采血护士在降低献血反应中的作用

我们工作中发现,在采血环境、体检和化验医生相同的情况下,接受不同的采血护士操作的献血者献血反应发生率是不同的.     

初次与固定无偿献血者献血反应比较分析与对策

自1998年《献血法》实施以来,我站已建立了一支相对固定的无偿献血队伍,但随着临床用血量的增长,新增献血员也不断增多,在采血过程中,我站发现初次献血者与固定献血者发生献血反应的比例差异有统计学意义,初次献血者发生献血反应比例明显高于固定献血者,现将我们的统计结果报告如下。     

2713名重复献血者献血情况分析

目的：了觧和掌握重复献血者的献血动态情况,评价现行无偿献血宣传、招募工作的效果,制订和调整新形势下的招募策略,为建立一支固定自愿无偿献血者队伍提供科学决策参考。方法：2008年8月—2010年1月调查在本中心流动采血车献血3次以上2713名自愿无偿献血者的献血情况及检测结果,调查内容包括献血品种、献血量、献血次数及血液感染性指标检测结果等。结果：2713名重复献血者中,首次献全血200ml、400ml人次的比例分别为51.42%和48.58%;随着献血次数的增加,400ml全血采集人次的比例逐渐递增,差异有统计学意义（P〈0.01）;占献血总人次的66.37%;血小板捐献的人次也相应增加,但只占调查总人次的1.97%。血液感染性指标检测结果明显优于其他类型献血者（P〈0.01）。结论：重复献血者对无偿献血持有积极的动机;无偿献血知识认知度较高,反复献血行为积极;多次定期献血,血液的质量与安全得到保证。     

患者亲属互助献血与街头自愿无偿献血相关因素对比分析

目的：探讨患者亲属互助献血与街头自愿无偿献血的差异。方法：对2类不同献血类型的相关因素对比分析。结果：①患者亲属互助献血人员构成与年龄及受教育程度无关,而自愿无偿献血者以25岁年轻人为主体,献血积极性与文化程度高低成正比,且比例明显高于互助献血者。②互助献血献血反应发生率及卫生部规定的4项血液传播性疾病检测阳性检测率明显高于自愿无偿献血者。结论：患者亲属互助献血多从亲情和友情角度出发,多属有目的的被动献血,只能做为无偿献血血源紧缺及偏型的暂时补充,目前无偿献血的宣传工作,应针对不同人群加大宣传力度和广度,使这部分人自愿加入到无偿献血的队伍中来。     

无偿献血者献血反应的预防及护理

献血反应的发生并非器质性病变所致,其主要原因是精神高度紧张、恐惧扎针时疼痛等各种因素引起的心交感神经兴奋性减弱,反射性迷走神经活动性增强,导致心输出量骤减,出现一般性脑供血不足,严重者可引起短暂性意识丧失,发生抽搐、晕厥等现象。因此,在血液采集过程中预防献血反应非常重要,是一个不可忽视的重要环节。我们对献血者发生献血反应的诱因进行了研究探讨,并采取了有效的预防及护理措施,现报告如下。     

咀嚼口香糖对降低初次献血者献血反应的效果观察

目的:探讨咀嚼口香糖降低初次献血者献血反应的作用。方法:将2013年5至9月初次献血者2 041人按献血日期分为2组,即观察组1 086人、对照组955人,对照组按常规采血程序进行,观察组按常规采血程序的同时给予咀嚼口香糖,观察比较2组献血反应率。结果:观察组与对照组献血反应率分别为0.83%、6.07%,2组比较差异有统计学意义(χ2=44.02,P0.01)。结论:在初次献血者献血时给予口香糖咀嚼,能有效预防献血反应的发生,适合在预防无偿献血反应中应用。     

影响我国单采血小板献血者招募和保留因素调研分析

目的:了解我国各采供血机构单采血小板献血者招募和保留的影响因素,为采供血机构制定切实有效的单采血小板献血者招募和保留策略提供参考建议.方法:采用问卷调查的形式,设计涵盖招募单采血小板献血者的部门、招募的方式、预约制或计划采集单采血小板、单采血小板献血者纪念品、单采血小板献血者交通补助、单采血小板献血者餐饮标准、单采血小...     

