Discard data for blood products generated during the blood component preparation process at Baise Central Blood Station from June 2024 to June 2025 were retrospectively collected, totaling 127 products. Twelve on-staff blood component preparation personnel from the same period were selected as study subjects. All personnel possessed relevant professional qualifications, had a work experience of ≥1 year, and there were no personnel changes, resignations, or position adjustments during the study period. The 12 staff members were randomly divided into a control group and a study group, with 6 individuals in each group. Baseline characteristics such as age, work experience, and professional qualifications showed no statistically significant difference between the two groups (P > 0.05), indicating comparability.

2.2.1. Data Collection and Cause Analysis

Information related to the 127 discarded blood products was extracted through the blood station’s quality management system, blood preparation records, and discard registration logs. This information included blood product type, discard time, specific discard cause, and involved operational steps. A database was established for statistical analysis to clarify the proportion of discards for different blood product types and the distribution characteristics of various discard causes.

2.2.2. Intervention Measures

Control Group: The conventional blood component preparation work mode was adopted, following the blood station’s existing operational protocols without additional interventions, allowing the blood discard rate to occur naturally.

Study Group: Based on the discard cause analysis, targeted solution strategies were implemented as follows:

1)Lipemic Blood Prevention: Before donation, clearly communicate health requirements to donors through online education and on-site presentations, including ensuring adequate sleep (≥7 hours) the day before collection, avoiding high-protein, high-fat, spicy, raw, cold, or irritating foods, abstaining from alcohol, and avoiding medication periods (especially drugs affecting lipid metabolism).

2)Testing Non-conformance Control: Strengthen the pre-donation consultation and physical examination process, adding preliminary screening items such as blood lipids, blood glucose, and infectious disease markers. Individuals who are obese, have abnormal blood lipids, hemoconcentration, or positive infectious disease markers are deferred from donation to reduce testing non-conformance risks at the source.

3)Insufficient Volume Improvement: Before collection, explain the blood collection process, precautions, and safety measures to donors in simple, understandable language to alleviate anxiety. Enhance staff professional skills training to improve venipuncture success rates. Provide detailed care during collection, promptly identify and manage pre-syncope signs to reduce insufficient collection due to syncope.

4)Blood Clot Prevention: Standardize blood collection operations, strictly control collection volume (according to standard ranges) and collection time. Ensure collection equipment is clean and uncontaminated, checking equipment seal integrity before use. Precisely proportion anticoagulant to blood ratio to avoid imbalance. Gently mix blood and anticoagulant promptly after collection.

5)Hemolysis Prevention: During blood storage, monitor preservation equipment temperature every 4 hours to ensure it remains within the standard range (4˚C ± 2˚C), promptly addressing equipment anomalies. Use dedicated blood transport boxes during transportation, with ice packs inside to maintain stable temperature. Avoid squeezing, collisions, and severe vibrations; handle gently.

6)Blood Bag Damage/Centrifugation Leak Prevention: Regularly maintain and repair large-capacity low-temperature centrifuges. Calibrate equipment before each use, accurately setting centrifugation speed and time. Strengthen staff operation training, standardize separation and preparation processes. Check blood bag integrity before centrifugation and carefully inspect for damage or leaks after centrifugation.

7)Inadequate Sealing Control: Optimize sealing operation protocols, regularly maintain and calibrate sealing machines. Post-sealing quality checks combine visual inspection with pressure testing to promptly identify and address sealing issues.

8)Whole-process Quality Control: Based on the “Blood Station Management Measures,” “Blood Station Quality Management Standards,” and “Chinese Technical Regulations for Blood Transfusion Operations,” refine operational standards for the entire component preparation process. Establish post responsibility and quality recording systems. Conduct regular staff training and assessments covering operational standards, quality criteria, and emergency response.

2.2.3. Observation Indicators

A self-developed blood component preparation quality management scoring system was used, evaluating seven dimensions. This scoring system was developed based on the “Blood Station Management Measures,” “Blood Station Quality Management Standards,” and local operational procedures. Each dimension includes 5 - 8 specific assessment items (e.g., operational compliance, record completeness, equipment status, temperature control). Two independent quality control personnel scored each item on a 100-point scale according to unified criteria, and the average was taken as the final score. The detailed scoring rubric is provided in the supplementary materials.

2.2.4. Statistical Methods

SPSS 30.0 statistical software was used for data processing. Given the small sample size of only 6 staff members per group, in addition to the independent samples t-test, the Mann-Whitney U test was also used for non-parametric verification of score data to mitigate the impact of individual performance variations on statistical significance. Measurement data are expressed as ( x ¯ ± s ), with inter-group comparisons using independent samples t-test. Count data are expressed as number (percentage) [n(%)], with inter-group comparisons using χ² test. P < 0.05 indicates a statistically significant difference.

Among the 127 discarded blood products, ordinary frozen plasma had the highest discard proportion (53.54%), followed by virus-inactivated plasma (22.05%) and whole blood (20.47%). Suspended red blood cells had the lowest discard proportion (3.94%). Specific distribution is shown in Table 1.

Table 1.Distribution of discarded blood product types [n (%)].

Lipemic blood was the primary discard cause, accounting for 70.87%; followed by testing non-conformance (10.24%). Insufficient volume and clots had the same proportion (5.51% each). Blood bag damage (3.94%), hemolysis (3.15%), and inadequate sealing (0.78%) accounted for lower proportions. Details are shown in Table 2.

Table 2.Distribution of blood discard causes [n(%)].

The study group’s quality management scores across all seven dimensions—blood control, collection management, preparation control, quality inspection management, blood transportation, storage management, and utilization management—were significantly higher than those of the control group, with statistically significant differences (P < 0.05). Details are shown in Table 3.

During the 3-month intervention period, the control group prepared 12,540 units of blood products, with 126 units discarded (discard rate 1.005%). The study group prepared 12,870 units, with 98 units discarded (discard rate 0.762%). The discard rate in the study group was significantly lower than that in the control group (χ² = 4.12, P = 0.042).

Table 3.Comparison ofblood component preparation quality management scores between groups( x ¯ ± s , points).