Updates from the Blood Collection Center Front line:

Donor Challenges and Donor Education

Program Chair: Dan A Waxman, MD, Versiti, Indianapolis, IN

Speaker: Susan Rossmann, MD, PhD, Gulf Coast Regional Blood Center, Houston, TX
Speaker: Gay Wehrli, MD, MBA, MSEd, University of Virginia School of Medicine, Charlottesville, VA

Tuesday, Oct. 16, 2018

11:00 a.m.-12:30 p.m. EST
Room 156
 Faculty Disclosure
(In compliance with ACCME policy, AABB requires the following disclosures to the session audience)

• Dan Waxman, MD
 Nothing to disclose
• Susan Rossmann, MD, PhD
 Nothing to disclose
• Gay Wehrli, MD, MBA, MSEd
 The Foundation for America’s Blood Centers’ grants supported the donor
education materials studies
 Nothing further to disclose

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 Objectives
1. Describe a challenging donor situation and assess how
best to resolve the situation
2. Cite key points that need to be incorporated in a
universal donor education document
3. Discuss the donor knowledge outcomes after
implementing a universal donor education document

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 In memory…
Celso Bianco, MD
August 16, 2018
 ABC President and CMO
 ISBT President
 BPAC member
 ACBTSA member
 Colleague
 Mentor
 Friend
 Husband, father and grandfather

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 Donor Challenges
Susan N. Rossmann MD PhD

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 What is a “challenging” donor?
• Challenging the rules
• Challenging our assumptions
• Challenging the staff
• Challenging our knowledge

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 What is a “challenging” donor?
• Challenging the rules
• Challenging our assumptions
• Challenging the staff
• Challenging our knowledge

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 Donor with tattoo
• 23 year old man with large Halloween tattoo
• Now undergoing removal of tattoo
• What are considerations for donor acceptability?

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 Accepting donors with tattoos
• FDA Guidance on Reducing the risk of HIV transmission
by blood
– December 2015
• One year deferral UNLESS
• Tattoo was administered in a state-licensed facility with
– Sterile conditions
– Single-use inks

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 Undergoing tattoo removal

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 Undergoing tattoo removal
• Laser treatment

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 Undergoing tattoo removal
• Laser treatment
• 3 treatments so far

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 Undergoing tattoo removal
• Laser treatment
Various wavelengths for different colors
• 3 treatments so far, 10 weeks apart
• Small fragments of dye can be pushed into skin
• Is deferral necessary?

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 Before and after laser removal

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 Tattoo removal and blood donation
• Wait until skin healed
• No need to defer after
• If original tattoo were infectious risk,
– Donor would have detectable infection by now
(seroconversion or NAT)

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 Challenging our assumptions

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 Case report- called by hospital
• 45-year old Hispanic woman was hospitalized for
renal issues and had 2 RBC transfusions
• In the next week, patient grew more febrile and
obtunded
• Laboratory technologist noticed ring forms on
peripheral smear

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 Diagnosis of malaria
• Patient had been to areas of Mexico where malaria
is present
– (P. vivax only species in Mexico)
• Also investigated 2 donors
– 1 45 year old man, from Houston, no travel
– 2 16 year old high school student, now from Houston
• Had emigrated from Nigeria 2 years previously

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P. falciparum

• Quite common in West

Africa, including Nigeria
• Causes highest
parasitemia

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 Case circumstances
• Diagnosis of P. falciparum based on morphology and level of
parasitemia
• Tested both donors
• Older man completely negative
• Young man from Nigeria had negative smears and negative PCR at
CDC, but positive serology for P. falciparum.
• He denied history of malaria, but Mom said he had had malaria,
treated when 5
• Completely asymptomatic for years
• Repeat PCR was positive

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 Numerous assumptions
• We assume donors know their history
• We assume they will understand the question and
tell us the right answer
• We assume our staff can follow the protocol

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 Challenging our staff
• 56 year old man on testosterone therapy for
hypogonadism has received prescription from his
urologist for therapeutic phlebotomy
• He comes to a Neighborhood Donor Center and
expects to be drawn
• Staff cannot find order, refuses to draw him
• He leaves angry

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 Process for therapeutic phlebotomy
• Our process (approved variance from FDA) involves
– Ordering physician faxes order to TBC, with dx, desired
minimum hematocrit, and desired interval of donation
– Staff enter orders into SafeTrace
– Donor can present to any Neighborhood Donor Center after
prescription is entered (72 hours, we say)
• Although it is FDA approved, many of long-time staff
have strict interpretation of “voluntary” donor standard,
which leads to caution

