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Outcome Summary Advanced Blood Bank

Title Advanced Blood Bank
Course Number 10513123
Credits 2
Organization Western Technical College
Developers MLT/CLT Curriculum Alignment Team Carolyn Byom
Development Date 12/1/2002
Revised by Carolyn Byom
Revised date 12/1/2008
Instructional Level Associate Degree Courses
Instructional Area Laboratory Assistant - 513
Division Health and Public Safety
Department Medical/Clinical Laboratory Technician

Instructional Type Contact Hours Outside Hours Credits
 Laboratory  36  0  1
 Lecture  18  0  1

Description


This course consists of advanced blood banking concepts and procedures including work ups for adverse reaction to transfusions and disease states.



Prerequisites


  • Prerequisite(s): 10806177 General A & P; 10513110 Basic Lab Skills; 10513111 Phlebotomy or 10513135 Phlebotomy Experience; 10513113 QA Lab Math; 10513114 Urinalysis

Supplies

  • Disposable Fluid RESISTANT Lab Coat
  • Safety goggles or glasses
  • Sharpie - permanent marker
  • three ring binder

Core Abilities

  • Use effective communication skills
  • Apply mathematical concepts
  • Transfer social and natural science theories into practical applications
  • Demonstrate ability to think critically
  • Demonstrate ability to value self and work ethically with others in a diverse population
  • Use technology effectively

Competency

1.  Interpret QC testing for advanced techniques


Criteria - Performance will be satisfactory when:

  • data collection is accurate
  • data is recorded completely and accurately
  • data is relevant
  • data is current
  • reagent sources are identified
  • data results are organized and clearly communicated
  • data is presented in a graph or chart; graphical representations are accurate and easy to read
  • data analysis includes an analysis of the results
  • data analysis makes a recommendation based on the results; recommendation is clearly supported by the data

Learning Objectives

  • Characterize minimum record requirements for Quality Assessment and Quality Control for donor centers, blood banks, and large transfusion services.
  • Explain minimum records requirements for patients relating to laboratory tests on unexpected antibodies, problems with ABO and Rh groupings, and adverse effects of transfusions.
  • Summarize the minimum record requirements for donors and donor units.
  • Articulate assessment examples relating to blood utilization related to both ordering appropriate blood components and handling and dispensing blood components.

2.  Interpret antibody identification results of Rh and other Blood Group Systems


Criteria - Performance will be satisfactory when:

  • cell panel sources and other reagents sources are identified
  • data collection from antibody identification testing is accurate
  • data is recorded completely (including grading of reactions) and accurately
  • data collected on follow-up testing is relevant
  • data is presented in a chart that is accurate and easy to read
  • data results are organized and clearly communicated including the grading of reactions and the phases tested and quality control testing performed
  • data analysis includes a written description and analysis of the results
  • data analysis makes a recommendation based on the results related to transfusions, hemolytic disease of the newborn or autoimmune hemolytic anemia that is clearly supported by the data
  • lab report includes an analysis of the test results
  • lab report includes follow-up testing performed or recommended to confirm the presence of specific antibody(y)ies such as antigen testing and probability testing (3 positive and 3 antigen-negative test)
  • lab report includes a description of the conclusions you drew and why
  • lab report is neatly handwritten in ink; corrections are properly documented
  • lab report and data reporting is prompt
  • laboratory practical based on both antibody identification testing procedures and the interpretation of the data is a C or better
  • written exam is a C or better in accordance with transfusion reaction objectives

Learning Objectives

  • Explain when an antibody screen should be followed by an antibody identification for transfusion recipients, blood donors, and obstetrical patients
  • Describe the method of crossing out on the antigen matrix to narrow down the antibody specificity.
  • Describe how multiple antibodies are recognized and identified.
  • Explain how dosage may affect antibody identification.
  • Explain the significance of a positive autocontrol when doing antibody identification.
  • Distinguish between the significance of a weak positive or mixed field autocontrol and an autocontrol of 2+ or greater.
  • Describe what steps to follow when the autocontrol is positive.
  • Discuss the usefulness and the limitations of phenotyping the patient when doing antibody identification.
  • List four methods that may be used to potentiate weak antibody reactions, and describe the mode of action of each.
  • Correctly perform all steps of an antibody identification procedure, identifying any and all antibodies present within a 95% confidence level within the limits of materials available with cell panels and patient phenotyping.

