SOP on

Post-Test
Notification
and Initial
Milagros M. Viacrucis, MD MPH
Counseling Honorary Consultant
Davao Blood Center
Learning objective
At the end of the lecture, you should be able to:
Explain the importance of confirmatory testing of
blood units reactive to screening test
Describe the challenges in post-test notification &
counseling
Discuss the procedure on post-test notification
and initial counseling

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Core topics
Donor notification and counseling
Challenges in post-test notification & counseling
Flow Chart
Maintenance of donor and public confidence in
the blood centre

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Confirmation of test results
To find out if the donor is truly infected
 Avoid unnecessary deferral and loss of future donations
To improve understanding of modes of transmission
 Assess risk factors for donors
 Improve donor selection procedures
To strengthen donor information and education
 Explore donor perceptions and understanding
 Improve donor materials

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Outcomes of confirmatory testing

Negative: reinstate donor according to policy

Positive: notify and counsel donor
Indeterminate: notify and counsel donor for
further investigation

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Donor Notification and Counseling
Donor should be notified and counseled if a
positive result for an infectious disease marker is
detected
Constraints on postdonation counseling
 Limited resources available for confirmatory testing
and counseling
 Lack of recognition of the need for this by blood
services
 Counseling session not always convenient for donors

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Challenges in donor notification
and counseling
Diagnosis is made when donor feels in good
health
Donor expects and is confident of negative results
Notification is made to someone responding to a
humanitarian need
Serology testing (both screening and confirmatory
tests) done on blood unit NOT on donor

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Donor notification
Donors should be informed of test results
 Medical significance of the result
 Eligibility to donate blood in future
 Responsibility
 Self
 Partner
 Other contacts
 Recipients of blood

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Stages in Donor Counseling

Positive

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Flowchart of Donor Notification/Recall upon Receipt of
Confirmatory Result from RITM down to Referral to HACT or VCT

Receipt of result
from RITM

Forwarded to Blood
Center Physician

Donor Notification/Recall by
Blood Center Head or
3x Failed attempts to communicate with donor;
Physician in-charge at BSF Document, then file result. (agreed during the meeting on Feb.23, 2010)

End
Initial Counseling by of
Donor referred to
Physician in-charge BSF
HACT / VCT
of BSF role

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SOP on Post-Test Notification

1. BC head receives official report of the

confirmatory test from RITM.
2. BC head retrieves the Donor History
Questionnaire (DHQ) of the affected blood
donor.
3. BC head recalls the blood donor through his
preferred method of communication. If such
information is not available, recall donor
through:
i. Cell Phone – call (method of 1st choice)
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SOP on Post-Test Notification
ii. House phone
iii. Letter
iv. Local BP Coordinator/Focal Person for the Program in
the agency/NGO
▪ If blood donor cannot be contacted within 48 hours from
receipt of official result, a letter is sent by courier or by
registered mail to the preferred address.
▪ BC head continues to contact blood donor by phone
(blood donor’s cell phone or phone at home, if any);
may send text message

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SOP on Post-Test Notification

▪ If donor cannot be contacted after a minimum of three

(3) attempts, donor is classified as “lost to follow up”

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SOP on Post-Test Notification

4. BC head informs the donor that the blood

that may have been sampled from his
donation is confirmed positive for
transfusion transmissible infection and
gives initial counseling that is similar to
pre-donation counseling (refer to
Counseling Checklist):
i. Knowledge of HIV
• Transmission awareness and understanding

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SOP on Post-Test Notification
• Previous test requests if any – when and why
• Personal acquaintance and involvement with people with HIV
ii. Significance and meaning of confirmed positive test
result including implications for behavior change
iii. Risk History Assessment
• Nature of sexual activities and partners
• Injecting drug use and needle sharing
• Recent illness and symptoms
• Family history of illness
• Blood and blood product transfusion
• Body tattoing and piercing
• Previous blood donation

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SOP on Post-Test Notification
5. BC head advises donor to agree to be referred to
the HIV/AIDS Counseling Team* (HACT) in many
DOH level 4 hospitals, or to the Voluntary
Counseling and Testing Centers (VCTs), for
further management. If he agrees he is made to
sign the informed consent for referral to HACT.
6. BC heads makes duplicate copies of the donor’s
DHQ, official result of the HIV confirmatory test
from RITM, and informed consent for referral to
HACT signed by the donor.

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SOP on Post-Test Notification
7. BC head informs HACT of the referral and sets
appointment for the blood donor. If counselor of
HACT is available, blood donor is escorted to
HACT’s Office by somebody from the BC who
also brings the donor’s file that contains the
duplicate copy of his DHQ, duplicate copy of the
confirmatory test results from RITM, and
duplicate copy of the informed consent for
referral to HACT.
An identical donor’s file is kept at the BC head’s
office separate from other files of donors’
records.
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Counseling after confirmed
negative TTI testing
Discussion of negative results
Encourage the donor to maintain safe lifestyle
behaviour
Encourage the donor to donate blood regularly
and to remain a safe blood donor
Give thanks to donor and remind of next donation
date

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Key points
There are many challenges for staff to overcome
in post-donation counseling following TTI testing
Dedicated, trained and skilled counselors and
SOPs for post-donation counseling at the BTS are
essential
A quality postdonation counseling system is built
on maintaining strict confidentiality

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