Recommendations for Hospital Transfusion Teams
| Recommendation | Action by |
|---|---|
| GENERAL RECOMMENDATIONS | |
| Education and training are of key importance for safe and effective blood transfusion practice. Education in blood transfusion must be included in the curriculum for all clinical staff involved in prescribing and administering blood. Adequate resource is needed in Trusts to ensure that all staff involved in the transfusion chain in hospitals must receive appropriate training, which must be documented. Effectiveness of training should be assessed with assessment based on competency | Local transfusion committee network |
| Mechanisms must be put in place for appropriate and timely communication of information regarding special transfusion requirements | Hospital Transfusion Teams (HTTs) |
| Appropriate use of blood components must be strenuously promoted and evaluated. This must include monitoring for serious adverse effects of alternatives to transfusion | HTTs |
| NEAR MISS | |
| All hospitals are encouraged to report “near miss” events as required by HSC 2002/009 (BBT2) in order to further identify local weaknesses in the transfusion process. All instances of ‘wrong blood in tube’ must be fully investigated | HTTs |
| Robust systems for noting patients’ special requirements should be developed together with a policy of empowering patients to be more aware of their own special needs | HTTs |
| Ward staff at all levels must be trained in appropriate storage of blood components once they have been collected from the blood bank | HTTs |
| ACUTE TRANSFUSION REACTIONS (ATR) | |
| In the continued absence of a published national guideline for investigation of ATR, SHOT is developing, in collaboration with the BCSH Transfusion Taskforce, a minimum standard for investigation. This will be included in the Toolkit on the SHOT website | HTTs |
| ADVERSE REACTIONS TO POST-OPERATIVE CELL SALVAGE | |
| Users of post-operative salvage should continue to monitor patients for adverse reactions. Those of sufficient severity to require discontinuation of transfusion should be reported to SHOT together with information on total numbers of procedures | HTTs |
| TRANSFUSION RELATED ACUTE LUNG INJURY (TRALI) | |
| Transfusion of whole blood should be discouraged | HTTs |
| Hospital staff should continue to be aware of TRALI and report possible cases to the local Blood Centre to facilitate investigation. Continued education of all relevant staff about this condition is needed | HTTs |
| TRANSFUSION TRANSMITTED INFECTIONS | |
| Hospitals should consult guidelines and the blood service about the investigation of transfusion reactions suspected to be due to bacteria. Attention should be paid to the sampling and storage of implicated units or their residues | HTTs |
| Hospitals should continue to report and investigate all possible incidents of post-transfusion infection appropriately and adequately | HTTs |