4: Safe transfusion – right blood, right patient, right time and right place
Data from the UK Serious Hazards of Transfusion (SHOT) initiative (http://www.shotuk.org) show that around 1 in 13 000 blood units are administered to the wrong patient with occasional fatal outcomes. ‘Wrong blood into patient’ incidents are preventable and nearly always caused by human error. The root cause of most incidents is misidentification at the time of pre-transfusion blood sampling, laboratory testing, collecting the blood component from the blood bank or administration of the transfusion at the bedside. Potentially fatal ABO-incompatible transfusions still occur although improved clinical policies, staff training and introduction of methods to improve identification, resulting from the various Better Blood Transfusion initiatives, has significantly reduced their number over the last decade. Avoiding unnecessary or inappropriate transfusions is an essential starting point for safe transfusion practice. The British Committee for Standards in Haematology (BCSH) Guideline on the Administration of Blood Components (2009) (https://b-s-h.org.uk) describes the essentials of safe requesting, collection and administration of blood components (summarised in Table 4.1) and should form the basis of local transfusion policies. The key principles that underpin every stage of the blood administration process are:
Table 4.1 Safe blood administration (adapted from the BCSH Guideline on Administration of Blood Components, 2009, with permission)
Last updated 01/04/2020 What should be done before administering blood products?Immediately prior to administration, two licensed personnel must verify the correct blood product and patient. Blood products require a dedicated line for infusion, and filtered intravenous tubing. Only normal saline should be used to prime the intravenous line, with no other solutions or medications used.
What are the required nursing interventions when administering blood or blood products to a patient?Nursing Interventions. Verify doctor's order. ... . Check for cross matching and typing. ... . Obtain and record baseline vital signs.. Practice strict asepsis.. At least 2 licensed nurse check the label of the blood transfusion. ... . Warm blood at room temperature before transfusion to prevent chills.. Identify client properly.. Which action will the nurse take during administration of blood products?Whenever blood or a blood product is being administered, the nurse must closely monitor the client for the signs and symptoms of a possible complication. The first thing that the nurse must do when a reaction or a complication is possible is to discontinue the administration of the blood or blood product.
What is an important nursing responsibility when administering blood?Nursing care of the patient undergoing a blood transfusion is of utmost importance. Nurses are responsible not only for the actual administration of the blood product and monitoring of the patient during its administration but also efficiently identifying and managing any potential transfusion reactions.
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