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 What can go wrong?
• Doctor did not fax order
• Doctor did order incorrectly
• Donor’s hematocrit is not high enough to meet rx
• Donor’s donation interval is too short
• Donor can be frustrated, get angry
• Staff can be frustrated

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 Testosterone therapy
• Growing exponentially in US
– Men in 40’s are fastest growing group
• Topical and IM forms available and new ones keep being approved
• Has risk of cardiac complications
• Causes erythropoiesis, which can lead to high hemoglobin, relieved
by phlebotomy
• Can also be managed by reducing testosterone dose
• Unclear (to me) relation between hemoglobin and cardiac issues
• Remains a challenging issue that is growing

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 Why so much therapeutic testosterone?
• Testosterone helps
– Build muscle
– Reduce body fat
– Improve sex drive
• Of recent prescriptions
– Half had hypogonadism
– 40% had sexual or erectile dysfunction
– One-third had a diagnosis of fatigue

www.aabb.org New York Times 30

 Challenging donor father-son pair
• 20-year old man and his 68-year old father come
together to a mobile (bus) blood drive
• Son has donated before?
• Father wants to accompany son to screening room
and help answer questions
• Refused by staff

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 Challenging our knowledge
• What is the appropriate level of donor
comprehension
– Of educational materials?
– Of screening questions?
• When can donor give consent?

• In research world, called decisional capacity

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 When is a donor acceptable?
• Accept donors with Down syndrome, early dementia,
schizophrenia and other disorders as long as they are
able to understand the questionnaire and consent and
fully participate in the process
• Only defer if these conditions get to the point where the
independence is lost.
• We do this on a case-by-case basis, using judgment of
most experienced staff

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 Donors with early Alzheimer’s
• Or similar, cognitive decline
• Memantine now used for migraines

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 When should we turn away donor?
• Donor can sign a waiver of confidentiality so that a legal
guardian can be in the screening, however the legal
guardian is not allowed to function as an interpreter.
• We must be sure the donor knows what is expected of
him
• Please know we’re thankful for people like your son who
want to help save lives, but we need to be sure he is
safe and understands the process of blood donation.

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 Father’s response to refusal
I feel he is being treated differently and I will be taking this up
with OCR, a federal government agency that protects the
disabled from discrimination
• Office of Civil Rights, part of HHS

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 Is there a right to donate blood??
Probably not But justice is a consideration
• Safety for patients is prime • We rely on public to freely
• Blood collector makes rules for donate, at some risk to
patient safety and own themselves
operational considerations • Want to be FAIR and
• Only impose restrictions that
are reasonable
• MSM discussion

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 Decisional capacity for healthcare
• Understanding, including risks and benefits,
alternatives
• Appreciation of information as applied to self
• Reasoning process, ability to manipulate information
• Expression of a choice, consistently

Palmer and Harmell, 2016

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 Aspects of understanding in blood donors
Consent Donor history screening
• Based on autonomy rights • Protection of recipient
• Right to bodily integrity • Protection of donor
• Understand risks and purpose
of activity

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 Obtaining valid consent is an ethical
requirement
• Meeting this requirement involves disclosing a lot of
information [about the study] to potential participants
in a manner that gives them a fair opportunity to
understand it, but it does NOT require that all that
information is also understood

Bromwich and Millum, 2018

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 Response from father of son refused
donation
• My son is disabled according to the Federal
Government.
• He would not understand the questions as the
questioner would/is unable to phrase the questions
so he can understand them
• He is not an IDIOT, as you implied, just has issues
understanding the info given

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 We need
• A sensitive, consistent method of evaluating these
donors
– For example, some Down syndrome donors can answer
questionnaire independently
• A method that is operationally feasible

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 A communication is adequate if
• It contains the information that is material to
effective decision making
• Consumers can access that information
• Consumers can understand that information
• Which facts matter to decision makers
[donors]??

