West Midlands Regional Training Package for Safe Blood Transfusion Practice

1
West Midlands Regional Training Package for Safe
Blood Transfusion Practice
MODULE 8 Collection of Blood Blood
Components/Products from the Hospital Blood Bank
and/or Issue Fridge

• The West Midlands Regional Transfusion Committee

2
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge

• Contents
• Pre-collection considerations
• Locating the blood / blood components for
  collection
• Positively identify the correct unit
• Documentation of removal
• Emergency O RhD negative units
• Transporting blood / blood components

Aim Increase knowledge and understanding of the
correct procedure when collecting blood blood
components for your patient according to your
Trusts policies
3
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge

• Objectives
• To locate Trust policies and be aware of content
• To identify the correct procedure for the correct
  patient
• To describe the selection, checking and
  documented removal of Blood/Blood Components from
  the hospital blood bank
• To recognise the correct storage conditions for
  Blood and Blood Components ready for issue
• To state how to transport Blood and Blood
  Components safely / correctly
• To explain the correct procedure for collecting
  Emergency O RhD Negative units

4
Introduction
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge
5
Trust Policies
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge
All Trusts have written policies on
Administration of Blood and Blood components.
These will include the correct procedures,
within your Trust, for collection of blood and
blood components from the Issue Fridge.
Ensure you know where the policies are kept on
your ward/department.
Learn how to access and use your Trust intranet.
Most Trusts now have this facility, with all
policies available online.
Read the policies frequently and be aware of
policy updates.
If you have worked in different Trusts, make sure
you know the policy for your current Trust.
Working practices and systems may vary.
Some hospitals have satellite fridges - ensure
you know who has responsibility for these
fridges.
6
Pre-collection Considerations
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge
Both manual and computer systems rely on the
following basic rules
7
Locating the blood / blood components for
collection
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge
On arrival at the Blood Bank / Issue Fridge
8
Positively identify the correct unit
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge
9
Documenting removal
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge
10
Returning a unit of blood / blood component
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge
11
Emergency O RhD Negative units
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge
There are always Group O RhD negative units of
blood available in the Issue Fridge for emergency
use only. These units must be clearly marked
For emergency use only. These units are to save
a patients life until at least ABO group
compatible / fully cross-matched units can be
made available.
12
Transporting Blood and Blood Components
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge
Transporting components requiring differing
temperatures Transporting a selection of
products from the blood bank to the ward /
department can cause problems if taking products
which are stored at different temperatures.
Care needs to be taken not to carry, for
example, blood (stored in fridge) and platelets
(stored at room temperature) in contact with each
other - components may become damaged and harmful
to the patient. Transport the different
components in separate containers to prevent
temperature transfer between the components.
13
Transport Boxes
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge
14
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge
Highlight Case 1 from SHOT 2001-2002 Blood
collection error leading to ABO
incompatibility A 58 year-old man, Group O RhD
positive, who had undergone transurethral
resection of bladder tumour received
approximately 200ml of Group A RhD positive
blood. He experienced rigors, hypotension and
subsequently developed renal failure. The
incorrect unit had been collected from a
satellite refrigerator by a qualified nurse and
a single qualified nurse had checked and set up
the transfusion. The patient made a good
recovery after being transferred to a
high-dependency unit.
Highlight Case 2 from SHOT 2003 Two patients,
same surname Joe Soap, who was O Rh negative,
required an urgent transfusion for bleeding
oesophageal varices. There was another patient,
(Fred Soap) with the same surname on the ward
for whom blood had also been crossmatched. Fred
Soap was O Rh D positive. Fred Soaps
compatibility form had been stuck in Joe Soaps
notes. An agency nurse had been sent to the
blood bank to collect blood for Joe. She
collected a unit of Freds blood which was then
checked against Joes notes but with reference
to Freds compatibility form. No bedside check
was carried out. A nurse noticed the discrepant
name when taking down the empty bag.
15
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge
Highlight Case 3 from SHOT 2003 Two patients,
same surname David Archer and Tony Archer were
patients on the same ward and blood was
crossmatched for both. David was O Rh positive
and Tony was A Rh positive. The porter
collecting blood for David removed a unit of
Tonys blood and Tonys compatibility form.
Nursing staff checked the details on the bag
label against the (wrong) form, which was signed
and placed in Davids notes. David was not
wearing a wristband and no identity check was
done. The transfusion was stopped when he
developed a fever, but only when the laboratory
came to investigate the reaction was the ABO
incompatibility realised. He survived the
event. Name coincidences are a source of error
here as at other stages of the transfusion
process and must be guarded against by full
positive identification at every stage. The
final patient identity check must be done at the
bedside against an identification wristband or
equivalent attached to the patient.
16
Key Points
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge
17
Module 8 - Quiz
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge

• Question 1 of 6
• What is the correct storage temperature for a
  unit of red cells?
• A. 30 oC
• B. 2 - 6 oC
• C. 2 - 10 oC
• D. 20 - 24 oC

18
Module 8 - Quiz
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge

• Question 2 of 6
• What is the correct storage temperature for a bag
  of platelets?
• A. 30 oC
• B. 2 - 6 oC
• C. 2 - 10 oC
• D. 20 - 24 oC

19
Module 8 - Quiz
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge

• Question 3 of 6
• There is no requirement to document removal of
  blood or components
• True / False

20
Module 8 - Quiz
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge

• Question 4 of 6
• If necessary, blood can be stored in a ward
  fridge before use.
• True / False

21
Module 8 - Quiz
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge

• Question 5 of 6
• An emergency unit of blood is
• A. A RhDve
• B. O RhDve
• C. O RhD-ve
• D. B RhD-ve

22
Module 8 - Quiz
Module 8 Collection of Blood and Blood Products
from the Hospital Blood Bank and/or Issue Fridge

• Question 6 of 6
• If a transfusion is cancelled, the unit of blood
  can be returned to the issue fridge providing it
  has not been out of the temperature controlled
  storage any longer than
• A. 30 minutes
• B. 45 minutes
• C. 2 hours
• D. 4 hours

23
Module 8 quiz answers

• Question 1 B
• Question 2 D
• Question 3 False
• Question 4 False
• Question 5 C
• Question 6 A