Module One: Field Work and Blood Collection Operations Study Guide

Document Control Software (Title 21 / Docs on Disk)

  • Title 21 and Docs on Disk (DOD): Title 21 is the official document control software that houses all current and previous versions of Standard Operating Procedures (SOPs). Docs on Disk (DOD) is used to view these SOP documents in PDF format.
  • Search Capabilities: SOPs can be searched within the software by entering the specific SOP number or by using relevant key phrases.
  • Access Protocols:
    • Mobile Units: Accessible on desktop computers and tablets via a dedicated Docs on Disk icon located on the desktop screen.
    • Fixed Sites: Found by navigating through TBC Central under the Applications section.

Standard Precautions, PPE, and Operational Hygiene

  • Personal Protective Equipment (PPE): PPE is utilized to prevent direct skin or mucosal contact with a donor's blood or body fluids. Phlebotomy operations primarily utilize gloves and safety glasses.
  • Glove Usage Requirements: Gloves are strictly required when performing any of the following tasks:
    • Performing a finger stick.
    • Performing phlebotomy.
    • Stripping and sealing blood bags.
    • Cleaning blood spills or other body fluid spills.
    • Performing regular decontamination procedures.
  • Safety Glasses Usage Requirements: Safety glasses are mandatory during the stripping and sealing of blood bags.
  • Hand Washing and Sanitization Guidelines:
    • Hand hygiene must be performed on a regular basis.
    • On bloodmobiles where soap and water are not available, it is acceptable to clean hands between donors using alcohol-based hand rubs.
    • Hands that are visibly soiled MUST be washed using soap and water.
  • Food and Beverage Restrictions: Staff members are strictly prohibited from consuming food or drinks, or chewing gum, inside screening areas or donor collection/processing areas.

Inventory Storage, Supply Management, and Vehicle Fleet Guidelines

  • Storage of Goods and Supplies:
    • All goods must be stored OFF the floor and OFF wooden pallets in a safe, orderly, and sanitary manner to ensure sterility is not compromised.
    • Inventory Rotation (FIFO): Follow the First In / First Out method. The only exception is if a newly received item has an expiration date prior to an item already in storage, in which case the earlier-expiring item must be used first.
    • Lot Number Separation: Similar goods that possess different lot numbers must be physically separated using an indicator or a physical barrier.
    • Non-Conforming Goods: Must be immediately segregated into a designated holding/quarantine area until final disposition is determined.
  • Fleet Card Protocol:
    • The fleet credit card is intended solely for purchasing gas for the specific TBC vehicle being driven.
    • Pump Transaction Steps:
      1. Swipe the fleet card.
      2. Enter the current vehicle odometer reading.
      3. Enter the assigned gas code.
      4. Enter the zip code for the Matrix: 2967329673.
  • Cooler Storage Capacity and Drive Packing Rules:
    • Each individual unit cooler holds up to 1212 units of blood.
    • Color Coding: Red Coolers are designated for blood units; Blue Coolers are designated for donor drinks and snacks.
    • Packing Over Goal Requirements:
      • Regular Drives: Pack enough unit coolers to accommodate 2020 units over the drive goal.
      • High School / College Drives: Pack enough unit coolers to accommodate 4040 units over the drive goal.

