When providing the written instruction (prescribing) for blood component transfusion, the following considerations are also required:
Consent
There is a legal and ethical duty to involve patients in the decision process
- Patients have the right to be involved in discussions and make informed decisions about their care
- Informed and valid consent is completed for all patients who will likely, or definitely, receive a transfusion
- Patients who were not able to give informed and valid consent prior to the transfusion are informed of the transfusion prior to discharge
Additional information can be obtained from the links below:
Guidelines from SaBTO on patient consent for blood transfusion:
https://www.gov.uk/government/publications/blood-transfusion-patient-consent
Supreme Court Ruling: Montgomery Vs Lanarkshire Health Board (March 2015)
https://www.supremecourt.uk/cases/uksc-2013-0136.html
NICE Guideline and Quality Standards [NG24]
https://www.nice.org.uk/guidance/ng24/chapter/Recommendations
GMC Decision making and consent:
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/decision-making-and-consent
Patient Information Leaflets: NHSBT Hospitals and Science:
https://hospital.blood.co.uk/patient-services/patient-blood-management/patient-information-leaflets/
Blood Assist - Patient Consent:
https://www.bloodassist.co.uk/patient-consent
Annual reviews NHSBT and PHE epidemiology unit's data and research activity infographics
https://hospital.blood.co.uk/epidemiology-reports/
Review of the NBTC Indication Codes for Transfusion is not anticipated before 2023. These are current guidelines and may change depending on new evidence.
TACO Risk Assessment:
Transfusion associated pulmonary complications (mainly TACO) is a significant cause of death and major morbidity. Additional information can be obtained from the links below:
SHOT TACO Checklist:
https://www.shotuk.org/wp-content/uploads/myimages/TACO-checklist.pdf
Blood Assist – TACO Risk Assessment:
https://www.bloodassist.co.uk/taco/
Specific Requirements
Blood Assist – Specific Requirements:
https://www.bloodassist.co.uk/requirements/
BSH Guidelines on the use of irradiated blood components:
https://b-s-h.org.uk/guidelines/guidelines/guidelines-on-the-use-of-irradiated-blood-components/
Alternatives to blood transfusion
PBM improves patient outcomes by improving the patient’s medical and surgical management in ways that boost and conserve the patient’s own blood. With better management, patients may require fewer transfusions, reducing the risk of transfusion-associated complications. Additional information can be obtained from the links below:
Patient Blood Management:
https://hospital.blood.co.uk/patient-services/patient-blood-management/
NICE: Alternatives to blood transfusion for patients having surgery:
https://www.nice.org.uk/guidance/ng24/chapter/Recommendations#alternatives-to-blood-transfusion-for-patients-having-surgery-2
General Information
Some additional useful resources can be obtained from the links below:
Blood Assist:
https://www.bloodassist.co.uk/
SHOT resources:
https://www.shotuk.org/resources/current-resources/
BSH Transfusion Guidelines:
https://b-s-h.org.uk/guidelines/
PBM Pre-Transfusion Sampling Process video:
https://www.youtube.com/watch?v=7tADOtE5RBQ&t=23s