Pre‐procedure

ActionRationale

1. 1.Show
   Check that the reason for the transfusion has been documented in the patient's notes.
   To ensure the transfusion is appropriate and necessary (Robinson et al. [236], C).
2. 2.Show
   Check that there is a valid written order for the administration of the component, including any special requirements.
   To ensure the selected component meets the patient's individual requirements (Robinson et al. [236], C).
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   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).
4. 4.Show
   Check the patient is wearing an identification wristband.
   To avoid delays in confirming the patient's identity (BCSH [16], C).
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   Check the patient is available.
   To avoid delays once the component has been removed from storage. E
6. 6.Show
   Take baseline observations to include blood pressure, temperature, pulse and respiratory rate.
   To ensure that any transfusion reaction can be immediately identified via changes from the baseline (Robinson et al. [236], C) and managed appropriately (Tinegate et al. [270], C).
7. 7.Show
   Check the patient has patent venous access. If not, ensure the appropriate device is inserted.
   To avoid any delay in commencement of the transfusion when it has been removed from storage and prevent possible wastage. E

Procedure

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   The collector must bring locally agreed documentation to collect the blood component and it must contain the core identifiers for the patient being transfused.
   To minimize the risk of the wrong blood component being given to a patient (Robinson et al. [236], C).
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   Remove the component (using an electronic or manual method) from storage in accordance with trust policy and ensure that the date, time and collector are recorded.
   To ensure that only authorized, trained and competent staff collect blood components and cold chain requirements are met (BSQR [34] C; Robinson et al. [236], C).

   Note: the blood cold chain is a system for ensuring the blood (or blood product) is kept at the correct temperature during storage and when being transported.
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   Remove one component at a time, unless rapid transportation of large quantities is needed or if blood is being transported to remote areas in specifically designed and validated blood transport containers. If large quantities are required, this must be discussed with the transfusion laboratory and local procedures followed.
   To meet cold chain requirements and ensure the components are stored and transported in the appropriate conditions (BSQR [34], C).
4. 11.Show
   Check the components at the point of removal for correct patient‐identifying details. A visual inspection of the components should also be performed to check the expiry date and any signs of clumping, discolouration, damage or leaks. The laboratory compatibility label attached to the unit must also be checked with the NHS Blood and Transplant label for batch number.
   In order to minimize the risk of administering the component to the wrong patient (Bolton‐Maggs [27], C; Robinson et al. [236], C). Expired or damaged products must not be used.

   To ensure that the correct label has been attached to the blood component. E

Post‐procedure

1. 12.Show
   Deliver the component to the clinical area.
   To ensure the correct component has been received for the patient, to comply with traceability and cold chain requirements (Robinson et al. [236], C).