Factors influencing confidential unit exclusions in blood donors

In many countries blood donors can exclude their donated blood from being transfused in a confidential unit exclusion (CUE) process. We aimed to identify characteristics which might influence the decision for CUE.

In a 3-step approach we first enrolled 29 German blood donation centers in 2005 and addressed how the clarity of different CUE forms applied in these centers was rated by first time blood donors and also assessed three newly designed CUE forms. Second, we performed a survey on the characteristics of the CUE process including 25 centers. Third, we performed an intervention study, in which the CUE form originally applied in the study centre was compared with a newly developed CUE form in a before-after study design with respect to the corresponding CUE rates.

(1) Clarity of the CUE forms varied considerably. (2) The CUE rate was higher (P < 0.05) when nurses rather than a physician were involved in informing the donors and when the CUE form was submitted anonymously instead of being handed to a person. (3) Application of the newly designed CUE form which was rated as being very clear resulted in a 31% decrease in the CUE rate.

Design of the CUE form and characteristics of the CUE process may considerably influence the CUE rates.