无偿献血者献血反应的心理原因及预防

2004年,山东省血液中心采血46160例,出现献血反应2631例,占5．7％。医护人员在工作中总结经验教训,分析献血者心理特点,消除其不良心理因素,在2005年50582例献血者中,出现献血反应1786例,占3．2％,比2004年降低2．5％。现将无偿献血者献血反应的心理原因及预防分析如下。     

自然灾害后参与献血人数与平时献血人数的比较分析

目的:通过发生自然灾害后与平时献血人数的比较,探讨在发生自然灾害后献血人数显著增多的情况下,如何更好的将他们发展为固定献血者。方法:将2次自然灾害后1周内我中心流动采血车的无偿献血者与后1年同期进行对比。结果:灾害发生后献血人数显著增多,尤其以初次献血者增加更为明显,灾害发生后初次献血者分别占献血人数的72.12%与70.19%,而对照组为51.08%与54.97%。结论:在灾害发生后,献血人数成倍增加;建立一个持续性的激励政策,与献血做好沟通工作,有可能将他们发展成为固定献血者。     

献血后皮下出血的预防与护理

皮下出血是献血后一种常见的局部反应，多数反应轻微。少数反应较重，甚至波及整个前臂，恢复较慢，个别人还并发血栓性静脉炎。如果处理不当，会给献血者带来一定的痛苦。因此，预防献血后皮下出血并对已经出现皮下出血者进行有效的护理，是一项非常重要的工作。现将我中心献血者献血后皮下出血的预防和护理方法，总结报告如下。     

Factors associated with fainting: before, during and after whole blood donation

Background Whole blood (WB) donation encompasses several periods during which some donors faint. Identification of factors associated with fainting during each period should guide intervention strategies. Reducing faint reactions may reduce donor injuries and disability. Methods Blood donation was divided into three periods: Period 1 – registration; Period 2 – phlebotomy; and Period 3 – post‐phlebotomy. Period 3 consists of two sub‐periods (3A – on‐site and 3B – off‐site). For each Period, stratified rates of fainting in relation to various donor and donation characteristics were calculated and multivariable logistic regression analyses to identify factors associated with fainting were conducted. Donor injuries in each period were also analysed. Results Of the 956 766 donors registered in 2007, 554 534 (58%) donated WB. There were 43 fainting episodes and two injuries in Period 1 and 1520 faints and 73 injuries in Periods 2 and 3. Regression analyses showed that youth and donor first‐time status are associated with fainting in all periods; but most significantly in Period 1. Small estimated blood volume is notably not a factor in Period 1 but is significant in Periods 2 and 3. The highest injury rate is seen in Period 3A (0·07 and 0·09/1000 donations) for male and female donors, respectively. Conclusions Variability in factors associated with fainting across defined periods of the donation process suggest differing underlying mechanisms and the possibility that interventions for the reactions most associated with injury during each time period can be designed. The highest rate of injury per donation occurred in ambulating donors.     

Complications related to blood donation: a population-based study

BACKGROUND: Population-based data on the rate and outcome of complications related to blood donation are sparse. STUDY DESIGN AND METHODS: Data from a survey conducted in 2003 in Aarhus County, Denmark, were used to assess the overall rate of donor complications. Additional nationwide data on moderate and severe donor complications were obtained from the Danish Register of Complications Related to Blood Donation, with records of all moderate and severe donor complications in Denmark occurring during the period 1997-2003. RESULTS: In the regional survey, we identified 340 complications of any type among 41 274 donations, corresponding to a rate of 824/100,000 donations [95% confidence interval (CI): 741-916]. All complications were either needle injuries or vasovagal reactions. In the nationwide register, a total of 752 moderate and severe complications were recorded among 2,575,264 donations, corresponding to a rate of 29/100,000 donations (95% CI: 27-31). The rates of complications leading to long-term morbidity or disablement (> 5% loss of working capacity) were 5/100,000 donations (95% CI: 4.2-5.9) and 2.3/100,000 donations (95% CI: 1.8-2.9), respectively. CONCLUSION: The risk of complications related to blood donation is low. However, attention towards donor complications is warranted, given the non-negligible rate of complications resulting in long-term morbidity and disablement.     