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 Can we test understanding?
• Is there a short form we could put in automated
questionnaire
– “Attention” question
• I am male (or female)
• Breaking pattern of responses
• Seems far away from our current comprehension

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 We also need
• The best donor materials we can have, to help
donors understand what we are saying
• They will not understand all risk factors we ask
about, but
• We need their confidence we are asking reasonable
questions

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 Blood collector responsibility
• A donor may not understand the questions because
the questioner is unable to phrase the questions so
he can understand them
• The responsibility for understanding then is on us as
much or more than on the donor

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 Donor Education
Gay Wehrli. MD MBA MSEd

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 Background: Educating Donors
• Donors need time and information for a truly informed
consent decision to donate blood
• Donor education materials (DEM) are key to this process
 Address topics required by regulatory agencies
• FDA Blood Product Advisory Committee (BPAC)
• AABB
 Accessible
 Understandable (7-8th grade)

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 ABC Working Group
Background
 Celso Bianco
 Louis M. Katz
• 1976: 8th Edition AABB Standards introduces donor consent
 Susan Rossmann
• 2007: Proposed rule on Human Blood & Blood Components for J. Sazama
 Kathleen
Transfusion & Further Manufacturing Use  Dan Waxman
 Written Statement of Understanding (WSU)  Gay Wehrli
• 2011: FDA BPAC re-visits WSU
 ABC Working Group for Donor Education & Communication

• 2016: 30th Edition AABB Standards adds donor iron education

 21 CFR 630.10 Donor’s Acknowledgement (replaces WSU)

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 Background
• 2011: FDA BPAC re-visits WSU
 7 Elements (5 focus on TTI and ID)

• 2016: Donor’s Acknowledgement with 6 Elements

1. Ed materials regarding relevant TTI
2. Agrees not to donate if potential risk to recipient
3. Blood will be tested for relevant TTI
4. If donation not suitable or deferred, then documented as ineligible & notified
with deferral basis plus deferral period
5. Hazards & risks of donation procedure
6. Ask questions & withdraw from donation procedure at any time

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ID: infectious diseases
 ABC Working Group: Donor Ed & Communication
• What does someone need to know?
 Information may in itself reduce harm
• Comprehensive, yet short
 Willingness to read compromised if too long
 Donors value their TIME as much as their BLOOD
• Complex information, yet simplistic language
 Donor may be anxious, uninformed
 Avoid our jargon in communications e.g., false-positive tests
• Ethical, medical and public relations impacts

Dmitry Azovtsev: http://www.daphoto.info

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 Risk Communication
• Share Information
 Make the lawyers happy
• Change Belief
 Provide risk & benefit info
• Change Behavior
 We know what is best
 Change belief back-up

www.aabb.org Communicating Risks & Benefits: An Evidence-Based User’s Guide. Published by FDA, US DHHS, August 2011. 52
http://www.fda.gov/ScienceResearch/SpecialTopics/RiskCommunication/ default.htm
 Risk Communication: Adequacy test

www.aabb.org Communicating Risks & Benefits: An Evidence-Based User’s Guide. Published by FDA, US DHHS, 53
August 2011. http://www.fda.gov/ScienceResearch/SpecialTopics/RiskCommunication/ default.htm
Risk Communication: What words make sense to people?
• NIH: All of Us Research Program

Office for Human Research Protections, Meeting New Challenges in Informed Consent in Clinical Research, 9/7/2018:
https://www.hhs.gov/ohrp/education-and-outreach/exploratory-workshop/2018-workshop/index.html
www.aabb.org Participant-Centered Design for Informed Consent. Megan Doerr, Sage Bionetworks. 54
The All of Us Research Program: https://allofus.nih.gov/
 Kutner, M., Greenberg, E., Jin, Y., and Paulsen, C. (2006). The Health Literacy of America’s Adults: Results From the 2003 National Assessment of
Adult Literacy (NCES 2006–483). U.S. Department of Education. Washington, DC: National Center for Education Statistics.
https://nces.ed.gov/pubs2006/2006483.pdf
Kutner, M., Greenberg, E., Baer, J. (2006). A First Look at the Literacy of America’s Adults in the 21st Century (NCES 2006 2006-470). U.S.
www.aabb.org
Department of Education. Washington, DC: National Center for Education Statistics. https://nces.ed.gov/NAAL/PDF/2006470.PDF
55
Risk Communication: What words make sense to people?
• NIH: All of Us Research Program

Office for Human Research Protections, Meeting New Challenges in Informed Consent in Clinical Research, 9/7/2018:
https://www.hhs.gov/ohrp/education-and-outreach/exploratory-workshop/2018-workshop/index.html
Participant-Centered Design for Informed Consent. (Manuscript in progress.) Megan Doerr, Sage Bionetworks.
www.aabb.org
The All of Us Research Program: https://allofus.nih.gov/
56
 Early Work: Developing Donor Education Materials (DEM)

