Introduction to Haematology and Transfusion Science

Module details

Title

Introduction to Haematology and Transfusion Science

Type

Rotation

Module code

SLS102

Credits

10

Requirement

Compulsory

Aim of this module

This module will provide the trainee with the knowledge and understanding of the formation of blood cells, the mechanism of haemostasis and the relevance of blood group antigens and antibodies. They will understand the principles and practice of common methods used in haematology, haemostasis and blood transfusion and perform some of them in the laboratory. They will understand common clinical disorders associated with abnormal haematology and haemostasis and gain experience of the interpretation of patient results in a variety of clinical settings. They will gain knowledge of blood transfusion in a variety of settings, and understand how to provide patients with safe and effective transfusion support.

Competencies

#	Learning outcome	Competency	Action
# 1	Learning outcome 1,2,5,6	Competency Receive, process and store common  haematology specimens.	Action View
# 2	Learning outcome 1,2,3,5,6	Competency Interpret request forms and recommend the most appropriate investigation strategy to investigate: basic haematological disorders haemostasis patients for blood transfusion.	Action View
# 3	Learning outcome 1,2,3	Competency Interpret laboratory data in light of clinical details and prepare basic interpretive written reports on patients with at least two of the following: iron deficiency anaemia and iron overload haemolytic anaemia megaloblastic anaemia/folate deficiency polycythaemia abnormal haemoglobin and thalassaemia (initial tests) haematological malignancy (blood cell abnormalities).	Action View
# 4	Learning outcome 1	Competency Identify one case requiring urgent intervention and describe relevant clinical advice on follow-up and/or further management.	Action View
# 5	Learning outcome 1,2,5	Competency Perform at least three of the following methods to specified quality standards: automated analysers to quantify erythrocytes, leucocytes, platelets, reticulocytes and white cell differentiation erythrocyte sedimentation rate prepare blood and bone marrow aspirate films peripheral blood cell microscopy recognition of malarial parasites.	Action View
# 6	Learning outcome 1,5,6	Competency Interpret laboratory data in light of clinical details and prepare written reports on patients with one of the following: common bleeding disorders common thrombotic disorders lupus anticoagulation.	Action View
# 7	Learning outcome 1,2,5,6	Competency Perform the following range of investigations: prothrombin time (PT) activated partial thromboplastin time (APTT) anticoagulation therapy monitoring (INR) POCT for INR d-dimer	Action View
# 8	Learning outcome 3,5,6	Competency Apply sample acceptance criteria for samples for pre-transfusion testing. Perform routine transfusion tests, including: indirect antiglobulin test (IAT) and ‘immediate spin’ cross- match ABO and RhD typing antibody screening simple antibody identification by IAT and enzyme (single specificity) Rh and K red cell phenotyping.	Action View
# 9	Learning outcome 3,5,6	Competency Issue appropriate blood components for patients with a range of clinical conditions.  Store blood components used locally in correct conditions.	Action View
# 10	Learning outcome 1,2,3,5	Competency Produce a basic interpretative report on haematological investigations.	Action View
# 11	Learning outcome 1,2,3,4	Competency Control infection risks in accordance with departmental protocols.	Action View
# 12	Learning outcome 1,2,3,4	Competency Minimise risks and hazards in compliance with health and safety policies.	Action View

Assessments

You must complete:

• 1 case-based discussion(s)
• 1 of the following DOPS/ OCEs:

Perform ABO and RH grouping on 3 patient samples	DOPS
Perform an manual WBC differential on 2 prepared blood films	DOPS
Perform either glandular fever screen or malaria RDT	DOPS
Observe the obtaining a blood sample	OCE
Observe an outpatient appointment with patient with haematological disorder	OCE

Learning outcomes

1. Perform a range of laboratory techniques used in screening and investigating haematological disorders.
2. Perform the range of laboratory and point-of-care techniques (POCTs) used in the investigation of disorders of haemostasis.
3. Perform blood group serology in the context of pre-transfusion testing.
4. Select safe and appropriate blood and blood components for patients with a range of clinical conditions.
5. Apply the principles of internal quality control and external quality assessment and draw conclusions about assay performance.
6. Use laboratory IT systems for handling, processing and storage of patient data.

Learning outcomes

1. Explain the haemopoeitic pathways and normal haemostatic mechanisms, and discuss disorders causing bleeding or thrombosis.
2. Describe the design, operation and performance of the routine tests used in screening and investigating haematological disorders and their normal limits.
3. Describe the design, operation and performance of the tests used to investigate disorders of haemostasis.
4. Discuss the concept of blood groups and the application of blood group serology in establishing compatibility between patient and donor.
5. Describe the design, operation and performance of the tests and procedures required to enable selection of safe and appropriate blood and blood components for patients with a range of clinical conditions.
6. Know the range of blood components and products in common use and the importance of correct storage.
7. Explain and justify legislation and guidance relevant to blood transfusion practice.
8. Discuss the partnership of haematology and transfusion science to other clinical specialisms in the investigation and management of common disorders and patient care.

Indicative content

• Normal haemopoiesis and bone marrow function in the development and differentiation of blood cells
• Normal haemostasis and its components
• Role of the liver in the production of coagulation factors
• Principles, scientific basis and clinical application of commonly performed analytical procedures in haematology
• Principles and scientific basis of automated coagulation analysers and point-of-care instruments in the assessment of coagulation function
• Principles and scientific basis of automated cell counters and point-of-care instruments for numeration and identification of cellular blood components
• Point of care testing in haematology
• Presentation, diagnosis and management of common haematological disorders
• The establishment, application and limitations of biological normal reference ranges, including age, ethnic and sex related reference ranges
• Bone marrow aspiration, trephine biopsy, preparation and staining techniques for the morphological identification of cells in bone marrow in normal and pathological conditions
• Blood film preparation, staining and interpretation in normal and pathological conditions, including parasites
• Principles and application of internal quality control and external quality assurance programmes
• Basic blood group systems – genes, antigens and antibodies
• Manual and automated techniques for ABO/D typing, serological crossmatching, red cell phenotyping, antibody screening and identification
• Overview of blood transfusion services and range of blood components/products manufactured and their applications
• Principles of pre-transfusion testing
• Normal ranges and predictive values for pathology tests used to inform transfusion support
• Aetiology and clinical features of conditions requiring transfusion support
• Overview of legislation / guidelines relevant to blood transfusion practice

Activities

• Participate in the local programme for monitoring anticoagulation Reflect on its importance to the service, to the patient and the benefits for patient management.
• Under supervision, prepare a report for patients being investigated for one of the following:
  • basic haematological disorders
  • haemostasis
  • blood
• Attend multidisciplinary team meeting, including the identification of at least one clinical case and review/report on the benefits of a multidisciplinary approach to patient investigation and management.
• Review and discuss the scope of the hospital haematology laboratory in the investigation of basic haematological disorders, haemostasis and blood transfusion.
• Report and discuss with your trainer the range of blood components and products in common use and their correct storage.
• Provide support in the investigation of basic haematological disorders, and discuss with your trainer the correct sampling technique and the use and validity of reference ranges.
• Review and discuss the interpretation and reporting of laboratory results in the context of common clinical disorders.
• Reflect on and present a report regarding the partnership between Haematology and Transfusion Science and other clinical specialisms in the investigation and management of common disorders.
• Observe, support and reflect on blood film preparation, staining and interpretation in normal and pathological conditions, including parasites.