The effect of pre-donation hypotension on whole blood donor adverse reactions: a systematic review

Blood services are reliant upon healthy blood donors to provide a safe and adequate supply of blood products. Inappropriate variables contained within blood donor exclusion criteria can defer potentially appropriate donors. The aim of this systematic review was to examine the effect of low pre-donation blood pressure, as compared with normal blood pressure, on adverse events in allogeneic whole blood donors. A systematic review was performed using highly sensitive search strategies within five databases (Cochrane Central Register of Controlled Trials, CINAHL, Embase, MEDLINE, and Web of Science) from inception date until April 12, 2013. Out of 8305 records, 10 observational studies were identified that addressed the question. Five of these studies (with a combined total of 1,482,020 donations and 2903 donors) included either a statistical analysis or an appropriate study design that controlled for possible confounding factors. Based on the currently available evidence, hypotension has not been shown to be an independent predictive factor for donor complications. However, the overall quality of evidence was rather limited and rated ‘low,’ using the GRADE approach. In conclusion there is currently no evidence that hypotensive blood donors have a greater risk for donor adverse events compared with their normotensive counterparts.     

Adverse reactions during voluntary donation of blood and/or blood components. A statistical-epidemiological study

Background

Voluntary donors normally tolerate blood donation very well, but, occasionally, adverse reactions of variable severity may occur during or at the end of the collection. Aim of this study was to estimate and possibly avoid the cause of unwanted reactions.

Materials and methods

The study was conducted over a period of 6 months, from 24^th October, 2005 to 24^th April 2006. The donor population analysed consisted of 4,906 donors (3,716 male and 1,190 female). In total, 3,983 (81%) voluntaries have donated whole blood, 851 (17%) plasma from apheresis, 64 (1.3%) experienced multicomponent donation, and 8 (0.1%) were donors of plasma-platelet apheresis.

Results

Only 63 donors (1.2% of all the volunteers) suffered some kind of adverse reaction: 59 (1.08% of the subjects) had mild reactions (agitation, sweating, pallor, cold feeling, sense of weakness, nausea), and only 4 (3 males and 1 female, 0.2%) had more severe disorders, including vomiting, loss of consciousness, and convulsive syncope.

Conclusions

Although the number of donors who developed disturbances during or at the end of blood donations was very low, it is nevertheless desirable to reduce risks to a minimum. A set of advices is provided for preventing problems.     

Relationship between first-year blood donation, return rate for subsequent donation and demographic characteristics

Background

The aim of this study was to determine any relationships between return rates of first-time donors, number of donations in the first year and the donors’ demographic characteristics.

Materials and methods.

Data from 1,500 volunteer, first-time donors who donated blood at Shiraz Blood Transfusion Centre (Iran) were obtained from the donor database. The donors’ demographic characteristics (sex, age, educational status) and donation histories were obtained for a 3-year period and the number of donations and interval between the first donation and the following donation within a 1-year period were recorded. We searched for correlations between return rate and demographic characteristics and the number of donations in the first, second and third years. The data were analysed with the chi-squared test, multiple logistic regression and Spearman’s correlation tests. P values less than 0.05 were considered statistically significant.

Results

More than half of the first-time donors returned to donate again (n=776, 51.7%) during the 3 years after the first donation. The mean number of donations in the whole 3-year period was 0.69±0.49, while it was 1.33±0.62 (median 1) in the first year, 0.4±0.7 (median 0) in the second, and 0.3±0.65 (median 0) in the third year. The return rate was directly correlated with the number of donations in the first year (r=0.74, P<0.001). The return rate increased as the interval between the first and second donations decreased (P<0.05, OR=1.03). The return rate was higher for male donors and single donors (P<0.05), but was not related to age or educational level (P>0.05).

Discussion.

In this study 51.7% of first-time donors returned to donate again, a high figure indicating the success of our recruitment strategy. Understanding the importance of the number of donations in the first year for donors’ return rate and planning recruitment programs and more effective measures to encourage donors in the first year may help to increase return rates.     

