Download check list - Uganda Blood Transfusion Service

Check list for hospital blood transfusion practice and registration supervision
1. Hospital:
Date of visit:
2. Location:
District:
3. Contact:
4. Name of nearest blood bank:
5. Distance from the blood bank:
6. Nearest district hospital:
Communication:
7. Distance between the two hospital:
8. Proprietor:
9. Hospital size: Bed capacity
10. Power source: Mains grid Y Backup generator Y tick as appropriate (Y for yes)
11. Water source:
12. Distilled water:
13. Monthly blood requirements:
14. Clinician I/C resident:
15. Clinician i/c deputy:
16. Laboratory I/c:
17. Designation:
18. Qualification:
19. Experience:
20. Contact:
21. Deputy Laboratory i/c:
22. Designation:
23. Qualification:
24. Experience:
25. Medical ethics: aware of Tick as appropriate
26. SOP’s
27. Cold chain: Blood Bank Refrigerator: make:
28. Storage capacity:
29. Service:
30. Freezer:
31. Cool box for blood transport:
32. Water Bath:
33. Centrifuge:
34. Consumables:
 12X75mm test tubes
 Blood grouping antisera
 Sodium chloride
 Markers
 AHG with controls
 Appropriate racks
 Pipettes
 Clip board
35. Protective wear:
36. Blood grouping facilities:
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Porcelain tile
Timer
Disinfectant
Markers
Record book
Blood order form
 Easy to decontaminate working surface
 Biohazardous/infectious waste handling facilities
37. recommendation: