OneMatch Stem Cell and Marrow Network Volunteer Initial Training v.2013-07-01
Learning Objectives OneMatch Information • Frequently Asked Questions Awareness Event • Who is the “ideal” donor to be a donor and why • Consent to Participate process • How to collect and pack buccal swab samples • Importance of Confidentiality and Privacy
What is OneMatch all about? OneMatch is a Canadian Program that matches and coordinates the collection of stem cells from potential donors to help save the lives of patients any where in the world who need a stem cell transplant. Recruits and maintains the Canadian database of potential stem cell donors.
What are stem cells Immature cells that can become: • Red blood cells (carry oxygen) • White blood cells (fight infection) • Platelets (help to stop bleeding) Stem cells can be collected from bone marrow, from our circulating blood (also known as peripheral blood) and umbilical cord blood.
How are stem cells donated – Stimulated Peripheral Blood Stem Cell Donation Stem cells in your circulating blood (peripheral blood) are collected using a procedure called apheresis In most cases, donor is given daily injections a few days prior to collection to stimulate growth of stem cells. Blood is drawn through a needle. The stem cells are separated from the rest of your blood, and remaining blood is returned back into your body through another needle.
The stem cells are separated from the rest of your blood How are stem cells donated – Stimulated Peripheral Blood Stem Cell Donation Remaining blood is returned back into your body through another needle Blood is drawn through a needle.
How are stem cells donated – Bone Marrow Stem Cell Donation Surgical procedure performed under anesthesia. Special needle is use to withdraw liquid marrow from the back of your pelvic bones. After donation, you’ll likely feel some soreness where the needle was inserted. Donors describe it as similar to the discomfort after hard exercise or a fall on the ice.
How are stem cells donated – Umbilical Cord Blood Blood from a baby’s cord is collected after the child is born. Umbilical cord blood is then stored using a technique called cryopreservation (freezing the stem cells until they are to be used)
What diseases are treated with stem cell transplants? Variety of diseases and disorders including blood-related diseases such as: • Leukemia • Aplastic Anemia • Inherited immune system and metabolic disorders
What do you mean by a “match”? Our immune system is responsible for removing things that do not belong (e.g. infections). To identify what does not belong in our system we have markers that are as unique as our fingerprints. These genetic markers make up our Human Leukocyte Antigen (HLA) system. HLA genetic markers are located on the outside of our white blood cells (which help us fight diseases). We need to match the donor and patient’s HLA markers to donate stem cells.
What do you mean by a “match”? HLA markers are inherited from your parents. Same parent siblings (Brothers and Sisters) have 25% chance of matching each other. When there is no family match, patients need to find an unrelated donor. Some HLA markers are only found within specific ethnic backgrounds such as people from the Aboriginal and Black communities. .
Is there a matching donor for every patient who needs a transplant? Even with millions of donors on registries worldwide, a perfect stem cell match isn’t always available. Some patients can have uncommon HLA markers that may be very difficult to match.
How can we help find matches?Recruit: Males, 17-35, and Ethnically Diverse
Transplant Doctors want male donors! WHY? Males have higher cell counts which improves post-transplant engraftment and potentially reduces donation complications such as graft vs. host disease (GVHD). Studies show that female donors (with or without history of pregnancy) may increase risk of chronic GVHD in male patients. Ethnically diverse registry will increase the likelihood that patients of mixed or ethnic backgrounds will find matches easier.
Pre-screening • Age 17 to 35 • Good general health • Will help all patients • Provide a tissue typing sample using a buccal (cheek) swab. • Valid Provincial Health Care Coverage Answer “no” to any question: Not eligible to register.
Other Ways to Help Blood Donation Stem Cell patients use many units of blood during treatments, as well before and after transplant Volunteering At OneMatch awareness events or blood donor clinics Financial Gifts Monetary donation to help build Canadian Blood Services programs. Call 1 888 2DONATE(1-888-236-6283) Visit website www.blood.ca
Informed Consent Registrants need to understand what they are signing up for. A person may state they may understand what they are consenting to, although they do not appreciate the impact of that action.
