title: Audit of clinical-laboratory practices in haematology and blood transfusion at Muhimbili National Hospital in Tanzania.
abstract: In Tanzania, there is paucity of data for monitoring laboratory medicine including haematology. This therefore calls for audits of practices in haematology and blood transfusion in order to provide appraise practice and devise strategies that would result in improved quality of health care services. This descriptive cross-sectional study which audited laboratory practice in haematology and blood transfusion at Muhimbili National Hospital (MNH) aimed at assessing the pre-analytical stage of laboratory investigations including laboratory request forms and handling specimen processing in the haematology laboratory and assessing the chain from donor selection, blood component processing to administration of blood during transfusion. A national standard checklist was used to audit the laboratory request forms (LRF), phlebotomists' practices on handling and assessing the from donor selection to administration 6f blood during transfusion. Both interview and observations were used. A total of 195 LRF were audited and 100% of had incomplete information such as patients' identification numbers, time sample ordered, reason for request, summary of clinical assessment and differential diagnoses. The labelling of specimens was poorly done by phlebotomists/clinicians in 82% of the specimens. Also 65% (132/202) of the blood samples delivered in the haematology laboratory did not contain the recommended volume of blood. There was no laboratory request form specific for ordering blood and there were no guidelines for indication of blood transfusion in the wards/ clinics. The blood transfusion laboratory section was not participating in external quality assessment and the hospital transfusion committee was not in operation. It is recommended that a referral hospital like MNH should have a transfusion committee to provide an active forum to facilitate communication between those involved with transfusion, monitor, coordinate and audit blood transfusion practices as per national guidelines.
authors.affiliation: Muhimbili University of Health and Allied Sciences, School of Medicine, P.O. Box 65001, Dar es Salam, Tanzania. Makubi55@gmail.com
authors.forename: Abel N
authors.initials: AN
authors.lastname: Makubi
authors.forename: Collins
authors.initials: C
authors.lastname: Meda
authors.forename: Alex
authors.initials: A
authors.lastname: Magesa
authors.forename: Peter
authors.initials: P
authors.lastname: Minja
authors.forename: Juliana
authors.initials: J
authors.lastname: Mlalasi
authors.forename: Zubeda
authors.initials: Z
authors.lastname: Salum
authors.forename: Rumisha E
authors.initials: RE
authors.lastname: Kweka
authors.forename: James
authors.initials: J
authors.lastname: Rwehabura
authors.forename: Amrana
authors.initials: A
authors.lastname: Quaresh
authors.forename: Pius M
authors.initials: PM
authors.lastname: Magesa
authors.forename: David
authors.initials: D
authors.lastname: Robert
authors.forename: Julie
authors.initials: J
authors.lastname: Makani
authors.forename: Ephata
authors.initials: E
authors.lastname: Kaaya
mesh_terms: D001803:Blood Transfusion / Q000592:standards*; D064790:Clinical Laboratory Services / Q000592:standards*; D003430:Cross-Sectional Studies; D006405:Hematology / Q000592:standards*; D006761:Hospitals; D006801:Humans; D008485:Medical Audit; D013636:Tanzania