Mobile Operations: Bloodmobile Setup Procedures

  • Pre-Departure Actions:
    • Verify adequate gas levels in the vehicle.
    • Pull up a donor on the computer to test and ensure both bexWISE and the computer hardware are working properly.
    • Review the drive trip sheet thoroughly.
    • Pack all required equipment and supplies.
  • Parking and Leveling Rules:
    • Park the vehicle in a stable, level area.
    • If a preferred spot is unavailable, the Bloodmobile must still be parked on a level surface. NEVER park on hills or inclines.
    • Engage leveling jacks and set wheel chocks if available on the vehicle.
  • Donor Eligibility and Screening Area Setup:
    • Start HemoFlow CMRS on the computer system. Crucial Sequence: Turn on HemoFlow CMRS on the computer BEFORE turning on HemoFlow mixers.
    • Start bexWISE software on all computers located in the screening rooms.
    • Remove blood mixers from their carrying cases, place them onto each donor bed mount, and turn them on.
    • Place the yellow sheet onto a clipboard along with a blue or black ink pen, and set it out in a convenient area accessible to donors (must be out and ready).
    • Screening Station Required Items: Each screening station must be set up with:
      • Small sharps container
      • Trash can lined with a trash bag
      • Lancets
      • Alcohol pads
      • Non-sterile gauze
      • HemoCue cuvettes
      • Yellow sheet
      • Welch Allyn blood pressure/vitals unit equipped with regular and large CP cuffs and temperature probes.
    • Perform and document all Daily Quality Control (QC) tasks.

Phlebotomy and Bag Making Station Setup

  • Phlebotomy Area Layout and Supplies:
    • Place one tourniquet and one hemostat at every donor bed.
    • Ensure all necessary supplies are arranged in an easily accessible manner, facing toward the worker:
      • Band-aids
      • Tape
      • Sterile and Non-Sterile Gauze
      • Rubber bands
      • Ice packs
      • Ammonia inhalants
      • Metal clips
      • Arm preps
      • Tubing strippers
      • Coban (wrap)
      • Gloves
      • Biohazard bag
    • Line trashcans with trash bags and place the trashcans into their dedicated trash can recesses.
  • Bag Making Station Setup:
    • Place the Donor Register in a convenient location.
    • Obtain unit numbers, blue/pink/yellow stickers, blood pack units, and sample tubes.
    • Arrange all materials to facilitate a productive workflow.

Segmenting Station Setup and Decontamination Protocols

  • Segmenting Station Setup:
    • Place the heat sealer on the counter with a large biohazard/sharps container nearby.
    • Organize segmenting equipment: tubing strippers, hemostats, rubber bands, goggles/face shield, O'Haus Digital Scale, and Digital Alarm Thermometer.
    • Position blood coolers and sample tube racks in convenient locations.
    • Perform and document Daily QC for the digital scales.
  • Refreshment Area and QC Review Setup:
    • Arrange donor refreshments neatly.
    • Review the Daily QC sheet to ensure all documentation is complete.

Bloodmobile Closing and Post-Drive Procedures

  • Closing Screening Stations:
    • If sharps containers are 23\frac{2}{3} full, tightly close the lid and secure them for transport and disposal upon return to the Center. Do NOT leave filled sharps containers on the Bloodmobile.
    • Clean the Welch Allyn unit and secure all components for transport.
    • Restock cleaning supplies and secure all equipment in designated screening room areas.
    • Clean screening tabletops with an approved cleaning solution.
    • Secure screening room stools to tie-down points to prevent them from rolling during transit.
    • Secure screening room doors for transport.
  • Closing Phlebotomy Area:
    • Clean work areas with an approved cleaning solution.
    • Remove mixer trays and store them under the donor bed flaps.
    • Wipe down donor beds and work surfaces using an approved solution.
    • Inspect the work area for clinical cleanliness; clean further as needed.
    • Clean HemoCue devices and ensure they are secured for transport.
    • Document all decontamination procedures on the Daily QC sheet.
  • Closing Segmenting Station:
    • Use a Bleach solution diluted at a ratio of 1:101:10 for decontamination.
    • Ensure all blood units, sample tubes, and Donor Record Forms (DRFs) are packed in the appropriate coolers.
    • Verify that all non-conforming blood units are processed, labeled, packed, and documented.
    • Turn off the heat sealer, clean it, and document the cleaning on the Daily QC sheet.
    • Store supplies and equipment in cabinets above or below the segmenting counter, or repack into appropriate containers.
  • Additional Closing Steps:
    • Complete the trip sheet; review all used DRFs and the Daily QC sheet.
    • Review donor deferrals and assign appropriate deferral codes.
    • Secure all biohazard waste and regular trash for return to the Center.
    • Secure blood coolers for transport inside cooler drawers or within screening rooms behind closed doors.
    • If applicable, remove back doorsteps and place them in designated storage areas.
    • Remove wheel chocks from Bloodmobile tires and release stabilizing jacks if engaged.
  • Return to Center Protocol:
    • Unload supply containers, leftover snacks, blood coolers, and paperwork.
    • Deliver supply containers and leftover snacks to designated areas in the mobile supply room.
    • Deliver blood coolers, DRFs, Donor Register, and all other paperwork to their designated areas.