3.  Determine transfusion reactions


Criteria - Performance will be satisfactory when:

  • lab report includes an overview of the procedures used in Blood Bank for Transfusion Reactions
  • lab report includes a list of the materials, equipment, and steps used to conduct the experiment
  • lab report includes the results of testing
  • lab results are presented in a chart
  • lab report includes a description of the conclusions you drew and why
  • lab report includes an appendix of supporting documentation on which you based your interpretation
  • lab report is neatly handwritten or electronically submitted; corrections properly documented
  • lab report uses appropriate blood banking vocabulary
  • case study response demonstrates a thorough understanding of relevant aspects of the transfusion reaction
  • transfusion reaction case study response outlines in detail the decision selected by you
  • transfusion reaction case study response includes an explanation of why the decision was selected
  • transfusion reaction case study response is supported by relevant evidence
  • transfusion reaction case study response is well organized
  • transfusion reaction case study response evidences correct grammar, punctuation, and spelling
  • written exam is a C or better in accordance with transfusion reaction objectives

Learning Objectives

  • Distinguish between the types of samples to be collected from a patient when doing a transfusion reaction workup.
  • Describe the steps to be taken by lab personnel in a basic transfusion reaction workup.
  • Describe the steps involved in an extended transfusion reaction investigation, when an extended workup would be done.
  • List at least three tests that would be done in further testing beyond an extended workup.
  • Discuss the kinds of hemolytic transfusion and non-hemolytic transfusion reactions with regards to: cause, symptoms and severity, relative frequency, laboratory findings, prophylaxis,
  • Explain how a delayed transfusion reaction occurs.
  • Interpret a transfusion reaction workup.
  • Perform elution procedure when necessary.
  • Interpret the results of an eluate.

4.  Determine autoimmune hemolytic diseases/conditions


Criteria - Performance will be satisfactory when:

  • lab report includes an overview of the procedure used in Blood Bank for Autoimmune Hemolytic Anemia (AIHA)
  • lab report includes a the results of the testing
  • lab results are presented in a chart
  • lab report includes a description of the conclusions you drew and why
  • lab report includes an appendix of supporting documentation upon which you based your interpretation
  • lab report is neatly handwritten or electronically submitted
  • lab report uses appropriate blood banking vocabulary
  • case study response demonstrates a thorough understanding of relevant aspects of the AHIA case
  • case study response includes an explanation of why the decision was selected
  • case study response outlines in detail the decision selected by the learner
  • case study response is supported by relevant evidence
  • case study response is well organized
  • case study response evidences correct grammar, punctuation, and spelling
  • written exam is a C or better in accordance with AIHA objectives

Learning Objectives

  • Differentiate between warm and cold AIHA regarding the class of antibody involved, antibody specificity, and the optimum temperature range each is observed.
  • Describe the typical serological pattern of a cold autoantibody - the effect on ABO/Rh typing, antibody screen results, DAT results, and methods to overcome serologic problems.
  • Describe the usual treatment for cold autoimmune hemolytic anemia.
  • Describe the typical serological pattern of a warm autoantibody - the effect on ABO/Rh typing, antibody screen results, and DAT results.
  • Describe what may be done to overcome the serological problems produced by warm autoantibodies.
  • Explain the principle of an autoadsorption technique and the purpose of ZZAP in said technique.
  • Explain how to determine whether or not it was necessary to perform an autoadsorption when testing a patient with Warm Autoimmune Hemolytic Anemia.
  • Describe the usual treatment for warm autoimmune hemolytic anemia.
  • Characterize drug-induced autoimmune hemolytic anemia and the offending drugs that typically cause AIHA.

5.  Determine hemolytic disease of the newborn (HDN)


Criteria - Performance will be satisfactory when:

  • lab report includes an overview of the procedure used in Blood Bank for Hemolytic Disease of the Newborn (HDN)
  • lab report includes a the results of the testing
  • lab results are presented in a chart
  • lab report includes a description of the conclusions you drew and why
  • lab report includes an appendix of supporting documentation upon which you based your interpretation
  • lab report is neatly handwritten or electronically submitted
  • lab report uses appropriate blood banking vocabulary
  • case study response demonstrates a thorough understanding of relevant aspects of the HDN case
  • case study response includes an explanation of why the decision was selected
  • case study response outlines in detail the decision selected by the learner
  • case study response is supported by relevant evidence
  • case study response is well organized
  • case study response evidences correct grammar, punctuation, and spelling
  • written exam is a C or better in accordance with HDN objectives

