1. Name of Participant: LYNORE S.

ROSARIO
2. Agency/BSF/Organization represented: JOSE R. REYES MEMORIAL MEDICAL CENTER
3. Category of BSF: HOSPITAL BLOOD BANK WITH ADDITIONAL FUNCTIONS
End-user hospitala
Blood Station
Blood Collection Unit and Blood Station
Hospital Blood Bank with additional functions
Blood Center
4. Role of participant in the Agency/BSF/Organization: _________________________
4.1 If as Blood Donor Recruitment Officer: Is your designation official: ☐ Yes ☒ No
4.1.1 No. of years working as BDRO: ______
4.1.2 Have you been involved as speaker in pre-donation information campaign?
☐ Yes ☒ No
4.1.3 In a scale of 1-10, how do you assess your ability as BDROb? _____7_____
5. If the facility that you are representing is BCU-BS/HBB-waf/BC,
5.1 how many units of blood donations have you collected in 2019? _______________
5.1.1 how many units from voluntary non-remunerated blood donors?c_______________
5.3 Sources of blood donations: [Tick all that applies]
☒ from communities of program partner
☒ from walk-in donorsd
☒ from donors recruited by relatives of end-users/patients
5.4 Does your BSF provide pre-donation counselinge? ☒ Yes ☐ No
5.5 Does your BSF provide post-donation counselingf? ☒ Yes ☐ No
5.6 Does your BSF provide post-test counselingg? ☒ Yes ☒ No
5.6.1 Who provides post-test counseling for those confirmed positive to HIV?
____________DOCTORS________________
5.6.2 Who provides post-test counseling for those confirmed positive to
hepatitis B, hepatitis C and syphilis?
_______________DOCTORS______________

5.7 Does your BSF provide counseling to all deferred donors? ☐ Yes ☒ No
5.7.1 Who provides the counseling?
____________________________
5.8 In a scale of 1-10, how do you assess your ability as BD Counselor? ____7____
6. No. of program partnersh your facility has at present? __________________
6.1 Do you conduct program partners’ meeting? ☐ Yes ☒ No
6.1.1 How often in a year? ____________

6.2 Do you conduct Blood Program Implementation Review with program partners?
☐ Yes ☒ No
6.2.1 How often in a year? ____________

a = a hospital that does not store blood; no. of transfused units is less than 1,000 units per annum
b = Blood Donor Recruitment Officer provides pre-donation information (pep talk on VBD), pre-donation counselling
(one-on-one talk with donor that includes risk assessment), counselling for deferred donors for different reason/s,
counselling for donors who experienced adverse reaction related to blood donation, and post-donation counselling.
BDRO also does advocacy and promotion for VBD.
c = donors who donate of their free will and whose intention to donate is not unduly influenced by other or by
incentives. Donors who give blood for the use of a specific person is not considered as voluntary.
d = donor who donates in a BSF (BCU/BS, HBBwfa, BC), donation is not intended for any patient and does not ask for
blood donor’s card
e = counselling given before donation and includes risk assessment – probing for risk factors associated with TTI
f = counselling given to BD after his/her donation on self-care and provision of contact number in case delayed adverse
reaction occurs
g = counselling given after receipt of result of confirmatory test (HIV, hep B and hep C) from RITM
h = program partner can be barangay/municipality/city/province, a work-based organization, faith-based organization,
civic organization, peoples organization