Standard 7

Blood and Blood Products

NSQHS Standards Standard 7 - Blood and Blood Products

Advisory

This page contains information about the first edition of the NSQHS standards. This edition has been superseded by the second edition that was endorsed by the Health Ministers in June 2017 and released in November 2017.

This latest edition addresses the gaps that were identified in the first edition, including mental health and cognitive impairment, health literacy, end-of-life care, and Aboriginal and Torres Strait Islander health.

Health service organisations will be assessed to the second edition from January 2019.

To find information and resources for the second edition, visit the Australian Commission on Safety and Quality in Health Care's new NSQHS Standards microsite.

Key messages

  1. The decision to transfuse blood or blood products should be made by balancing the potential benefits and risks for the patient.
  2. Transfusion of blood and blood products requires informed consent to be documented in the clinical record following a conversation about the specific transfusion and associated risks, benefits and alternatives.
  3. Patient safety is dependent upon the correct administration of blood and blood products.
  4. Efficient handling, transport and storage of blood and blood products is required.

Introduction

Australia has one of the safest blood supplies in the world. There are comprehensive national regulations that cover all aspects of blood donation and processing of blood and blood products. Blood products are stored and delivered to health services under regulated conditions, and are carefully stored and managed within health services and laboratories.

However, the transfusion of blood and blood products is not without risk and can lead to complications and adverse outcomes for patients. Blood and blood products should only be given when clearly indicated and the expected benefits to the patient are likely to outweigh the potential hazards.

The main areas that jeopardise safe transfusion are: the blood sample for cross matching is taken from the wrong patient; the wrong name is written on the blood sample tube; the patient did not need the transfusion; and bedside verification is not done correctly to ensure that the right blood product is being given to the right patient at the right time and in the correct manner.

Facts and Figures

The risks associated with transfusions of blood products usually fall into two categories:

  • errors in procedure (such as patient identification or blood sample labelling errors and administration of blood products to the wrong patient)
  • transfusion reactions (for example, fevers and chills) and bacterial infections.

During 2008–09 there were 294 blood product serious adverse events reported in Australia– 241 involved febrile and allergic reactions, while 22 involved incorrect blood component transfusion.

Information above is taken directly from the Safety and Quality Improvement Guide Standard 7: Blood and Blood Products, October 2012 document published in the Australian Commission on Safety and Quality in Health Care website.

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Responsibilities under Standard 7 include:

  • ensure the patient and carer understand and agree to the transfusion
  • confirm the patient’s identity:
    • at the time of pre transfusion sample collection
    • before the administration of blood or blood products
  • commence transfusions only when there are adequate numbers of staff to observe and monitor the patient during transfusion
  • ensure intravenous access and equipment are in place and ready for use before collecting the blood or blood product from storage
  • check the prescription or order for the blood or blood product at the patient’s side immediately before the transfusion commences
  • closely observe and monitor the patient throughout transfusion to identify any adverse effects
  • accurately document all aspects of blood and blood product management
  • comply with systems to receive, store, transport and monitor wastage of blood and blood products.

eLearning modules

Further information

Below is a full copy of the Blood and Blood Products contained in the National Safety and Quality Health Service Standards. It includes the criteria, items and actions required for health services to meet this Standard and is available on the Commission’s website at www.safetyandquality.gov.au.

  • Download Safety and Quality Improvement Guide Standard 7: Blood and Blood Products, October 2012