Transfusion medicine handbook

3. Guide to Good Transfusion Practice

3.12 Administration and Observation of Transfusion

All transfusions should be performed and monitored in accordance with relevant hospital policies and guidelines, by staff trained and competent in the safe administration of blood and management of acute transfusion reactions. The Australia and New Zealand Society of Blood Transfusion (ANZSBT) and Australian College of Nursing Guidelines for the Administration of Blood Products, 3rd Edition, Revised October 2019, provide supplementary guidance and underpin best practice.

Right patient, right blood, right time, right reason.

• Before a transfusion commences always ensure an independent double-check occurs at the patient’s side, which includes ensuring the right patient (positive patient identification) is verified, that the right blood (component or fractionated product) has been prescribed and obtained, that the right blood group is supplied and that it has not expired.
• Transfuse only if the patient is wearing an identification band (or equivalent); and can be observed and monitored by trained and credentialed clinical staff.
• Blood transfusion vital signs (RR, HR, BP, T) can be recorded up to 60 minutes before commencing the transfusion. On commencement closely observe the patient for the first 15 minutes of the transfusion, repeating the blood transfusion vital signs after 15 minutes. Further vital signs are defined by local hospital policy, with many sites utilising a 30-minute to one hour observation schedule until completion; ensuring a final set of vital signs is documented after the transfusion has finished (up to one hour post).
• Staff who transfuse blood components or products must demonstrate on-going competence and receive transfusion-related update every 2-3 years, as per local hospital policy.