The blood donation experience: self-reported motives and obstacles for donating blood

Background and Objectives The aim of the study was to investigate motives for donating blood as well as difficulties and obstacles associated with blood donation as perceived by the donors themselves. Materials and Methods Six hundred consecutive blood donors (i.e. all blood donors with a history of at least one previous whole blood donation attending, during nine working days, the Blood Centre of Umeå University Hospital) received a self‐administered questionnaire that contained questions aimed at elucidating motives for donating blood (general motives for donating blood, specific motives for the first donation and motives for continuing to be an active blood donor). Questions concerning difficulties and obstacles that had to be overcome in order to continue being a blood donor were also included in the questionnaire. Results Altogether 531 whole blood donors filled in the questionnaire (88·5%; 322 men and 209 women). No statistically significant differences were found between male and female blood donors concerning general reasons and motives related to donating blood. The most frequently reported reasons for giving blood the first time were ‘influence from a friend’ (47·2% of donors) and ‘request via media’ (23·5% of donors). Among general reasons/motives with highest ranking of importance, the most commonly reported motive for donating blood were ‘general altruism’ (40·3%), ‘social responsibility/obligation’ (19·7%) and ‘influence from friends’ (17·9%). General altruism’ and ‘social responsibility/obligation’ were also the most frequent reasons for continuing to donate blood (68·4 and 16·0%, respectively). The most commonly reported obstacle to becoming a regular blood donor was ‘laziness’ (19·1%) followed by ‘fear of needles’ (10·5%). Conclusions Altruism was the most common general motive for donating blood and also for continuing to be an active blood donor. Yet, for the first blood donation, direct ‘influence from friends/relatives’, ‘media appeal’ and other types of recruitment were more commonly reported as reasons or motives for donating blood than altruism. The findings support the notion that different strategies should be used/adopted to get people to donate blood the first time (e.g. recruitment through other blood donors using, for example, the ‘bring a friend along’ method) and to retain these subjects as active blood donors (e.g. by information and by strengthening their sense of being a blood donor or their self‐efficacy etc.).     

Attitudes and behaviours of Greeks concerning blood donation: recruitment and retention campaigns should be focused on need rather than altruism

Background

Blood supplies in Greece are insufficient to meet the high transfusion needs arising from car accidents and treatment of thalassaemia. This study was designed to determine Greeks’ opinions about blood donation, in order to identify the reasons for the lack of motivation to donate and allow experts to establish better recruitment campaigns for the enrichment of the donor pool, based on our findings.

Materials and methods

The opinions of randomly selected Greek citizens (n=800) about volunteer blood donation were assessed by means of a standardised, anonymous questionnaire. The results were analysed using the χ² test and Spearman’s correlation coefficient.

Results

With regards to attitudes towards intention to donate, only 7.1% were indifferent, while 88.0% of the individuals believed that donating blood was an “offer”. Reasons for not donating mainly involved safety (36.0%) and fear (24.0%), whereas need (77.9%) was the most fundamental positive motivation. Of the people enrolled in the present study, 10.0% were active donors, 31.3% occasional donors, 15.0% rare donors and 36.6% non-donors.

Discussion

The considerable percentages of occasional and rare donors in comparison with the low proportion of active donors in the Greek donor pool indicates that “need” is a more important motivation for blood donation than altruism in Greece. These results could be useful for establishing advertising campaigns on blood donation and for a more direct approach to the population, aiming for a change in mentality in favour of active blood donation.     

702例抗结核药物所致不良反应分析

目的分析结核病专科医院住院患者抗结核药物所致药物不良反应(ADR)的发生情况。方法由结核科专业医师提供病程记录,医嘱单,实验室检查及辅助检查结果,回顾性分析抗结核药物所致不良反应的发生情况。结果1 222例住院患者中发生不良反应702例(57.4%),共25种。287例合并多种不良反应。总的不良反应为1 097例次。其中332例(332/1 222,27.17%)因不良反应严重需要调整治疗方案。最多见的不良反应为血尿酸增高,占所有不良反应的37.28%(409/1 097)。96%的不良反应发生在60 d之内。结论应重视抗结核药物所致的不良反应,加强对相关专业人员的培训和对患者的宣教,对具有危险因素的人群采取个体化治疗并密切监测以便及时发现各种不良反应,需进一步完善抗结核药物所致不良反应的呈报系统。