Purpose This presentation has been written by Public Health - - PowerPoint PPT Presentation

Dried blood spot scheme for infants born to hepatitis B positive mothers

How to take a good quality blood spot sample

Purpose

• This presentation has been written by Public Health England’s Immunisation

Department, to support The National Dried Blood Spot Testing Scheme for Infants of Hepatitis B Positive Mothers

• It was adapted from the UK Newborn Screening Programme Centre’s

(UKNSPC) presentation which supports the updated Guidelines for Newborn Blood Spot Sampling (2012)

2 Public Health England: How to take a good quality blood spot sample

Overview

• Why is it important to take a good quality blood spot sample?
• How do I prepare for taking a blood spot?
• How do I take a good quality sample?
• What do I do after taking the sample?
• Where can I find more information?

3 Public Health England: How to take a good quality blood spot sample

Why is it important to take a good quality blood spot sample?

• Facilitates referral of an infected child to a specialist as needed
• Reassurance to family that transmission has been avoided if negative
• Included in the NHS Commissioning Board service specification for the

neonatal hepatitis B vaccination programme

• Monitor delivery of immunisation programme
• Recommended by NICE (2009)
• Recommendation to immunise and test babies since 2000 (HSC 1998/127)
• Inadequate samples = requests for repeats = costly delays

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How do I prepare for taking a blood spot?

• The blood spot should be taken at 12 months. The test is recommended at

the same visit as the fourth dose of hepatitis B vaccine

• At this visit, discuss screening with parent(s)
• Provide information (Q&A leaflet)
• Record discussion and leaflet provision
• Record parents’ choice

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How do I prepare for taking a blood spot?

• Hepatitis B Dried Blood Spot Testing kit which includes: request form, clear

bag, alcohol wipe, instruction sheet, reply-paid specimen bag, automated safety lancet, Dried Blood Spot card

• Infant’s NHS number
• Child health record
• Non-sterile protective gloves
• Sharps box
• Cotton wool / gauze
• Hypoallergenic spot plaster

6 Public Health England: How to take a good quality blood spot sample

How do I take a good quality sample?

• Check the expiry date of the blood spot card and place on a clean surface
• The infant’s NHS number on the card is mandatory in England
• Complete all fields
• Fill in request form with demographic details, hepatitis B vaccine history,

maternal hepatitis history and GP details

7 Public Health England: How to take a good quality blood spot sample

How do I take a good quality sample?

• Recommend comfort measures for the infant
• Clean the heel with the alcohol wipe
• Allow the heel to dry completely
• Wash hands and apply gloves
• Ensure the infant is warm and comfortable
• Additional warming of the foot is not required

8 Public Health England: How to take a good quality blood spot sample

How do I take a good quality sample?

• Use an automated safety lancet, placed firmly against the infant’s heel
• Preferred puncture site:

9 Public Health England: How to take a good quality blood spot sample

How do I take a good quality sample?

• The aim is to fill each circle on the card with a single drop of blood
• Wait for the blood to flow – do not squeeze the foot
• Allow the blood to fill each circle by natural flow and seep through from front

to back

• Do not layer the blood
• Do not compress the blood spot

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11 Public Health England: How to take a good quality blood spot sample

What do I do after taking the sample?

• Wipe excess blood from the heel and apply gentle pressure with cotton

wool / gauze

• Apply a spot plaster if necessary
• Allow spots to air-dry away from direct sunlight or heat before placing in

glassine envelope

• Send the card within 24 hours
• Record taking the blood spots in the infant’s Red Book and in GP notes (if

applicable)

• Inform parents from whom they should expect the results (e.g. GP, hospital,

local coordinator)

12 Public Health England: How to take a good quality blood spot sample

Where can I find more information?

• Neonatal Hepatitis B Immunisation Programme:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/fil e/213173/01-Neonatal-hepatitis-B-immunisation-programme.pdf

• British Liver Trust information on hepatitis B:

http://79.170.44.126/britishlivertrust.org.uk/wp- content/uploads/2012/12/Hepatitis-B-Low-Res-PDF1.pdf

• PHE information on hepatitis B:

http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/HepatitisB/G eneralInformationHepatitisB/hepbGeneralInfo/

• UK Newborn Screening Programme Centre Blood Spot Sampling

Guidelines: www.newbornbloodspot.screening.nhs.uk/bloodspotsampling

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