The Why’s to our Informed Consent • It’s the LAW! (cannot be influenced unduly to provide consent) • Reliable long-term committed donors • Cost-effective (health care $/time) Please note: Someone may verbally agree to something from fear or perceived social pressure.
How do we ensure Informed Consent has been obtained? Ask: “What happens if you are a match?” “What are the risks involved in donating stem cells?” “What happens if you say no?” * Note: all answers to questions are located in the OneMatch Information for New Registrants pamphlet that should be given to all people who are registering.
Personal Information and Health Screening • Information printed clearly. • If not, ask them to fix the area by printing the information clearly. • Each question has been answered in corresponding box with a or and not with a line through all questions. • All areas are filled out
Health Screening Each question must be answered with a or in the corresponding box.
Consent to Participate Ensure Consent to Participate has been: • Read • Completed with signature/current date • Date format: YYYY-MM-DD
Consent to Participate Errors Common • Not completed in pen. • Fields on forms not completed. • Written information not legible. • Transposition errors - when two digits/characters have been reversed. • Drawing a line through health questions instead of answering each question.
Errors - Why do we care? Registration form and Buccal Swab kits must be redone by the Registrant if there is an error. Having to redo the registration form and/or buccal swab delays processing and testing, which could result in the delay for a patient to find a matched donor.
Error Correction If an error occurs, you must: • Draw a line through the error. • Write your initials and the current date. • Write the correction above the error.
Buccal Swabbing/Labelling Ask Again: “Have you read the consent section of the Registration Form and understand this is a long term commitment?” Prepare buccal swabs with labels IMPORTANT: Only work with one registrant at a time to avoid errors and maintain registrant’s privacy.
Barcode Labels The label sheet has 12 labels • 4 labels are non-barcode labels • 8 are barcode labels
Labelling Buccal Swabs (end of stick) Consent to Participate Form (office use only) Exterior buccal swab kit envelop.
Labelling Errors Common Label not applied to Consent to Participate Labels are swapped between two different registrant swabs and/or paperwork *When in doubt, start the collection from the beginning and discard old samples*
Need to use a new set of barcode labels? • Black out all old labels with permanent marker. • “Error correct” and black out any old labels on the paperwork and envelope.
Discarding Old Buccal Swabs • Place the completed swabs in the kit envelope, and seal closed • Write the reason for the use of the new labels. • Include old collection kit with new collection kit and registration paperwork
Buccal Swabbing Instruct registrant how to swab their cheeks. • Remove one labelled swab at a time from sterile packaging. • Cheek cells instead of saliva • One cheek quadrant per swab • Rub cheek harder than brushing teeth (20-30 seconds)
Buccal Swabbing Errors Common Why do we care? Registrants not swabbing properly: • Sucking • Twirling Not enough cheek cells collected for the testing.
Buccal Swabbing Place completed swab into buccal swab kit into one of the four slots
Final Steps • Have registrant place completed buccal swab kit into envelope and seal closed. (only completed buccal swab kits go in this envelop. No other paperwork or labels should be sealed in this envelop) • Apply barcode label to back of sealed envelope (not over seal). • Attach paperwork, left over labels and then sealed envelope with buccal swab kit.
Final Steps.. continued • Provide information to registrant: • OneMatch may contact by telephone if there are any questions about their registration. • “Welcome to the Network” letter. • Update OneMatch with any changes to health and/or address. • Thank them for registering! Send the registrant to “Reconciliation”
Reconciliation Why do we have this role? To ensure quality assurance. • Confirming paperwork and collection is complete and free from errors • Registrations are traceable if collection kit is lost during transit
Registrant Data Log • Information should be kept private at all times This information should be kept private from public view at all times during event • First name • 2 phone numbers If no number available, use email Enables us to contact registrants in the unlikely case a shipment is lost
Tracking Log Use barcode labels stapled to the package. Apply one label to appropriately “numbered field”.
Once 50 buccal swabs have been collected or at the end of their shift, sign off the tracking log. Note: Any numbered fields not used must have N/A indicated in the field. Tracking Log: Signature
Event Reconciliation Bundle Swab kits into 5s and place them in a box to be shipped End of the event, Count the number of tracking log sheets and number accordingly