EVALUATING THE IMPACT OF QUALITY IMPROVEMENT INTERVENTION ON DIAGNOSTIC ACCURACY OF HIV SCREENING IN BLOOD DONORS: A STUDY IN NORTHERN SAUDI ARABIA

Abstract

This study evaluates the impact of quality improvement interventions on the accuracy of HIV screening among blood donors in the Northern Borders Region of Saudi Arabia, with a focus on the Central Blood Bank. Ensuring safe blood transfusion is critical, as inadequate screening may lead to the transmission of infectious diseases, particularly in low-prevalence settings where minor inaccuracies can compromise blood safety. A mixed-methods approach was employed. Quantitatively, a retrospective analysis of 385 blood donor samples was conducted to assess diagnostic performance, including sensitivity, specificity, and error rates. Results showed one true positive, six false positives, and no false negatives, yielding a false-positive rate of 1.56% and a false-negative rate of 0%. Although overall sensitivity was high, the low positive predictive value highlighted the importance of confirmatory testing and robust quality control measures. In addition, the effectiveness of a quality improvement intervention was evaluated through a structured training program delivered to 30 laboratory staff. The intervention significantly improved performance, with mean test scores increasing from 11.07 to 14.00 (p < 0.001), alongside improved internal consistency (Cronbach’s alpha: 0.762 to 0.794). Qualitative findings identified three key sources of variability affecting HIV testing performance: pre-analytical, analytical, and post-analytical factors, including inconsistencies in sample handling, equipment maintenance, and result interpretation. Overall, the findings demonstrate that both procedural weaknesses and staff competency gaps can affect HIV screening accuracy. Strengthening standardization, continuous training, and quality assurance systems is essential to enhance blood safety and ensure reliable transfusion services in the region.