Transfusion medicine handbook

3. Guide to Good Transfusion Practice

3.4 Requesting Blood Components and Fractionated Products

The NZBS  Blood Bank Request Form (nzblood.co.nz)  used in New Zealand hospitals has a three-fold purpose, it:

• Documents the clinical instruction to collect and process pre-transfusion test samples, a variety of diagnostic tests, as well ordering blood components and fractionated products, from the hospital blood bank. Local hospital policies will determine which staff can place orders; it may form only part of the documentation indicated. It should be noted that the form used to request testing, blood components and fractionated products is not a prescription.
• Incorporates a mandatory declaration, which must be completed by the person collecting the blood samples, directly after they have labelled the blood tubes and before they leave the patient's side. The mandatory declaration essentially verifies the collector has positively identified the patient, to ensure the right person receives the right blood.
• Provides a blood bank worksheet, linking the patient identifiers and the blood sample test result summary.

The request form instruction must:

• Correctly identify the patient.
• Include the clinical indication for transfusion and urgency of the request.
• Provide details of any previous transfusion or obstetric history.
• Indicate the quantity of the blood component or fractionated product required, when it is required (date and time), and where it should be sent to (hospital and clinical setting/ward).
• Document the treating consultant and include the name / contact details of the requestor, to ensure follow-up by the blood bank is directed to the correct team in a timely manner.

Full and accurate completion of the request details is essential for:

• Ensuring that the right quantity and type of blood component or fractionated product is made available to the right patient, at the right time, for the right reason and in the right place.
• Minimising the risk of patient identification errors.
• Alerting the blood bank to the possibility of antibodies, based on a history of previous transfusions or pregnancy, in which case, suitably matched blood may be required.

Patients who, at the time of admission, cannot be reliably identified must be given an identity band with a unique emergency number. This number must be used to identify this patient until full and correct details are available. Blood components and fractionated products will only be issued to the unique emergency number until a new pre-transfusion sample, with verified patient identifiers, is provided to blood bank. Written confirmation of the identity merge is required.