Blood and Tissue Resources Program

Guidelines for Training Personnel for Performing Intraoperative Blood Recovery Procedures

Each facility should develop a fully detailed standard operating procedure for training personnel for performing intraoperative blood recovery (IBR) procedures. The following should be included:

1. Criteria for eligibility for training.
2. Didactic instruction in risks, preventive practice, and use of IBR procedures (Risks include: fatal air embolism; sepsis; contamination from wound additives such as agents used to reduce topical bleeding; excessive hemolysis; mislabeling of harvested units; and surgical infusion to wrong patient). This instruction should cover indications and contraindications (e.g. a contaminated field, potential for dissemination of malignant cells).
3. The minimum number of IBR procedures for each model of instrument or device to be observed by the trainee.
4. The minimum number of IBR procedures to be performed by the trainee under direct supervision, for each model of instrument or device, and whether training is required for different procedures (e.g., vascular, orthopedic).
5. Documented record of training, including date of hire and checklist of each training event (listing model of instrument or device used and dated and signed or initialed by an identifiable supervisor), dated and signed or initialed by an identifiable supervisor.
6. Signed, dated record that a trainee was deemed competent after training. The director of the IBR program should have discretion as to whether someone who met all requirements would be certified proficient.
7. Statement of the minimum number of events performed annually required to retain proficiency without retraining.
8. Annual competency evaluation. Documentation of annual review of each trainee, with checklist of items required (with date of completion and signature/initial of identifiable supervisor for each), including: identification of reviewer; date of review; and signed, dated statement of the reviewer that the trainee meets minimum requirements.
9. List of employees currently proficient in performing procedures, specifying specific model of instrument or device for which proficiency was demonstrated.
10. The standard operating procedure (SOP) for IBR procedures and the SOP for training must be approved by the blood bank director.