Delivering a Healthy WA

M e t h o dAn observational audit was performed of clinical staff undertaking the bedside checking procedure and administration of blood components at the two sites. The audit included a sample of patients who received a blood component

between May 2013 and February 2014. Practices observed included: checking validity of patient consent, prescription, visual check of blood component, verification of positive patient identification with patient/parent and blood

component label, time to start of infusion, and correct administration procedures. The presence of appropriate documentation including date and time, checking signatures and observations was also included. The observed practices

were assessed against the ANZSBT Guidelines for the Administration of Blood Products and Hospital Transfusion Medicine Protocols.

P r o d u c e d b y M e d i c a l I l l u s t r a t i o n R e f :

Comparative Observational Audit of Transfusion

Bedside Checking Procedures

Department of HealthGovernment of Western AustraliaChild and Adolescent Health ServiceWomen and Newborn Health Service

T a y l o r , A l i s o n 1 , G a l l a g h e r - S w a n n , M a d a l e i n e 2

1 P r i n c e s s M a r g a r e t H o s p i t a l , P e r t h , W e s t e r n A u s t r a l i a2 K i n g E d w a r d M e m o r i a l H o s p i t a l , P e r t h , W e s t e r n A u s t r a l i a

Produced by Medical Illustration Ref:19576-14

A i mTo assess compliance with Australian New Zealand Society of Blood Transfusion (ANZSBT) Guidelines for the Administration of Blood Products and Hospital Transfusion Medicine Protocols, on procedures for bedside checking and

administration of blood components at two hospitals specialising in Women’s and Children’s healthcare.

R e f e r e n c e sAustralian and New Zealand Society of Blood Transfusion (ANZSBT) and Royal College of

Nursing Australian (RCNA) Guidelines for the Administration of Blood Products, 2nd Edition

2011.

Children and Adolescent Health Service (CAHS) Transfusion Medicine Protocols. http://www.

pmh.health.wa.gov.au/services/blood_transfusion/protocols.htm

Women and Newborn Health Service (WHNS) Transfusion Medicine Protocols. http://www.

kemh.health.wa.gov.au/services/blood_transfusion/protocols.htm

Human Factors in Patient Safety, World Health Organisation (WHO) Patient Safety Report 2009.

http://www.who.int/patientsafety/research/methods_measures/human_factors/human_factors_

review.pdf

Keywords: Transfusion, Audit, Observation, Patient Identification

Conflict of interest: No

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C o n c l u s i o nThis observational audit demonstrates that transfusion practices at both sites were consistent with the ANZSBT Guidelines for the Administration of Blood

Products and organisation protocols. Areas identified for improvement include verbal positive patient identification and checking the documentation of consent

prior to administration.

Specific interventions to improved practice have now been implemented, including feedback of audit results and education focused on positive patient

identification. A repeat audit is in process to monitor compliance and promote best practice.

R e s u l t sA total number of 63 transfusion episodes were audited. The results

showed excellent compliance with validity of prescription, documentation

and administration procedures. However the audit highlighted some

key areas where expected practice was not observed. These included

checking of consent, and performance of verbal positive patient

identification. Although all audited staff cross checked the blood

component and identification band with the prescription, they did not

always verbally confirm the name and date of birth with the patient/parent

as mandated by the ANZSBT Guidelines for the Administration of Blood

Products and organisational protocols (see table).