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Please attach patient sticker here or record: Name:…………………………………. Unit No: D.O.B:

Please attach patient sticker here or record:

Name:………………………………….

Unit No:

Name:…………………………………. Unit No: D.O.B: ……………………………… Male Consultant:

D.O.B: ………………………………

Male

Consultant: ……………

Unit No: D.O.B: ……………………………… Male Consultant: …………… Female Ward: …………

Female

Unit No: D.O.B: ……………………………… Male Consultant: …………… Female Ward: …………

Ward: …………

CARE PATHWAY FOR BLOOD TRANSFUSION – SINGLE USE

For use with all patients requiring blood transfusion, day case and in-patient, in all departments.

A multidisciplinary team has developed this Care Pathway. It is intended as a guide to care and treatment, and an aid to documenting patient progress. The Care Pathway document is designed to replace the conventional medical and nursing clinical record and be retained in the medical notes within this admission episode.

All healthcare professionals are of course free to exercise their own professional judgment when using this Pathway. However any decision to deviate from the pathway should be documented and filed in the patients’ notes.

Any comments regarding this Care Pathway should be sent to the Author, Hilary Morgan, Blood Transfusion Nurse Practitioner, 01905 763333 Ext: 30633

Approved by CEC and Issued: July 2005

Review: July 2008

Reviewed by Hilary Morgan, Blood Transfusion Nurse Practitioner and re-issued with minor amendments in July 2006 and October 2007

Guidelines referred to when developing this Care Pathway:

1. Worcestershire Acute Hospitals NHS Trust, Policy & Guidelines for Blood Transfusion, November

2004.

2. SHOT guidelines (Serious Hazards of Transfusion) 2000.

3. British Committee for Standards in Haematology 1999.

Abbreviations used in Care Pathway

 

RN

Registered Nurse

Dr

Doctor

Aux

Auxilliary Nurse/HCSW

T

Any member of the above team

SHO

Senior House Officer

S

Surgeon

A

Anaesthetist

AA

Anaesthetic Assistant

St N

Student Nurse

   
All users of this pathway must enter their specimen signature and initials below PRINT NAME
All users of this pathway must enter their specimen signature and initials below
PRINT NAME
SIGNATURE
INITIALS
DESIGNATION

©Worcestershire Acute Hospitals NHS Trust Care Pathway for Blood Transfusion – Single Use

Page 1 of 6

Unit Number:

Unit Number: Name: ……………………………… DOB: ………………………………   Designation

Name: ………………………………

DOB: ………………………………

 

Designation

INTERVENTION If an intervention is not carried out for any reason, please tick No and document intervention number, reason and action taken, in multidisciplinary progress notes (Page 6)

Y

N

Signature

(Time /

No.

Date)

SECTION A - GROUP / CROSS MATCHING AND PRESCRIBING OF BLOOD

 

1 Dr

Reason for transfusion: …………………………………………………….

     

or

RN

See WAHT Guidelines Protocol 1 of Blood Transfusion Policy Hb prior to transfusion: ………. g /dl

 
 

2 Dr

Patient has received information re procedure, risks and benefits

     

or

RN

Aware of reason for transfusion

 

Written information leaflet given

Verbal explanation of procedure, risks and benefits given

 
 

3 Dr

Patient wristband in place and contains: surname, first name, gender, DOB, ID number

     

or

RN

 

NB: If in pre-assessment clinic verbally check 3 items: name, ID number, DOB or address

 
 

4 Dr

Request form fully completed

       

or

 

RN

Ensure the following information is included: surname, first name, gender, DOB, ID number, location of patient, time and date, type of blood product, diagnosis, reason for request and any special arrangements.

 

5 Dr

Sample tube labeled with above information plus date sample taken and location of patient:

     

or

RN

Tubes must be labeled by hand, after blood has been taken, by person taking blood

 

Blood taken in Phlebotomy Clinic

Yes / No

 
 

6 Dr

Blood prescribed on intravenous infusion sheet:

       

Ensure the following information is included: surname, first name, DOB, ID number, blood/blood components required, plus any special requirements e.g. irradiated, quantity and duration of transfusion.

 

7 Dr

Any special instructions required documented:

       

Diuretics

must be prescribed on medicines chart CMV neg.

 

Blood warmer

Irradiated

SECTION B - COLLECTION & DELIVERY OF BLOOD

 

-

Blood Transfusion Must Be Commenced Within 30 Minutes of Arriving On Ward

 
 

8 Dr

Blood requested / collected from blood bank:

1

st

     

or

Information to be taken to lab: name, DOB, ID, location, type and number of units. NB: Person collecting must have been trained in procedure. Time requested:

Unit

RN

2

nd

     

Unit

 

3

rd

     

Unit

1 st Unit ……… 2 nd

 

3 rd

 

4 th

 

4

th

     

….

….

….

Unit

 

9 Dr

Correct blood delivered to ward / department and received by RN/Dr:

1

st

     

or

Unit

RN

 

2

nd

     

Time blood arrives on ward / department …………………………….

 

Unit

 

3

rd

     

Unit

1 st Unit ……… 2 nd

 

3 rd

 

4 th

4

th

     

….

….

….

Unit

©Worcestershire Acute Hospitals NHS Trust Care Pathway for Blood Transfusion - Single Use

Page 2 of 6

Unit Number:

Unit Number: Name: ……………………………… DOB: ………………………………   Designation

Name: ………………………………

DOB: ………………………………

 

Designation

INTERVENTION If an intervention is not carried out for any reason, please tick No and document intervention number, reason and action taken, in multidisciplinary progress notes (Page 6)

Y

N

Signature

(Time /

No.

