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Summary of Checklist of Requirements of Issuance of COI

This document contains checklists of requirements for obtaining a Certificate of Inclusion into the Regional Voluntary Blood Services Network for various types of blood collection facilities. The requirements include attendance at network meetings, submission of blood reports, utilization of standard forms, compliance with blood service fees, and maintenance of appropriate agreements and documentation. Verification is through attendance sheets, submitted reports, official receipts, signed agreements, and other records. The requirements and verification methods are tailored to the specific functions of Blood Collection Units, free-standing Blood Stations, hospital-based facilities, and Blood Centers.

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HAZEL
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2K views4 pages

Summary of Checklist of Requirements of Issuance of COI

This document contains checklists of requirements for obtaining a Certificate of Inclusion into the Regional Voluntary Blood Services Network for various types of blood collection facilities. The requirements include attendance at network meetings, submission of blood reports, utilization of standard forms, compliance with blood service fees, and maintenance of appropriate agreements and documentation. Verification is through attendance sheets, submitted reports, official receipts, signed agreements, and other records. The requirements and verification methods are tailored to the specific functions of Blood Collection Units, free-standing Blood Stations, hospital-based facilities, and Blood Centers.

Uploaded by

HAZEL
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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ANNEX A

Checklist of Requirements of Issuance of Certificate of Inclusion into the Regional


Voluntary Blood Services Network

For Blood Collection Unit (BCU):

Requirements Means of Verification


1. Attendance to the Zonal Blood Services Network 1. Name with signature in the BSN
Meeting Attendance sheet & copy of Certificate
of
Appearance/Attendance/Participation
2. Submission of blood reports to Blood Program 2. Blood reports submitted, collated &
Coordinator analyzed
a. Blood Monitoring reports (BM forms 01, 02
& 05) quarterly
b. Blood Safety Indicator report (BSI Sections 1
& 2) annually
3. Utilized NVBSP prescribed Donor History 3. Utilized properly accomplished DHQ
Questionnaire

Checklist of Requirements of Issuance of Certificate of Inclusion into the Regional


Voluntary Blood Services Network

For Blood Station (BS) free-standing, non-hospital based:

Requirements Means of Verification


1. Attendance to the Zonal Blood Services Network 1. Name with signature in the BSN
Meeting Attendance sheet & copy of Certificate
of
Appearance/Attendance/Participation
2. Submission of blood reports to Blood Program 2. Blood reports submitted, collated &
Coordinator analyzed
a. Blood Monitoring reports (BM forms 06,&
07) quarterly
b. Blood Safety Indicator report (BSI Sections 1,
4, & 6) annually
3. MOA with BC or Lead BSF 3. Signed MOA
4. Blood Inventory Management 4. Submitted weekly blood stocks (signed
by BS Head & as reflected in the
MOA)
5. Utilized NVBSP prescribed blood request forms 5. Utilized properly accomplished blood
(Adult &Pedia) request forms
6. Complies with recommended Maximum Blood 6. Official Receipts reflecting blood
Service fees (as per DOH AO No2015-0045 & service fees
DC # 2016-0318)
Checklist of Requirements of Issuance of Certificate of Inclusion into the Regional
Voluntary Blood Services Network

For Blood Collection Unit/Blood Station (BCU/BS) free-standing, non-hospital based:


Requirements Means of Verification
1. Attendance to the Zonal Blood Services Network 1. Name with signature in the BSN
Meeting Attendance sheet & copy of Certificate
of
Appearance/Attendance/Participation
2. Submission of blood reports to Blood Program 2. Blood reports submitted, collated &
Coordinator analyzed
a. Blood Monitoring reports (BM forms 01, 02,
05, 06, & 07) quarterly
b. Blood Safety Indicator report (BSI Sections 1,
2, 4 & 6) annually
3. MOA with BC or Lead BSF 3. Signed MOA
4. Blood Inventory Management 4. Submitted weekly blood stocks (signed
by BS Head & as reflected in the
MOA)
5. Utilized NVBSP prescribed forms 5. Utilized properly accomplished DHQ
a. Donor History Questionnaire (DHQ) and blood request forms
b. blood request forms (Adult &Pedia)
c. Complies with recommended Maximum 6. Official Receipts reflecting blood
Blood Service fees (as per DOH AO No2015- service fees
0045 & DC # 2016-0318)

Checklist of Requirements of Issuance of Certificate of Inclusion into the Regional


