Transfusion checklist

There are more than a dozen steps involved in the transfusion process.

The use of transfusion checklists can help organise yourself and your patients to ensure a safe and appropriate transfusion occurs - every time.

1. Before prescribing blood components, ask yourself the following questions:
   • What improvement in the patient’s condition am I aiming to achieve?
   • Can I minimise blood loss to reduce the patient’s need for transfusion?
   • Are there other treatments I should give before making the decision to transfuse, such as intravenous replacement fluids, oxygen, iron replacements or other haematinics?
   • Has the patient been given a clear explanation of the potential risks and benefits of blood component therapy in their particular case?
2. Document the transfusion decision rationale based on the Patient Blood Management Guidelines and appropriate transfusion practice.
3. Check if your patient has given informed consent.
4. Complete the blood component prescription and blood request form.
5. Collect pretransfusion specimen after accurately confirming patient’s identity.
6. Verify that request form and sample carry the same patient identification information.
7. The laboratory performs compatibility testing.
   • ABO and Rh type
   • Antibody screen
   • Crossmatching if required
   • Checks historical records
   • In an emergency, Group O neg blood may be issued
8. When the correct blood component is released, check that the patient’s details completely match the identification details on the blood component and compatibility label.
9. Follow guidelines for administration of blood components and monitor patient clinical status.
10. If patient has an unexpected transfusion reaction follow the steps below:
    • Stop transfusion immediately
    • Check and monitor vital signs
    • Maintain IV access (Do not flush existing line and use new IV line if required)
    • Check that the right pack has been given to the right patient
    • Notify the Medical Officer and Transfusion Service Provider
    • Administer therapy appropriate to the adverse event
11. Assess response
    • Assess to determine if desired outcome of transfusion has been achieved
    • Assess patient for further blood product transfusion/s as necessary
    • Document assessment