• 2013 Focus Group (N = 10)

 4 pages
• 2014 Individual Interviews (N = 7)
 3.5 pages with key points
• Pre- and Post-Quiz
 10 Multiple choice, single best, answer questions
 “I don’t know” response option

If you think you have HIV (the virus that • True

causes AIDS) then going to donate blood • False
is a good way to get tested. • I don’t know
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Wehrli G, Rossmann S, Katz LM, Waxman DA. Developing blood donor education materials. Transfusion 2017; 57(S3):106A(CP101).
 Early Work: Quiz summary
Focus Group (FG) Individual Interviews (II)
10 Quiz Questions 10 Participants 7 Participants
Pre Post Pre Post
Correct responses 43 (43%) 91 (91%) 31 (44.3%) 70 (100%)

I don’t know responses 31 (31%) 0 25 (35.7%) 0

Incorrect responses 26 (26%) 9 (9%) 14 (20%) 0

Total responses 100 (100%) 100 70 (100%) 70 (100%)

FG and II feedback: document is too long

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Wehrli G, Rossmann S, Katz LM, Waxman DA. Developing blood donor education materials. Transfusion 2017; 57(S3):106A(CP101).
 DEM Overview: Key Points
a. We want you to know more about donating blood. Plan ahead & be
prepared by reading this and asking questions about anything that is not
clear.
b. To give blood you must be healthy & meet minimum age & weight
requirements.
c. You will need a photo ID.
d. In privacy, you will be asked to answer questions about your health,
medicines, travel & very personal things including sex & using needles to
take drugs.

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 DEM Overview: Key Points
e. We work to keep donor safe, but a few donors faint & some develop a low
iron level.
f. Do not donate blood to be tested for HIV or hepatitis. Go to your
healthcare provider or public clinic.
g. You will not be paid to donate.
h. Contact us at any time if you think your blood donation might not be
safe for patients.
i. If you have a medical problem after donating, contact us immediately. If
serious, first seek immediate medical attention and then call us.

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 DEM Overview: Topics

1. What are some basics about blood donation?

2. How should you plan ahead to donate blood?
3. What happens when you donate whole blood?
4. What should you do while donating?
5. What should you do after donating?

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 DEM Overview: Topics

6. You may be told you cannot donate, this is called, “deferral.”

7. What if you are deferred for a low red blood cell (or hemoglobin
or hematocrit)?
8. How will we test your blood & protect your privacy?
9. How, when & where can you ask questions before, during or
after donating blood?

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 2018 Pilot Study
Purpose Specific Aims
 We know donor knowledge is less  To better understand baseline
than desirable and we believe one knowledge between 4 donor groups
reason is that education materials
(EM) are suboptimal  To determine if new EM could
improve knowledge compared to
 Therefore, we designed a study to current EM
compare new EM versus current EM
in the blood donor population  Identify specific areas of strength and
weakness in donor knowledge
 We hypothesized donors would
acquire greater knowledge from the
new versus current EM

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 Pilot Study: Methods Overview All Donors

• Multicenter (3) RCT 10 Question

Pre-quiz
• Convenience sample volunteer donors (N = 180)
• New Donor & Returning Donor randomized to use:
New Donors Returning Donors
 New vs Current Education Materials
 New: 3 pages, font 12-12.5, grade 6.7
 Current: 1 page, font <11, grade 8.1 New Current New Current
• 10 Question Pre- and Post-quiz Education Education Education Education
Materials Materials Materials Materials
 Multiple choice with single best answer
• UVA IRB for Health Sciences Research

10 Question Post-quiz

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 Results: Demographics
Group 1 Group 2 Group 3 Group 4
Totals
ND + NEM ND + CEM RD + NEM RD + CEM
Total (N) 34 41 45 45 165
Male % 35.3% 41.5% 46.7% 44.4% 42.7%
Male/Female 12/22 17/24 21/24 20/24* 70/94
Mean Age ± SD 35.8 ± 15.2 34.2 ± 13.6 45.9± 19.8** 42.3 ± 17.9 39.6
Range 18-66 18-68 18-83 18-73 18-83
Education† 4.4 ± 1.5 4.3 ± 1.3 4.4 ± 1.6 4.3 ± 1.7 4.36 ± 1.5
Range 2-8 3-7 2-8 3-8 2-8
Race: White % 70.6 75.6 89.9 91.1 82.4
Black %‡ 5.9 14.6 6.7 2.2 7.3
Others %‡ 23.5 9.8 3.4 6.7 10.3

