A new clinic model in Donor Screening - Update

Overview

Canadian Blood Services is confident that the Multi-skilled Workforce initiative will ensure safe blood and blood products for all Canadians while addressing the nursing shortage in this country. Safety is paramount and will not be compromised for any purpose. A carefully controlled and thoroughly evaluated pilot is planned prior to nation-wide implementation to ensure that no additional risks are introduced into the system

Justice Horace Krever, who headed the inquiry into the Canadian Red Cross Society and Canada's tainted blood scandal in the late 1980s and early 1990s, referred to the need for a careful screening process. He did not specify that it be performed by a nurse nor did he outline the qualifications required by the person doing the screening.

The Multi-skilled Worker approach builds on common trends by other blood operations from around the world. Other large blood operators in the United States of America (USA) and the United Kingdom (UK) do not use Registered Nurses (RNs) in the screening process. Much like Canada, the USA and UK blood systems are highly regulated and have utilized non-nurses in their donor screening function for many years without jeopardizing the safety of their blood supplies.

Written endorsements of this initiative have been issued from the Canadian Haemophilia Society, the Canadian Lymphoma and Leukemia Society, and Candlelighters Childhood Cancer Foundation-patient groups that receive blood and blood products on a regular basis.

The Initiative

The Multi-skilled Workforce initiative does not propose a change in our safety and screening processes, but rather, a change in who performs part of the process. Currently, Canadian Blood Services trains RNs to perform this highly regulated and prescriptive function; in the new model, Canadian Blood Services will require trained clinic staff called "Donor Care Associate", who demonstrate 100 per cent competency in this portion of the intensive training program to screen blood donors. Donor Care Associates will receive extensive training on when escalation to an RN is required.

RNs are highly valued and play a key role in our future at Canadian Blood Services. They are important leaders in our organization. A minimum of two RNs will be present on all clinics and will provide their clinical and leadership expertise in the new donor screening model.

Rationale

The nursing shortage in Canada is a reality. The Canadian Nurses Association (CNA) estimates that if significant action isn't taken now, the shortage of RNs who provide direct clinical care to Canadians will climb from the equivalent of 11,000 full time nurses in 2007 to almost 60,000 in 2022. This pressure will only increase with time, and it is prudent to address the situation now in a proactive manner, rather than waiting for a crisis. Canadian Blood Services has an unwavering commitment to meet Canadian demand for blood and blood products.

In 2009, the CNA published a report outlining several steps that can be taken to help reduce the impact of the nursing shortage. The first recommendation centred around aligning roles to nurses training and capabilities and allow others to perform tasks not requiring nursing skills. As such, Canadian Blood Services is following this recommendation by asking trained staff to perform aspects of screening not requiring RN judgement and having them available on clinic to utilize their expertise when required. They will continue to have a strong clinical and leadership presence as a minimum of two RNs will be present on every clinic.

Safety

Safety is not addressed exclusively at screening but throughout the entire donation process, in addition to testing and production of blood and blood products. Also, all blood donations are tested for known pathogens that already have tests in place.

The Pilot

Currently, there is no evidence that has been uncovered which indicates that this model will introduce additional risk into the blood system.

In order for us to collect Canadian-based evidence, Canadian Blood Services will first pilot this initiative in a few clinics across the country. The pilot will provide the organization with scientific data we need to ensure success.

Throughout the pilot, 100 per cent of donations where a Donor Care Associate is involved in the screening process will be audited. The unit of blood and associated blood products, such as platelets and plasma, will not be released to hospitals until the results of the audits are available and deem the product acceptable for transfusion.

Importance for Canadians

Like any organization, Canadian Blood Services is always exploring ways to better deliver our services. Canadian Blood Services is committed to proactively address any potential impacts of the nursing shortage in Canada to ensure that we are able to meet the demand for blood in the future.

For media assistance, please contact
Ron Vezina
Director, Media Relations and External Communications
Canadian Blood Services
(613) 739-2044
ron.vezina@blood.ca