Background & Aims: The outbreak of coronavirus disease 2019 (COVID-19) has led to the alteration in hygienic conditions. Direct transmission of the respiratory droplet during speaking and coughing and reaching the droplet to the mucosa is the most common way of transmitting COVID-19. Also, hand contact with contaminated surfaces can lead to indirect transmission of the virus between individuals. Therefore, the cleanliness of the environment and the professional training of health workers are very effective in preventing the transmission of COVID-19.
One of the concerns in blood transfusion centers is that blood donors may have had contact with the coronavirus during donation and subsequently become infected. One of the reasons for a 40 to 67 percent decrease in donations in the early days of the pandemic was the fear and anxiety of donors about contracting the virus at donation centers and travel restrictions. In one province in China (Jiangxi Province), due to the pandemic, the number of blood donors decreased by 67 percent, and surveys showed that about 10 percent of donors were concerned about contracting the disease during donation sessions. This issue was immediately anticipated by blood transfusion centers, and many of them provided spaces to ensure a minimum distance of 6 feet between individuals and to protect the staff. Additionally, cleaning and disinfection of blood donation centers were carried out with greater care.
The main challenge for blood centers is ensuring the safety of blood donors and providing an adequate blood supply. In the Iranian Blood Transfusion Organization (IBTO), since the beginning of the outbreak COVID-19, a station for measuring body temperature and mask distribution was established in blood collection centers to protect blood donors. Disinfecting materials were provided and distancing was set up between the chairs of the reception area and blood collection beds. In fact, the improvement of hygienic conditions in the blood donation departments as the first step of blood collection is critical to increase the safety of the blood donors and blood supply. Therefore, the present study was conducted with the aim of monitoring the performance of blood donation centers during the outbreak of COVID-19. There are three types of blood donors: a first-time donor is a person who donated blood for the first time; a repeated donor is a person who has donated blood in the past, but not in the preceding 12 months and a regular donor is a person who has donated twice or more during one year. Regular blood donors were selected because of their sufficient knowledge of the blood donation process. These donors can compare hygienic conditions in the blood donation centers before and after the pandemic. This method is considered as a novel assessment tool.
Methods: Data were collected in December 2020. Regular blood donors were selected in 31 provinces of Iran. One blood donation center from each province and three blood donation centers from Tehran province have been evaluated by Regular blood donors of the same province. A questionnaire containing 10 questions was presented to evaluate the performance of blood transfusion centers to prevent the transmission of COVID-19. The comparison and evaluation of the questionnaires were done by assigning an Information Coefficient (IC) score to each question. The study was approved by the High Institute for Education and Research in Transfusion Medicine: IR.TMI. REC.1399.018. Frequencies and percent of descriptive data were analyzed by descriptive statistics. Data with normal distribution was analyzed by parametric tests and data with abnormal distribution were analyzed by nonparametric tests. A p value of less than 0.05 indicates that a difference is significant. All Statistical analyses were carried out with SPSS software (version 22).
Results: Analysis of the Questionnaires obtained from 31 centers revealed that 6 questions received >80% positive responses that among this "sanitation in blood centers" and "staff encounters behavior" had the maximum satisfaction percent (%100 and 97% respectively). On the other hand, four questions received <80% positive response and “mask distribution among blood donors” had the minimum satisfaction percent (45%). Monitoring the performance in blood centers by regular blood donors in 31 provinces of Iran showed that 17 centers (58.1%) received IC scores >10(Strong performance), 8 centers (22.6%) received the range of IC scores between7-10(acceptable performance), and 6 centers (19.4%) received IC scores <7(poor performance). The difference in IC scores between provinces was not statistically significant.
Conclusion: The result of this study showed that the evaluation of blood donation centers through regular blood donors can play an important role in the improvement of services provided to blood donors, and it indirectly affects the quality and health of blood. Also, detailed analysis of questioners in each province can lead to troubleshooting and effective corrective actions.
In the present study, the results showed that 7 provinces received a range of scores between 7-10 which was acceptable scores. These results provide valuable information on the identification of poorly performing provinces, which leads to greater focus and closer monitoring of these areas (six provinces with scores less than 7). The results also showed that there was a high percentage of dissatisfaction with “the stand”, “sitting space”, and “overcrowding” questions. It is necessary to mention that in many blood transfusion centers, it is not possible to change the infrastructure and this issue leads to limited space to place the posters and sitting. It seems that the crowd management with blood donation staff and the transfer of donors to the outdoor space leads to effective space management and reduces the possibility of disease transmission.
In the present study, the results showed that in 31 provinces of the country, 34 individuals (more than 100 percent) participated actively in the evaluation program of blood transfusion centers. By organizing these individuals, it is possible to utilize them as helpers for blood transfusion services in similar crises and subsequent ones.
Our study is limited, by the small sample size and lack of previous research studies on the topic. However, this research can provide an effective guide to the use of blood donors for Monitoring the performance of blood donation centers, especially in critical situations..