*1 did not respond † 4 = 2 year college degree/A.A./A.S. New/Current Education Materials = N/CEM
www.aabb.org **Difference between Group 2 & 3; p<0.05 ‡ Difference between white; p<0.05 New/Returning Donor = N/RD 65
 Results: Quiz Scores for each Group
Mean Score Group 1 Group 2 Group 3 Group 4
All Groups
(10 questions) ND + NEM ND + CEM RD + NEM RD + CEM

Pre-Quiz Correct ± SD 5.91 ± 1.99* 6.37 ± 1.93* 7.91 ± 1.20 7.96 ± 1.73 7.13 ± 1.96
(Range) (2-9) (2-10) (4-10) (0-10) (0-10)

Post-Quiz Correct ± SD 8.76 ± 1.44 7.61 ± 1.66 9.36 ± 0.83 8.27 ± 1.50 8.50 ± 1.52
(Range) (4-10) (4-10) (7-10) (1-10) (1-10)

Change Score ± SD 2.85 ± 1.67† 1.24 ± 1.39† 1.44 ± 1.34† 0.31 ± 1.06† 1.38 ± 1.60
(Range) (0-7) (-1.0-4) (-1.0-5) -2.0-3.0 (-2.0-7.0)

Pre-quiz: No significant difference between Grps 1&2 or between Grps 3&4

*Pre-quiz: Significant difference between Grp 1 versus Grps 3&4 and between Grp 2 versus Grps 3&4
†Pre-Post: significantly different within each group; p < 0.01

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Grp = Group New/Returning Donor = N/RD
 Results:
Quiz Change Scores in New Donors versus Returning Donors
2.5
Change in Correct Answers

1.5

1
*

0.5

0
Groups 1 & 2 Groups 3 & 4

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*Statistically significant difference, p < 0.05 67
 Results:
New EM versus Current EM Post-Quiz Scores
10.00 *
9.00
8.00
Post-Quiz Score

7.00
6.00
5.00
4.00
3.00
2.00
1.00
0.00
Groups 1 & 3 Groups 2 & 4
New Educational Current Educational
Materials Materials

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*Statistically significant difference, p < 0.001 68
 Results: Quiz Change Scores by Group
3.5
Change in Correct Answers

*
3
2.5
2
1.5
1
0.5 †
0
1 2 3 4

* Mean Δ Score Significantly Different between Groups 2, 3 & 4; p < 0.05

† Mean Δ Score Significantly Different between Groups 2 & 3; p < 0.05
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 What about the
individual
questions?

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 Results: Pre-Quiz Percent Correct
New Donors Returning Donors
Groups 1 & 2 Groups 3 & 4
120 • 2 weeks
Q1. After successfully
PERCENT CORRECT

100 donating whole blood, how • 4 weeks

long do you need to wait • 6 weeks
80 before returning to donate • 8 weeks
whole blood again? • I don’t know
60

40
Q3. At which • Before donating blood.
20 • While donating blood.
point during the
donation process • Immediately after donating
0
might you be blood.
1 2 3 4 5 6 7 8 9 10
asked not to • All of the above are true.
QUIZ QUESTION donate blood? • I don’t know

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 Results: Pre-Quiz Percent Correct
New Donors Returning Donors
Groups 1 & 2 Groups 3 & 4
120 Q7. You stayed home • Go donate whole blood
from work one day
PERCENT CORRECT

and don’t mention

100
because you were sick. anything about being sick
The next day, when you yesterday.
80
go back to work, there • Walk away and never try
is a mobile blood drive to donate whole blood in
60 the future.
and you would like to
• Ask one of the mobile
40 donate whole blood. blood drive staff when you
Which of the following could donate in the future.
20 should you do? • I don’t know
0
1 2 3 4 5 6 7 8 9 10
Q9. The needles used during the • True
QUIZ QUESTION blood donation process are used • False
only one time. • I don’t know

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 Results: New Donors versus Returning Donors
Groups 1 & 2 Pre-Quiz Groups 3 & 4 Pre-Quiz
New Donors Post-Quiz Returning Donors Post-Quiz
100 * * * *
Percent Correct 80 * *
60

