POSITIVE PATIENT IDENTIFICATION POSITIVE PATIENT IDENTIFICATION AT ALL STAGES OF THE BLOOD TRANSFUSION PROCESS IS ESSENTIAL 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, e.g. paediatric, unconscious patients or language barrier, verification of the patient’s identification should be obtained from a parent or carer (if present). ii. These information MUST MATCH EXACTLY the information on the patient’s wrist band / case note. THE ADMINISTRATION OF BLOOD/ COMPONENTS: KEY ACTION POINT PATIENT INFORMATION AND CONSENT • Where possible, patients (and/or 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 • The documentation in case note MUST contain: i. 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 • The prescription MUST contain: i. Patient Core Identifiers ii. components are to be transfused iii. date of transfusion, iv. the volume/number of units to be transfused v. the rate of transfusion vi. and any other clinical special instructions or requirements e.g. irradiated, blood warmer, REQUEST FOR TRANSFUSION • Requests MUST BE ELIGIBLYWRITTEN 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 ONETIME 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 patient’s 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 – 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 patient’s 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 patient’s 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 completed. ii. 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