Preface
WHO recognizes the importance of haemovigilance, systematic blood safety surveillance, to identify and prevent occurrence or recurrence of transfusion-related adverse events, and to increase the safety, efficacy and efficiency of blood transfusion. The WHO Action Framework to Advance Universal Access to Safe, Effective and Quality-Assured Blood Products 2020–2023 reaffirms the importance of haemovigilance as one of the strategic objectives of global efforts to improve capacity to monitor, investigate and assess adverse events in blood donors and transfusion recipients.
While national haemovigilance systems are well established in some countries, there is a lack of effective blood safety surveillance in many settings, as outlined in the WHO fact sheet on blood safety and availability. An effective haemovigilance system is an integral part of a comprehensive quality system in blood establishments and hospitals and should cover blood collection, testing, processing, storage, distribution and availability of blood and blood products, transfusion decisionmaking, administration, and monitoring of blood transfusions. It improves quality by enhancing the ability to objectively identify, learn from, and take appropriate actions to improve suboptimal practices at local and national levels.
In a 2015 WHO Global Database on Blood Safety survey of all WHO regions, only 49% of countries who responded reported having a national haemovigilance system. One of the challenges cited was lack of ability of blood establishments and hospitals to carry out end-to-end traceability from collection to use of blood and blood products, and to conduct surveillance. Even where haemovigilance systems are in place, opportunities exist to further raise the bar in safety and quality by expanding the scope of these systems – for example, by incorporating rapid alert or early warning channels; by including capture of poor transfusion decision-making, under- or unnecessary transfusion, and avoidable blood wastage; and in analysis of risks related to particular patient groups, procedural weaknesses, and alternatives to blood transfusion. Recognizing that all countries can take steps, both small and large, to improve blood safety, and to assist countries as they develop and evolve their haemovigilance systems, WHO has developed this User guide for navigating resources on stepwise implementation of haemovigilance systems, working with experts from the International Haemovigilance Network (IHN), the International Society of Blood Transfusion (ISBT), WHO-related units, and others in haemovigilance systems worldwide.
The specific objectives are to:
- outline the necessary steps for implementation of haemovigilance systems in blood establishments and hospitals;
- support development of haemovigilance as part of the activities of a nationally coordinated blood system; and
- provide information and technical guidance resources on monitoring and investigating adverse events.
WHO and its partners have made these tools and resources available to Member States and to the public at the International Society of Blood Transfusion (ISBT) Working Party on Haemovigilance website (https://www.isbtweb.org/working-parties/haemovigilance) and the Notify Library (https://www.notifylibrary.org/content/educational-materials). Haemovigilance provides a way to focus limited resources in a structured manner towards solutions that best impact safety – and is a practical way of helping to make tomorrow a bit safer than today.
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