40

20

0
1 2 3 4 5 6 7 8 9 10
Pre-Quiz 6.7 74.7 20 84 48 46.7 88 76 94.7 77.3
Post-Quiz 54.7 86.7 48 97.3 80 76 93.3 90.7 97.3 89.3

Pre-Quiz 64.4 96.7 31.1 94.4 61.1 67.8 94.4 88.9 96.7 97.8
Post-Quiz 81.1 97.8 52.2 95.6 83.3 86.7 96.7 91.1 98.9 97.8
Quiz Question Number
www.aabb.org *Change Score Significantly Different between Groups 1&2 versus Groups 3&4; p < 0.05 73
 Results: New Donors Group 1 Pre-Quiz Group 2 Pre-Quiz
New EM Post-Quiz Current EM Post-Quiz
100 *
*
Percent Correct

80
*
60

40

20

0
1 2 3 4 5 6 7 8 9 10
Pre-Quiz 2.9 79.4 17.6 73.5 38.2 47.1 85.3 79.4 97.1 70.6
Post-Quiz 79.4 97.1 58.8 100 94.1 76.5 91.2 91.2 100 88.2

Pre-Quiz 9.8 70.7 22 92.7 56.1 46.3 90.2 73.2 92.7 82.9
Post-Quiz 34.1 78 39 95.1 68.3 75.6 95.1 90.2 95.1 90.2
Quiz Question Number
*Post-quiz, significantly more people correct in Group 1 vs. 2; p < 0.05
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 Results: Returning Donors Group 3 Pre-Quiz Group 4 Pre-Quiz
New EM Post-Quiz Current EM Post-Quiz
* * *
100

80 *
Percent Correct

60

40

20

0
1 2 3 4 5 6 7 8 9 10
Pre-Quiz 60 95.6 20 95.6 64.4 68.9 100 88.9 100 97.8
Post-Quiz 88.9 97.8 68.9 100 95.6 95.6 97.8 93.3 100 97.8

Pre-Quiz 68.9 97.8 42.2 93.3 57.8 66.7 88.9 88.9 93.3 97.8
Post-Quiz 73.3 97.8 35.6 91.1 71.1 77.8 95.6 88.9 97.8 97.8
Quiz Question Number
*Post-quiz, significantly more people correct in Group 3 vs. 4; p < 0.05
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 Summary
• Returning donors have greater baseline knowledge compared to new
donors, but new donors improved more versus returning donors
• Donors utilizing new educational material showed statistically significant
greater improvement in knowledge compared to donors utilizing current
educational material allowing them to have the highest post scores
• With this sample size the results suggest that the findings are
independent of demographic characteristics
• Challenges remain in conveying to donors:
 when they may be asked not to donate
 the 8 week deferral period between each whole blood donation

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 What we have learned
• Keep it short and sweet
• Comprehension level is critical and challenging
• Test your materials for knowledge acquisition

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 Next Steps
• Refine new EM
 Key points: When you may be asked not to donate
 Key points: 8 week deferral after successful whole blood donation
 Format
• BPAC presentation
• Manuscript
• Broader study at more sites with more participants
 Look at other variables: education, race/ethnicity and age

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 Thank you!
Gulf Coast Regional Blood Center &
Ryan Nobles, MLS(ASCP)CMSBB
Director, Neighborhood Donor Centers

Mississippi Valley Regional Blood Center &

Pete Lux, RN
Director, Donor Services

Versiti Indiana Blood Center &

Tajuana L. Ryder, MSM-HCM
Continuous Improvement Advisor

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 Questions?
“While collecting a safe and sufficient blood supply,
we must encourage, protect and retain our donors.”

www.aabb.org
Wehrli G, Sazama K. Universal donor education and consent. Transfusion 2010;50:2499-2502. 80
Updates from the Blood Collection
Center Frontline: Donor Challenges
and Donor Education

10/16/2018
 Faculty Disclosures
The following faculty have no The following faculty have a
relevant financial relationships to relevant financial relationship:
disclose:
– Susan Rossmann MD, PhD
– Dan Waxman MD Roche Molecular:
– Gay Wehrli MD, MBA, MSEd Grant/Research Support

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 Learning Objectives
• Describe a challenging donor situation and assess
how best to resolve the situation
• Cite key points that need to be incorporated in a
universal donor education document
• Discuss the donor knowledge outcomes after
implementing a universal donor education document

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