POSITIVE PATIENT

IDENTIFICATION

P O S I T I V E PAT I E N T I D E N T I F I C AT I O N AT A L L S TAG E S O F T H E B L O O D

T R A N S F U S I O N P R O C E S S I S E S S E N T I A L

Patient Core Identifiers are Full Name Whenever possible ask the patient to state their full name

Unique identification number (Identity Card Number and Registration Number)i For patients who are unable to identify themselves eg paediatric unconscious patients or language barrier verification of the

patientrsquos identification should be obtained from a parent or carer (if present)

ii These information MUST MATCH EXACTLY the information on the patientrsquos wrist band case note

THE ADMINISTRATION OF BLOOD COMPONENTS

KEY ACTION POINT

PATIENT INFORMATION

AND CONSENT

bull Where possible patients (andor for paediatric patients those with parental responsibility) SHOULD have

i the benefits

ii the risks

iii and alternatives to transfusion explained to them in a timely and understandable manner

PRE-TRANSFUSION

DOCUMENTATION

bull The documentation in case note MUST containi the reason for transfusion (clinical and laboratory data)

ii details of the information provided to the patient

(risks benefits and alternatives to transfusion)

i and consent to proceed

PRESCRIPTION

bull The prescription MUST containi Patient Core Identifiers

ii components are to be transfused

iii date of transfusion

iv the volumenumber of units to be transfused

v the rate of transfusion

vi and any other clinical special instructions or requirements eg irradiated blood warmer

REQUEST FOR

TRANSFUSION

bull Requests MUST BE ELIGIBLY WRITTEN and include i Patient Core Identifiers

ii gender

iii current diagnosis and any relevant significant co-morbidities

iv a clear unambiguous reason for the request

v type of component and volume

BLOOD SAMPLES FOR

PRE-TRANSFUSION

TESTING

ALL PATIENTS BEING SAMPLED MUST BE POSITIVELY IDENTIFIED

SEE ABOVE POSITIVE PATIENT IDENTIFICATION

i The process of taking and labeling blood samples MUST BE DONE IN ONE PROCESS AT THE BEDSIDE ONE PATIENT

ONLY AT ANY ONE TIME

ii By competent healthcare worker only

iii Sample tubes SHOULD NOT BE PRE-LABELED

iv Patient Core Identifiers MUST be written clearly on the tube label

COLLECTION AND

DELIVERY OF BLOOD

COMPONENT

ENSURE THE PATIENT IS READY TO START THE TRANSFUSION AND

HAS PATENT VENOUS ACCESS BEFORE COLLECTING THE BLOOD COMPONENT

i When collecting the blood component from the laboratory or blood refrigerator a trained and competent healthcare worker

should take authorised documentation containing the patientrsquos core identifiers and check these with the label on the blood component

ii Core patient identifiers date and time of collection and staff identification details must be recorded

THE COMPONENT SHOULD BE DELIVERED TO THE CLINICAL AREA WITHOUT DELAY

ALL PATIENTS RECEIVING A TRANSFUSION MUST BE POSITIVELY IDENTIFIED ndash

SEE ABOVE POSITIVE PATIENT IDENTIFICATION

i The final administration check MUST BE CONDUCTED NEXT TO THE PATIENT BY 2 TRAINED AND COMPETENT

HEALTHCARE PROFESSIONALS who also administers the component

ii All Patient Core Identifiers on the patientrsquos identification wristband MUST MATCH THE DETAILS ON THE BLOOD

COMPONENT LABEL

iii All blood components should be administered using a blood administration set integrated filter (170 mm) to trap any large aggregates

ADMINISTRATION

MONITORING OF THE

PATIENT

WHILE RECEIVING BLOOD TRANSFUSION PATIENTS MUST BE MONITORED CLOSELY

i The patientrsquos vital signs including T PR and BP should be recorded before periodically during the transfusion and after the completion of

each transfusion

ii The patient should be carefully and closely observed and monitored for the first 5 to 10 minutes of the transfusion

iii For red cell transfusion the first 50 ml of each unit should be transfused slowly as it serves as an in vivo compatibility

testing (EXCEPT for massive bleeding)

iv An unconscious patient should have the vital signs checked at 15 minutes intervals during transfusion

PATIENT SHOULD BE PERIODICALLY OBSERVED DURING THE TRANSFUSION FOR

ANY CLINICAL FEATURES OF ACUTE TRANSFUSION REACTIONS

i Upon completion of blood transfusion ensure ALL transfusion documentation is completedii Ensure that the RECIPIENT CARD ATTACHED TO EACH BAG OF BLOOD COMPONENT IS FILLED COMPLETELY

AND RETURNED TOTHE BLOOD BANK together with the blood bag containing remnants of the blood transfused

COMPLETION OF

TRANSFUSION

v number of units required

vi any clinical special requirements

vii time needed

viii the location of the patient

ix full name of the requester

x the blood request form should be signed by the requester

JABATAN PERUBATAN TRANSFUSI HSAJB 2012 - drzk