Implementation of Fact Guidelines Improves Donor Screening

                                    Implementation of FACT Guidelines Improves Donor Screening

 

An allogeneic bone marrow transplant offers potentially curative therapy to patients with leukemia, lymphoma, multiple myeloma, and myelodyspastic syndrome.  Identification of a human leukocyte antigen matched donor, through a standardized screening process, is an essential component of the allogeneic transplant.  At this transplant center, nurse practitioners (NP) screen all donors and determine eligibility based on a history and physical, review of a Health History Questionnaire (HHQ), and various diagnostic tests.  The Foundation for the Accreditation of Cellular Therapy (FACT), set standards of operation to promote quality medical and laboratory practice in hematopoietic transplantation and other cellular therapy products. Adherence to the FACT standards helps to ensure donor eligibility thereby reducing the risks of transmissible diseases. The HHQ guides the NP in determining donor eligibility.  A retrospective chart review of 46 medical records from January 2011 through December 2011 revealed the rate of accuracy of 60% in determining donor eligibility based upon FACT criteria.  All donors (46) were deemed as eligible; however, only 28 met FACT criteria for eligibility. Eighteen patients were ineligible; yet they were medically acceptable to donate.  Reasons for ineligibility included: a missing or incomplete HHQ, a tattoo within a year,  donor lived in Europe.  NPs were re-educated regarding FACT criteria and how to use the HHQ when determining eligibility.  A tool provided a guideline for the NPs highlighting special considerations for donors that would make them potentially ineligible.  Following these interventions, the rate of accuracy improved to 84%.  From June 2012 to September 2012, 19 medical records were reviewed 16 met FACT criteria for eligibility.   By re-educating NPs about FACT guidelines, NPs were able to utilize the HHQ as a crucial step in their assessment process and improve the rate of accuracy in determining donor eligibility thus improving donor screening.