Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 17 3 2023 07 20 167 176 Saeed Mohammadi 1) Research Institute for Oncology, Hematology and Cell Therapy, Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran 2) Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran Seyed Morteza Tabatabaei Yazdi Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran Sahar Balagholi Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran Saeid Saremi Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran Rasul Dabbaghi Ophtalmic Research Center, Research Institute for Ophtalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran Shirin Ferdowsi Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran Peyman Eshghi 2Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2021 05 23 2022 05 01 Background: The coronavirus disease 2019 (COVID-19) outbreak has led to an alteration in hygienic conditions. In this situation, improving standard operating procedures (SOPs) in blood donation centers is critical. The purpose of this study was the assessment of SOPs in the blood donation centers during the outbreak of COVID-19 by regular blood donors as external audits. Materials and Methods: Regular donors were selected as external inspectors in 31 provinces of Iran. The questionnaire containing 10 closed questions was provided to assess the hygienic SOPs of blood transfusion centers in the prevention of COVID-19 transmission. Comparison and evaluation of questionnaires were conducted by assigning an importance coefficient (IC)  score to each question. Results: Assessment of SOPs in blood donation departments by regular donors in 31 provinces of Iran showed that 18 centers (58.1%) received IC scores >10(Strong performance), 7 centers (22.6%) received the range of IC scores between7-10(acceptable performance), and 6 centers (19.4%) received IC scores <7(poor performance). The difference in IC scores between provinces was not statistically significant. Conclusion: This study confirms that the assessment of blood donation centers through regular blood donor inspection is a reliable method to identify the strengths and weaknesses of blood transfusion center services and ultimately leads to corrective intervention and improvement of hygienic SOPs to prevent COVID-19 transmission. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1642 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1642/986