Update for nurses and phlebotomists taking blood samples

Update for nurses and phlebotomists taking blood samples for Transfusion in General Practice The Hospital Transfusion Team rde-tr. HTT@nhs. net. Respond Deliver & Enable

Welcome to Blood Transfusion training • The aim of this training is to support you to take blood for transfusion in a safe and correct way • There is a national mandatory requirement for all involved in the process of blood transfusion to have regular 3 yearly training, which this training will fulfil Respond Deliver & Enable

The Request Form • Before taking a sample for transfusion make sure you have a completed request form available • The clinical information regarding how many units of blood, where and when the transfusion will take place and the reason for the transfusion should be completed by a doctor • A maximum of 2 units will be cross matched for each transfusion Respond Deliver & Enable

Use patient sticker or hand write: • Hospital or NHS number • Surname • Fore name • Date of birth Requesting Doctor to print name Sample taker should print/sign name/grade and date/ time sample Doctor to complete special requirements box Doctor to complete time and place Of transfusion Doctor to complete reason for transfusion (if possible not low Hb but symptoms etc) Respond Deliver & Enable

Taking the Blood Sample • The most common reason for blood samples to be rejected is that there is a discrepancy between the patient identification details on the form and the sample • The lab staff have a zero tolerance policy over any discrepancy, this has been shown to improve patient safety • The sample label must be hand written but a sticker can be used on the form Respond Deliver & Enable

Patient Identification Errors • In the RD&E we detect about 6 samples per year where the blood in the sample is not the blood of the patient whose details are on the sample label. • There are 2 main reasons for this: • Failure to identify the patient correctly, so blood is taken from the wrong patient but labelled with correct patient details • Failure to label the sample at the bedside so right patient bled, but sample then labelled with wrong patient’s details. Respond Deliver & Enable

Taking the blood…… • Ask the patient for their name and date of birth, let them tell you. • Always write details on the tube straight away and AT the bedside • Only take blood and label samples for one patient at a time Respond Deliver & Enable

Patient Identification details • 4 forms of ID are needed: Forename Surname Date of Birth Hospital or NHS number • If you use a sticker on the request form you can decide on whether you use the NHS number or the RD&E number on the sample bottle label as both numbers are on the sticker. • If you hand write the request form using only one of the numbers, you must use the same number on the sample • Patient address is not required Respond Deliver & Enable

Taking the sample. . How many do you need to take? • We need confirmation of a patient’s ABO group from 2 separate samples before cross matching blood, to reduce the risk from mislabelled samples • Over 90% of patients already have a group recorded on our computer system and so just 1 sample is needed • If you are unsure of how many samples to take please ring the Transfusion Laboratory • If taking 2 samples they should be taken from 2 venepunctures with 2 SEPARATE attempts at patient identity, please use 2 forms with time difference on samples Respond Deliver & Enable

Taking the sample. . How far in advance of the transfusion can it be taken? • The standard sample validity time is 72 hours between sampling and transfusion • If no pregnancy or transfusion within previous 3 months then the sample validity time extends to 7 days • In transfusion dependent haematology patients it may be possible to waive the 72 hr rule after discussion with their consultant Respond Deliver & Enable

Time to blood transfusion from taking blood sample……. • Day 1: • Day 2: • Day 3: Blood sample taken in Community, arriving in lab on transport at 3 pm when the blood sample will be cross matched but not in time for community transport that leaves RD&E at 4 pm each day Blood transported to Community Hospital, leaving RD&E at 4 pm Blood Transfusion Respond Deliver & Enable

Key Points…. . 1. Identify patients correctly and label the specimen immediately by hand at the patient/ bedside 2. Ensure the patient ID details are identical on the request form and the sample bottles, if not they will be rejected 3. The sample generally lasts 72 hours from being taken to transfusion being completed, check the time for transfusion on the form 4. The lab need 48 hrs from the sample being taken to the time of transfusion Respond Deliver & Enable

Thank You! The Hospital Transfusion Team rde-tr. HTT@nhs. net. Respond Deliver & Enable