Improving the Clinical Use of the Scarce Blood: The Ugandan Perspective

In Uganda the demand of blood by hospitals outstrips its supply. The National Transfusion Services faces the daunting challenge of making sufficient supplies of blood while ensuring quality and safety of these products. National data on clinical use of blood are limited. In order to improve quality of health care delivery to blood recipients and effectively use the limited blood components, this study aimed at identification of quality gaps in practices and procedures of in-hospital transfusion services. 

Mixed research methods were used to qualify and quantify challenges and solutions to the existing suboptimal use of blood in Ugandan Hospitals. 

Identified challenges to quality transfusion practices include paucity of administrative structures bottlenecks in the processing blood banks and a staff that is not aware of the special attention needed when prescribing and transfusing blood. This is compounded by lack of hospital transfusion policies. Additionally, documentation of transfusion procedures is still under-developed.

To address these issues, a step-by-step quality improvement strategy should be developed. First, small working groups of clinicians, laboratory technicians and administrators should be created to design the policy and strategies for clinical use of blood. Secondly, create Hospital Transfusion Committees with appropriate terms of reference. Third, design simple education materials for the in-hospital transfusion processes with their respective standard operating procedures and related outcome documents. Disseminate these materials through continuous professional trainings and curriculum reviews. Embark on updating the National Transfusion Policy to embrace and support the development of National clinical standards. These steps will be achieved when the concept of quality assurance is formally and philosophically incorporated into the structure and functioning of Uganda’s health systems, consistently implemented, and supported by a culture of quality, as reflected in organizational values and policies that advocate quality of care.

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