Treatment with blood and blood products can be lifesaving, but there are also risks associated with their administration and use. Actions to minimise these risks include screening and testing donors and donated blood, conserving and managing a patient’s own blood and ensuring that all treatment options and their risks and benefits are considered and discussed before deciding to transfuse.
A patient’s own blood is a valuable and unique resource that should be conserved and managed. Good patient blood management requires a patient’s blood (haemopoietic and circulatory system) to be considered in the same way as the management of all other body systems. PBM should be the standard of care applied by all clinicians for patients facing a medical or surgical intervention who are at high risk of significant blood loss.
Task for Clinicians
Clinical governance and quality improvement to support blood management
What this Criterion means:
Organisation-wide governance and quality improvement systems are used to ensure safe and high-quality care of patients’ own blood, and to ensure that blood product requirements are met.
What clinicians can do:
- Familiarise yourself with the evidence on the importance of blood management including participating in training
- Help to develop and use your health service organisations’ policies and procedures on blood management
- Participate in the monitoring and evaluation of blood management within your organisation
- Partner with patients and carers in the management of their own blood and in the use of blood and blood products
- Ensure there is informed consent prior to transfusion of blood or blood products.
Prescribing and clinical use of blood and blood products
What this Criterion means:
The clinical use of blood and blood products is appropriate, and strategies are used to reduce the risks associated with transfusion.
What clinicians can do:
- Manage the need for and minimise the inappropriate use of blood and blood products by:
- Optimising patients’ own red cell mass, haemoglobin and iron stores
- Identifying and managing patients with, or at risk of, bleeding
- Determining the clinical need for blood and blood products, and related risks
- Document decisions relating to blood management, transfusion history and transfusion details in the healthcare record
- Prescribe and administer blood and blood products appropriately, in accordance with national guidelines and national criteria
- Observe and monitor a patient during transfusion to identify any adverse events
- Report any transfusion-related adverse events, in line with national guidelines and criteria.
Managing the availability and safety of blood and blood products
What this Criterion means:
Strategies are used to effectively manage the availability and safety of blood and blood products.
What clinicians can do:
- Use your organisation’s processes for receiving, storing, transporting and to minimise unavoidable wastage and ensure there are sufficient blood and blood products to meet clinical need.