Pre‐procedure

ActionRationale

1. 1.Show
   Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [198], C).
2. 2.Show
   Note that pre‐transfusion blood should be taken from one patient at a time and the whole procedure, including labelling, should be completed in one continuous event.
   To ensure that samples from different patients are not confused, which can have fatal consequences (Bolton‐Maggs [27], C; Robinson et al. [236], C).
3. 3.Show
   Check all packaging before opening and preparing the equipment.
   To ensure there has been no contamination and all equipment is in date. E

Procedure

1. 4.Show
   Before taking the sample, ask the patient to state their first name, surname and date of birth. Cross‐check these details against the blood request form. For patients unable to identify themselves, verification can be obtained from a carer or relative if present.
   To ensure that the sample obtained corresponds with the request (Robinson et al. [236], C).
2. 5.Show
   Check these details against the patient's identity wristband.
   To ensure that the patient is positively identified before obtaining a blood sample (Robinson et al. [236], C).
3. 6.Show
   Check the patient's hospital number on the wristband against that on the blood request form.
   To ensure that the sample obtained corresponds with the request (Robinson et al. [236], C).
4. 7.Show
   Obtain the blood sample by direct venepuncture or via central venous access device, in the appropriate tube.
   To ensure the correct procedure is followed and an adequate sample is obtained. E

Post‐procedure

1. 8.Show
   Hand‐write the required information on the sample tube clearly and accurately, ensuring all names are spelled correctly. Alternatively, print an on‐demand patient identification label. This should only be done once the sample has been successfully obtained and should be done at the patient's bedside. Information to include:

   • first name
   • surname
   • date of birth
   • sex
   • hospital identification number
   • ward or department
   • date.
   To ensure the sample is labelled with the correct patient details. Robinson et al. ([236], C) state that only labels printed on demand next to the patient and immediately attached to the sample bottle are acceptable for transfusion samples. Blood tubes should never be pre‐labelled in advance either by hand or electronically as this has been identified as a major cause of patient identification errors (Bolton‐Maggs [27], C).