Download Post Transfusion

NHS Tayside Documentation for Transfusion of Blood Components
This is a formal record of transfusion and must be filed in the appropriate case records
Please use a new document for each transfusion event
Patient Details- CHECK AGAINST PATIENT’S IDENTIFICATION BAND
Affix label here or write patient details
Hospital/Unit:
Forename:
Ward/Dept:
Surname:
Gender:
Date of birth:
Consultant:
CHI:
Authorisation / Prescription
 This section should be completed by the person Authorising /prescribing the transfusion
 It is the responsibility of the authoriser /prescriber of the blood components(s) to ensure that any special
transfusion requirements are met (e.g. irradiated/CMV negative units, use of blood warmer)
 Medications related to transfusion (e.g. diuretics, antipyretics) must be prescribed on a Drug Prescription
chart
Before authorising /prescribing blood or blood components check patients previous transfusion history for
 Blood group & Presence of antibodies
 Any previous transfusions reactions
Consent for Transfusion
 Intended procedure explained
No  Yes  Risks
Hepatitis
(1:1,000,000)

 Reasons for transfusion explained to
(1:5,000,000)

patient /guardian
No  Yes  HIV
Variant CJD
(very small)

 Transfusion alternatives discussed: Cell Salvage
Iron supplementation
No  Yes  NA 
Bacterial Contamination ( 1:2,000)

 Was the patient/ guardian offered a Transfusion
*Patient Information Leaflet (PIL)?
Yes  No 
Serious incident related to blood transfusion
 Was the patient offered an opportunity to ask questions (wrong blood ,transfusion reaction, acute
after reading the PIL?
Yes  No 
lung injury, circulatory overload,
 Does this patient/ guardian agree to have a blood
Inappropriate or unnecessary transfusion)
transfusion?
No  Yes 
(1:2,270)

 Is an advanced directive (refusal of transfusion)
document in place?
Yes  No  Emergency Transfusion-Discussion
Pease delete patient/guardian as appropriate
is not possible

I confirm that I have current valid training in safe blood transfusion and have obtained
consent
Name & Designation …………………………… …….. …............................................
Signature………………………..
Date…………………………………
*Patient Information Leaflets :”Receiving a Transfusion - Information for Patients and Relatives”
are available free of charge from Scottish National Transfusion Service (SNBTS) Public Affairs Department
on tel. 0141 357 7752
THB (MR) 020
V4.0 May 2013
THIS SECTION SHOULD BE COMPLETED BY THE PERSON AUTHORISING / PRESCRIBING
THE TRANSFUSION
Patient Name:
UNIT 1
Blood
component
Unit/
Pool/
mls
Date of birth/CHI:
Special Requirements /
Instructions (please tick)
Affix completed pink portion of compatibility label here
Irradiated

CMV negative

Blood warmer

Other medication 
Reason for transfusion
Date
Duration
Authoriser /Prescriber signature
Reassess before you progress! (Venflon site and observations)
UNIT 2
Blood
component
Unit/
Pool/
mls
Special Requirements /
Instructions (please tick)
Affix completed pink portion of compatibility label here
Irradiated

CMV negative

Blood warmer

Other medication 
Reason for transfusion
Date
Duration
Authoriser /Prescriber signature
Reassess before you progress! (Venflon site and observations)
UNIT 3
Blood
component
Unit/
Pool/
mls
Special Requirements /
Instructions (please tick)
Affix completed pink portion of compatibility label here
Irradiated

CMV negative

Blood warmer

Other medication 
Reason for transfusion
Date
Duration
Authoriser /Prescriber signature
Reassess before you progress! (Venflon site and observations)
UNIT 4
Blood
component
Unit/
Pool/
mls
Special Requirements /
Instructions (please tick)
Affix completed pink portion of compatibility label here
Irradiated