Date)

SECTION C - PATIENT IDENTITY AND BLOOD UNIT CHECK

 

-

All patients undergoing blood transfusion, in ANY setting, MUST have an identification wristband in place

-

Blood unit and patient identity checks MUST always be done in the presence of the patient who is to receive the transfusion

-

Patient identity and the blood unit MUST also be checked by a second person

 

10

RN

Unit of blood inspected / no abnormalities found:

1

st

     

Unit

Check for: leaks, haemolysis, unusual discolouration or turbidity, presence of large clots

2

nd

     

Unit

3

rd

     
 

Unit

4

th

     

Unit

11

RN

Patient identity checked verbally with patient:

1

st

     

Unit

 

2

nd

     

Unit

3

rd

     

Unit

4

th

     

Unit

12

RN

Surname, first name, date of birth and identification number – all identical on each of the below:

1

st

     

Unit

 

2

nd

     

1. Wristband (N.B. A & E number can be used)

2. Blood bank slip

3. Compatibility label

Unit

3

rd

     

Unit

 

th

     

4. Prescription

4

Unit

13

RN

Blood group and blood unit number identical on each of the below:

1

st

     

Unit

 

2

nd

     

1. Blood unit

2. Blood bank slip

Unit

3

rd

     

Unit

 

4

th

     

Unit

14

RN

Blood unit within expiry date

1

st

     

Unit

 

2

nd

     

Unit

3

rd

     

Unit

4

th

     

Unit

-

The blood bank slip AND the prescription chart MUST be signed by both persons carrying out the patient and unit check, and the time and date of commencement of the unit entered.

-

The blood bank slip to be kept with the patient during the transfusion

 

-

Sign and return traceability slip

©Worcestershire Acute Hospitals NHS Trust Care Pathway for Blood Transfusion - Single Use

Page 3 of 6

Unit Number:

Unit Number: Name: ……………………………… DOB: ………………………………   Designation

Name: ………………………………

DOB: ………………………………

 

Designation

INTERVENTION If an intervention is not carried out for any reason, please tick No and document intervention number, reason and action taken, in multidisciplinary progress notes (Page 6)

Y

 

N

Signature

 

(Time /

No.

Date)

SECTION D – TRANSFUSION PROCESS / MONITORING

 

15

RN

Patient informed of any possible adverse effects of procedure and the importance of reporting these immediately to clinical staff:

       

e.g. shivering, rash, flushing, shortness of breath or pain in extremities or loins.

-

There is no minimum or maximum size of cannula for transfusion, size will depend on size of vein and speed blood is to be transfused

-

Blood will be transfused through a sterile giving set designed for the procedure. Additional filters are not required

-

Each giving set must only be used for a maximum of 12 hours

 

MONITORING OF TRANSFUSION TO BE RECORDED ON BLOOD OBSERVATIONS CHART ON PAGE 5

 

16 RN

Blood unit administered within 4 hours of leaving the blood fridge

1

st

     

Unit

2

nd

     
 

Unit

3

rd

     

Unit

4

th

     

Unit

 

17 RN

Blood unit transfused with no adverse effects:

1

st

     

Unit

NB: details of any adverse reactions MUST be documented in multidisciplinary notes (page 6) together with any actions taken and a reaction report form completed.

2

nd

     

Unit

3

rd

     

Unit

 

4

th

     

Unit

SECTION E – DISPOSAL OF BLOOD BAGS

 

18

RN

Blood bag disposed of as below:

1

st

       

Unit

1. Sealed with a suitably sized spigot or attached blue plug

2. Placed in dated bag and stored in dirty utility room

nd

2

Unit

       

3

rd

       

NB: After 24 hours the pack can be disposed of as clinical waste

Unit

4

th

       

Unit

©Worcestershire Acute Hospitals NHS Trust Care Pathway for Blood Transfusion - Single Use

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Unit Number:

Unit Number: Name: ……………………………… DOB: ……………………………… BLOOD TRANSFUSION

Name: ………………………………

DOB: ………………………………

DOB: ……………………………… BLOOD TRANSFUSION OBSERVATIONS CHART 1. Record temperature,

BLOOD TRANSFUSION OBSERVATIONS CHART

1. Record temperature, pulse,respirations and blood pressure prior to start of the transfusion 2. Record
1.
Record temperature, pulse,respirations and blood pressure prior to start of the transfusion
2.
Record temperature, pulse respirations and blood pressure 15 minutes after each unit has commenced
3.
Record temperature, pulse respirations and blood pressure at the end of each unit
4.
Record observations when the transfusion has been completed
NB: These are the only recordings required UNLESS any adverse reactions occur
Date
Time
1 st Unit
Sign and return
traceability slip
2 nd Unit
Sign and return
traceability slip
3 rd Unit
Sign and return
traceability slip
4 th Unit
Sign and return
traceability slip
Please enter
unit number
40
39
38
240
37
Temperature
220
36
200
35
180
170
170
160
160
150
Blood
150
Pressure
140
140
130
130
120
120
110
110
100
100
90
90
80
80
70
70
60
60
Pulse rate
50
50
40
40
30
30
20
20
10
10
0
0
Resps
Baseline
Completion

©Worcestershire Acute Hospitals NHS Trust Care Pathway for Blood Transfusion - Single Use

Page 5 of 6

Unit Number:

Unit Number: Name: ……………………………… DOB: ……………………………… MULTI-DISCIPLINARY

Name: ………………………………

DOB: ………………………………

MULTI-DISCIPLINARY PROGRESS NOTES

Please use this sheet to document any additional communications required to ensure appropriate care for patient.

NO Signature / Designation / Time / Date
NO
Signature /
Designation / Time /
Date

©Worcestershire Acute Hospitals NHS Trust Care Pathway for Blood Transfusion - Single Use

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