieved from https://mt-lectures.blogspot.com /2017/08/administrative-order-no-9-s-1995.html Operational Guidelines for Blood Services Network, D.C. 20100013. (2010, January 12). https: //home.nbbnets.net/program/includes /document/issuance/DC-2010-0013.pdf Policies and Guidelines for the Philippine National Blood Services (PNBS) and the Blood Services Networks (BSN), A.0. 2010-0001. (2010, January 6). https://home.nbbnets.net/program/includes/document/iss uance/AO-2010-0001.pdf Policies and and Guidelines pertinent to the Establishment and Operation of Local Blood Councils to Support the Implementation of the National Voluntary Blood Services Program for Blood Safety and Adequacy, Quality Care and Patient Safety, A.O. 2010-0002. (2010, January 7). https://home.nbbnets.net/program/includes/document/iss uance/AO-2010-0002.pdf Puno, A. (2021). Blood banking laws [PDF].

Rules and Regulations Governing the Regulation of Blood Service Facilities, Republic of the Philippines A.O. 2008-0008. (2008, May 2). https: //home.nbbnets.net/ program/includes/document/issuance/AO-2008-0008.pdf The Republic of the Philippines. (1956, June 16). Republic Act No. 1517 s. 1956. An Act Regulating the Collection, Processing and Sale of Human Blood, and the Establishment and Operation of Blood Banks and Blood Processing Laboratories. Retrieved from: https://www. lawphil.net/statutes/repacts/ra1956/ra_1517_1956.html The Republic of the Philippines. (1994, May 5). Republic Act No. 7719 s. 1994. An act promoting voluntary blood donation, providing for an adequate supply of safe blood, regulating blood banks, and providing penalties for violation thereof. Retrieved from: https://www.official gazette.gov.ph/1994/05/05/republic-act-no7719/

FEEL BLOOD, KNOW BLOOD, SEE BLOOD

c 2021

ARANAS I ARANCES I BARRIENTOS I MAON I RAMOS I ROSARIO