Blood Counts Program

Guidelines and Standards
Haemovigilance and data
Education, information sharing & best practice

Guidelines and Standards

Factor VIII and Factor IX Guidelines
The National Blood Authority supported the production of evidence based guidelines for the use of plasma derived and recombinant Factor VIII and Factor IX products in Australia. The Guidelines were published in July 2006.
Clinical Criteria for IVIg Use in Australia
The NBA, through the Blood Counts Team, provided support to the Jurisdictional Blood Committee IVIg Working Party overseeing the development of the Criteria for the Clinical Use of Intravenous Immunoglobulin (IVIg) in Australia
The process to review arrangements for the use and supply of IVIg in Australia began in 2004. Two literature reviews, a cost effectiveness review, two broad consultation processes, and the commissioning of a report on the use of IVIg in Australia were undertaken to inform the development process. In October 2006 this work culminated in the release to the clinical community of a draft document that describes clinical criteria for the use of IVIg in Australia. The document was also the focus of a clinicians workshop held in November 2006 in Sydney. August 20, 2008 clinician workshop a second draft was circulated broadly for comment in March 2007. Written submissions from this round were considered by the IVIg Working Party and a panel of clinical experts and final amendments to the document have been made in the light of those considerations

The Criteria for the Clinical Use of Intravenous Immunoglobulin in Australia (i) identifies the conditions and circumstances recommended by experts for IVIg therapy; (ii) categorises those conditions in accordance with the available evidence of effectiveness; and (iii) describes diagnostic, qualifying, exclusion review criteria for the use of IVIg in those circumstances. The document also provides an overview of the manufacture, supply and safety aspects of IVIg.

Subject to Ministerial approval, the Clinical Criteria document will replace the current AHMAC 2000 recommendations on the use and supply of IVIg in Australia

Haemovigilance and data

National Haemovigilance Project
This project is a major initiative of the NBA. It involves developing the reporting and governance frameworks for a voluntary haemovigilance program for Australia. It will report on serious transfusion related adverse events occurring in public and private hospitals.
The project's working group is comprised of experts in transfusion medicine and science, nursing and epidemiology from both the private and public healthcare sectors. The group aims to facilitate data capture through existing State and Territory incident management systems, and produce an annual publication of adverse event types and rates for public consumption.
This initiative will contribute to our understanding of peri-transfusion errors, incrementally improve safety and quality, and ultimately deliver better transfusion outcomes.

Related Downloads
- Haemovigilance Project Working Group Progress Report - July 2007 (1.14Mb)
Redevelopment of the Australian Bleeding Disorders Registry
Project Aim
Develop and implement a system that provides clinical, treatment product and patient demographic information on people with haemophilia, von Willebrand's disease and other bleeding disorders for all stakeholders.

Background
The Australian Bleeding Disorder Registry (ABDR) is collection of data sourced from 16 Haemophilia Treatment Centres (HTC's) in Australian states and territories. It is currently funded by the National Blood Authority (NBA).
The ABDR is primarily used to improve clinical practice in the treatment of people with haemophilia, von Willebrand's disease and other bleeding disorders. In addition, it provides associated stakeholders with various reports and information relating to the supply and management of blood products used in the treatment of haemophilia, von Willebrand's disease and bleeding disorders.

The ABDR was established almost 15 years ago and has been supported by governments from 1995 onwards. At this time an agreement was reached to fund HTC's to establish a national focus for the registry to improve the availability of information relating to bleeding disorders.

Stakeholders are seeking further improvements in the ABDR to ensure completeness of data currently collected and increased reporting capacity to meet individual stakeholder needs.
Red Cell Usage
Both the NSW state government through the Clinical Excellence Commission and the South Australia Department of Health are investigating blood cell usage. The National Blood Authority will facilitate sharing of learnings from these investigations and encourage other states to undertake similar investigations. Results from these investigations will contribute to inter-state comparisons and facilitate a better understanding of the variance of red cell usage and wastage. Both the NSW and SA investigations intend to tap into existing data sets for this quality assurance exercise.

Education, information sharing & best practice

Meeting of experts to share transfusion practice improvement
The NBA supported a meeting of senior transfusion medicine and nursing specialists to encourage the sharing and exchange of tools, methodology and ideas aimed at promoting and implementing standardised, safe and appropriate transfusion practice in Australia. The Australian and New Zealand Society for Blood Transfusion have established a clinical practice improvement sub-committee to take this initiative forward.
National Prescription / Order Form for Blood
Clinicians and experts who attended a national Data Workshop organised by the National Blood Authority identified the need for a national prescription / order form for fresh blood products. Some individual hospitals use blood prescription / order forms already to collect data on clinical triggers for red blood cell orders. The NBA is keen to work with clinical societies and colleges to assess whether this approach could be implemented nationally in a consistent way and the data used to report on the degree to which ordering practices accord with national guidelines.

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