Learning Objectives

  • Describe how HDN occurs and the symptoms
  • Distinguish between the more common blood group antibodies that cause HDN and those that do NOT cause HDN
  • List the differences between ABO and Rh HDN regarding: antibodies involved, severity, detection, treatment, HDN laboratory workup results.
  • Explain how HDN is initially detected
  • Explain what further testing is done on both parents if HDN is detected
  • Explain how the severity of HDN is monitored during the pregnancy including antibody titration, amniocentesis and Percutaneous Umbilical Blood Sampling.
  • Discuss indications for and methods of intrauterine transfusion and exchange transfusions
  • List the criteria for selection of blood for intrauterine transfusion and exchange transfusions
  • Identify solutions to problems occuring in HDN and Rh immune globulin workups
  • Select the appropriate elution method to perform when the baby has a positive DAT
  • Explain the purpose of Rh immune globulin.
  • Describe the method of action of Rh immune globulin.
  • Describe the steps involved in a Rh immune globulin workup.
  • List the criteria to determine Rh immune globulin eligibility.
  • State the standard dose of Rh immune globulin.
  • Explain why multiple doses of Rh immune globulin may sometimes be required.
  • Describe the principle and general procedure of each of the following tests: rosette test, Kleihauer-Betke test, and ELAT test
  • Explain how antenatal Rh immune globulin may affect the results of the workup done at delivery.
  • Name two other clinical situations (besides pregnancy and delivery) where use of Rh immune globulin may be indicated.
  • Correctly perform and interpret Rh immune globulin workups.Determine the eligibility for Rh immune globulin based on the results of a workup. Perform and interpret the rosette test for fetal-maternal hemorrhage to determine the need for multiple doses of Rh immune globulin

6.  Identify blood donor requirements according to AABB standards


Criteria - Performance will be satisfactory when:

  • evaluation includes general information about your interview
  • evaluation includes information that will determine whether or not a donor is acceptable
  • evaluation questions are directly related to donor qualifications
  • evaluation includes a summary of what you learned about donor qualification
  • evaluation provides relevant details
  • all work evidences correct spelling, grammar and punctuation
  • written exam is a C or better in accordance with blood donor requirements objectives

Learning Objectives

  • Identify the required donor registration information.
  • Distinguish between donor medical history criteria that are protecting the donor or the recipient
  • State the acceptable limits for donor: Age, Weight, Temperature, Blood Pressure, Pulse, Hematocrit.
  • Describe the blood collection process, including skin preparation, collection of blood, care of donor after phlebotomy and how much blood is normally collected in the donation process
  • State the minimum interval of time between donations for whole blood and pheresis donors.
  • Contrast requirements for autologous donations and regular donations
  • Describe the directed donor process, two unacceptable directed-donor situations, and why some directed donor blood must be irradiated.
  • List the routine laboratory tests done on donor blood.
  • List the infectious diseases that are required to be tested for on donor blood.

7.  Correlate component therapy with disease states/conditions


Criteria - Performance will be satisfactory when:

  • report is based on important features and attributes of component therapy
  • report includes similarities of components
  • report includes differences between components
  • report includes which specific components are used for which specific disease states and conditions
  • written exam is a C or better in accordance with component therapy objectives

Learning Objectives

  • Identify at least five risks inherent in blood component therapy.
  • List the physical factors that are monitored during a blood transfusion and the maximum length of time for said transfusion.
  • List all the possible components that can be made from a unit of whole blood.
  • Explain the process of dividing a unit of whole blood into its component parts.
  • State the uses for transfusion each of the following blood components: packed cells, fresh frozen plasma, cryoprecipitate, random donor platelet concentrates, HLA matched platelets, granulocyte concentrates
  • State which components must be crossmatched with the recipient's blood and which need to be ABO-compatible with the recipient's blood before releasing for infusion.
  • Explain what graft-vs-host disease is and how it relates to irradiation of blood components
  • Explain when leukocyte-poor blood components are indicated.

8.  Resolve BB testing problems


Criteria - Performance will be satisfactory when:

  • case study response demonstrates a thorough understanding of relevant aspects of the case
  • case study response outlines in detail the decision selected by the learner to resolve the BB testing problems
  • case study response includes an explanation of why the decision was selected
  • case study response is supported by relevant evidence
  • case study uses appropriate blood banking vocabulary
  • written exam is a C or better in accordance with testing problems objectives

Learning Objectives

  • Describe problems and solutions relating to ABO discrepancies
  • Identify problems and solutions relating to Rh and Other Blood Group System
  • Detail problems and solutions relating to Incompatible Crossmatches and Emergency Crossmatches
  • Explain problems and solutions relating to HDN and Rh Immune Globulin Workups
  • Summarize problems and solutions relating to Autoimmune Hemolytic Anemia.
  • Characterize problems and actions relating to donor selection and processing.