CMV negative

Blood warmer

Other medication 
Reason for transfusion
Date
Duration
Authoriser /Prescriber signature
THB(MR) 020
V4.0 May 2013
THIS SECTION SHOULD BE COMPLETED BY THE PERSON ADMINISTERING THE TRANSFUSION
Patient Name:
Date of birth/CHI:
Transfusion Checklist - Please initial each box as checks are completed
Pre- Collection
Pre-administration
Checks below should be
completed before collection of
component from temperature
controlled storage is undertaken
Unit
No.
1
Patent IV
access
(Patient
safety
bundle
adhered
to)
Blood
authorised
/ prescribed
Check for
special
requirements
& consent
Post Transfusion
*Only remove clear outer wrap bag
immediately prior to commencing
transfusion and only when all
positive identification checks have
been completed
Date/Time blood
removed from
cold
temperature
storage
Inspect
bag
(condition
& expiry
date)
Baseline
Verbal
*Identification
Observations
identification band details
recorded on
at the
are verified
SEWS chart
bedside
and correct &
(Temperature
(if
match details
Pulse
applicable)
on
Oxygen sats
Traceability
Respiration rate
“bag& tag”
& BP)
label
Traceability
Tag signed,
with starting
time & date of
transfusion
recorded
Date/Time
Transfusion
completed
Tag ready to
return to lab
Completion of
Observations
Noted on the
SEWS chart
(Temperature
Pulse
Oxygen Sats
Respiration rate &
BP
………………………
…………………
………………………
…………………
3
………………………
……………….
4
………………………
………………….
2
THB(MR) 020
Identification
band
insitu &
details
verified and
correct
At Bedside
V4.0 - May 2013
Observations
All patient observations must be highlighted as blood transfusion observations, utilising patient’s
current observation chart, for example SEWS chart.
The minimum observations that must be recorded for each unit are:
 Baseline observations (Temperature, Blood Pressure, Oxygen Saturation, Respiration Rate &
Pulse), must be recorded no more than 60 minutes prior to transfusion commencing
 15 minutes after the start of the transfusion, vital signs (Temperature, Blood Pressure, Oxygen
Saturation, Respiration Rate & Pulse ) must be recorded and repeated again at another 15
minute interval
 Thereafter Temperature, Blood Pressure and Pulse * hourly until completion of the blood
component
 At end of transfusion, Temperature, Blood Pressure, Oxygen Saturation, Respiration Rate &
Pulse must also be monitored within 60 minutes of completion
*NB if any of these measurements have altered from baseline values, Respiratory Rate must also be
recorded and concerns escalated to the medical team according to the SEWS.
Adverse Events


Transfusion reactions in unconscious or compromised patients may be more difficult to identify,
therefore more frequent observation may be required
Any adverse transfusion incident must be reported to the attending medical team in the first
instance and the hospital transfusion laboratory at the earliest opportunity after the clinical
symptoms have been dealt with. Thereafter the adverse incident must also be reported through
the local adverse incident management scheme(DATIX)
Post Transfusion


Adverse reactions may manifest many hours after the transfusion is completed. It is
recommended that patients, discharged within 24 hours of transfusion are issued with a contact
card giving 24-hour access to clinical advice through NHS 24. Parents of paediatric patients
should be advised to contact the ward directly for advice
When pre-transfusion discussion has not taken place, the reasons for transfusion should be
discussed with the patient and written information offered retrospectively. Confirmation that this
discussion has taken place must be written in the patient’s nursing and medical notes
Best Practice Points






Positive patient identification is essential at all stages of the blood transfusion process
A patient identification band (or risk assessed equivalent) must be worn by all patients receiving a
blood transfusion and include minimum patient data set
It is the responsibility of the healthcare professional administering the blood component to perform
the final patient identification check, before administering the blood component
Only staff who have been assessed as competent should collect blood components
It is a legal requirement to complete the blue traceability label and return it to the hospital
transfusion laboratory
Transfusion should not take place during overnight periods unless clinically indicated
Resources
Transfusion Laboratory Contact Numbers
Hospital Transfusion Laboratory
Transfusion Practitioner
Ninewells: ext 32953
PRI: ext 13338(out of hours page 5122)
Ninewells :page 5099
PRI :page 5082
Reference: British Committee for Standards in Haematology (BCSH) Guidelines
http://www.bcshguidelines.com
THB(MR)020
v 4.0 May 2013