Inside Setup Operations (Non-Bloodmobile Drives)

  • Pre-Departure Requirements:
    • Obtain a computer tower.
    • The Team Leader must take the Team Leader notebooks.
    • Take the Equipment Cart(s) designated for the drive.
    • Pack a blue drink cooler for the refreshment area.
  • Site Arrival and Flow Configuration:
    • The Team Leader determines the layout setup and donor flow.
    • Flow Guideline: A continuous circular pattern with minimal backtracking is optimal.
    • Unload equipment and supplies from the vehicle (primarily a box truck).
  • Registration and Screening Station Setup:
    • Position the computer tower in an area that yields the best network connectivity.
    • Ensure auditory privacy for each screening station by deploying screens and placing stations 6 to 8 feet6\text{ to }8\text{ feet} apart.
  • Phlebotomy Station Setup:
    • Arrange donor beds to promote donor safety and work efficiency. Standard arrangement is 33 donor beds per Phlebotomist station.
    • The Team Leader determines the placement of plastic runners.
    • Position Phlebotomy carts conveniently relative to the donor beds.
    • Ensure at least one blood tubing stripper is available for each set of donor beds.
  • Segmenting Area Setup (Inside Setups):
    • Place the heat sealer on a cleanable, non-porous table/surface and plug it into a power source.
    • Organize segmenting supplies neatly: tubing strippers, hemostats, rubber bands, goggles/face shield, peroxide, rubbing alcohol, biohazard bags, and cotton swabs.
  • Refreshment Area Setup:
    • Arrange the refreshment area in a position that allows for direct donor observation.
    • Ensure the blue drink cooler is accessible and snacks are clearly visible to donors.

Decontamination, Packing, and Final Site Disposition for Inside Setups

  • Packing Screening Carts:
    • Clean screening, segmenting, and all other utilized tables with an approved solution, and document on the Daily QC sheet.
    • Pack screening supplies into screening cart(s), restocking as needed from supply pods.
  • Packing Phlebotomy Carts:
    • Wipe down the following items with approved cleaning solution:
      • Donor beds
      • Arm trays
      • Blood mixers
      • HemoCue units
    • Document additional supply needs on the daily supply sheet while packing equipment into Phlebotomy carts.
  • Packing Equipment and Vehicle Loading:
    • Turn off the heat sealer, clean it, and document cleaning on the Daily QC sheet.
    • Place equipment and supplies into carts, restocking from supply pods as needed. Repack additional items into appropriate containers.
    • Load all equipment onto the transport vehicle.
  • Final Disposition Before Leaving Mobile Site:
    • Secure all biohazard waste and regular trash for return to the Center.
    • Double-check the facility to ensure the area left behind is completely clean and all supplies have been packed.

Medical, Screening, and Deferral Contextual Information

  • Androgen / Testosterone Medications:
    • Testosterone
    • Andro
    • Depandro 100
    • Depo-Testosterone
    • Cy
  • Donor Screening Eligibility Criteria and Risk Assessments:
    • Verification of prior donation of a double unit of red blood cells.
    • History of continuous confinement in juvenile detention, lockup, or jail.
    • Travel or residency history outside the United States.
    • Use of antiviral PrEP or PEP medications.
    • Receipt of any medication by injection.
    • Ever testing positive for or having an HIV infection.
    • Organisms and procedures referenced in donor evaluation: Babesia microti, Xenotransplantation (transplantation of non-human cells, tissues, or organs into a human body).
  • Container Recycling Identification:
    • CA CRV
    • IA-HI 5C