Voluntary Blood Services Network

For Hospital-based Blood Station (BS) and Hospital Blood Bank (HBB):
Requirements Means of Verification
1. Attendance to the Zonal Blood Services Network 1. Name with signature in the BSN
Meeting Attendance sheet & copy of Certificate
of
Appearance/Attendance/Participation
2. Submission of blood reports to Blood Program 2. Blood reports submitted, collated &
Coordinator analyzed
a. Blood Monitoring reports (BM forms 04, 06&
07) quarterly
b. Blood Safety Indicator report (BSI Sections 1,
4, & 6) annually
3. MOA with BC or Lead BSF 3. Signed MOA
4. Blood Inventory Management 4. Submitted weekly blood stocks (signed
by BS Head & as reflected in the
MOA)
5. Functional and active Hospital Blood Transfusion 5. Hospital Order for HBTC & Minutes of
Committee (HBTC) the Meetings; Blood Utilization
Review
6. Utilized NVBSP prescribed forms 6. Utilized properly accomplished DHQ
a. Donor History Questionnaire (DHQ) and blood request forms
b. blood request forms (Adult &Pedia)
c. Complies with recommended Maximum 7. Official Receipts reflecting blood
Blood Service fees (as per DOH AO No2015- service fees
0045 & DC # 2016-0318)
Checklist of Requirements of Issuance of Certificate of Inclusion into the Regional
Voluntary Blood Services Network

For Hospital Blood Bank (HBB) with additional functions:

Requirements Means of Verification


1. Attendance to the Zonal Blood Services Network 1. Name with signature in the BSN
Meeting Attendance sheet & copy of Certificate
of
Appearance/Attendance/Participation
2. Submission of blood reports to Blood Program 2. Blood reports submitted, collated &
Coordinator analyzed
a. Blood Monitoring reports (BM forms 01 to
08) quarterly
b. Blood Safety Indicator report (BSI Sections 1
to 6) annually
3. MOA with BC or Lead BSF 3. Signed MOA
4. Blood Inventory Management 4. Submitted weekly blood stocks (signed
by BS Head & as reflected in the
MOA)
5. Functional and active Hospital Blood Transfusion 5. Hospital Order for HBTC & Minutes of
Committee (HBTC) the Meetings; Blood Utilization
Review
6. Utilized NVBSP prescribed forms 6. Utilized properly accomplished DHQ
a. Donor History Questionnaire (DHQ) and blood request forms
b. blood request forms (Adult &Pedia)
7. Complies with recommended Maximum Blood 7. Official Receipts reflecting blood
Service fees (as per DOH AO No2015-0045 & service fees
DC # 2016-0318)
8. HIV and other TTIs Proficiency Training 8. Certificate of Proficiency from RITM
Workshop for RMTs TTI-NRL
9. Referral of tested reactive blood units for 9. Confirmatory request form & results
confirmation at RITM TTI-NRL
10. Participation in NEQAS with RITM TTI-NRL & 10. Certificate of Participation in
NKTI IH-NRL respective NRLs with Very
Satisfactory to Excellent Ratings
11. Subscription to NBBNetS 11. Use of NBBNetS barcode sticker
Checklist of Requirements of Issuance of Certificate of Inclusion into the Regional
Voluntary Blood Services Network

For Blood Centers (BC)

Requirements Means of Verification


1. Attendance to the Zonal Blood Services Network 1. Name with signature in the BSN
Meeting Attendance sheet & copy of Certificate
of
Appearance/Attendance/Participation
2. Submission of blood reports to Blood Program 2. Blood reports submitted, collated &
Coordinator analyzed
a. Blood Monitoring reports (BM forms 01 to
08) quarterly
b. Blood Safety Indicator report (BSI Sections 1
to 5) annually
3. MOA with BC or Lead BSF 3. Signed MOA
4. Blood Inventory Management 4. Submitted weekly blood stocks (signed
by BS Head & as reflected in the
MOA)
5. Utilized NVBSP prescribed forms 5. Utilized properly accomplished DHQ
a. Donor History Questionnaire (DHQ) and blood request forms
b. blood request forms (Adult &Pedia)
6. Complies with recommended Maximum Blood 6. Official Receipts reflecting blood
Service fees (as per DOH AO No2015-0045 & service fees
DC # 2016-0318)
7. HIV and other TTIs Proficiency Training 7. Certificate of Proficiency from RITM
Workshop for RMTs TTI-NRL
8. Referral of tested reactive blood units for 8. Confirmatory request form & results
confirmation at RITM TTI-NRL
9. Participation in NEQAS with RITM TTI-NRL & 9. Certificate of Participation in
NKTI IH-NRL respective NRLs with Very
Satisfactory to Excellent Ratings
10. Subscription to NBBNetS 10. Use of NBBNetS barcode sticker

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