Republic of the Philippines

Laguna State Polytechnic University

College of Nursing and Allied Health
Province of Laguna
Sta. Cruz, Laguna
A.Y. 2022-2023

Ma. Daniela V. Rosal May 2023

BSN IIA - NCM 108 Clinical Instructor: Mr. J. E. Rogado

Blood transfusions in adults: ensuring patient safety.

A blood transfusion is a routine medical procedure in which donated blood is provided to a patient
through a narrow tube placed within a vein in the arm. A life-saving procedure that can help
replace blood lost due to surgery or injury. A blood transfusion also can help if an illness prevents
the body from making blood or some of blood's components correctly. The procedure involves
the transfer of whole blood, or one of its components, from a donor to a recipient.

For blood transfusion procedures to be safe and effective, medical staff must carefully choose
donors, process, store, and distribute blood components. However, mistakes are still made in the
ordering, gathering, and administering of blood components, which puts patients at serious risk,
according to the British Society for Haematology (BSH) (2017). These risks and adverse events are
monitored by the Serious Hazards of Transfusion (SHOT), which is the UK's independent,
professionally led haemovigilance scheme. In 2019, 84.1% (2857/3397) of all reports (including
near miss and right blood right patient reports), were due to errors (Narayan and Poles, 2020).
Blood transfusion is really essential in presenting serious condition of the patient. And to prevent
this from happening, nurses are responsible in the completion of pre-transfusion sampling,
bedside checks and monitoring the patient who is prescribed for blood transfusion. The National
Institute for Health and Care Excellence (NICE) (2015) has produced guidelines for the assessment
and management of blood transfusions. It includes information on patient safety during the blood
transfusion process to further reduce errors, as well as providing alternatives to blood transfusion.

To prevent ethical issues in blood transfusion, we as nurses must ensure to make a thorough
assessment most specially to know their religion because some religion refuse to be having blood
transfusion. And this will connect to the concept of the patient’s autonomy; they have the
freedom to make decisions for themselves. The nurse should also practice with compassion and
respect for the inherent dignity, worth, and unique attributes of every person, promotes,
advocates for, and protects the rights, health, and safety of the patient. Maintains, and improves
the ethical environment of the work setting and conditions of employment that are conducive to
safe, quality health care conditions of employment that are conducive to safe, quality health care
dignity, worth, and unique attributes of every person. As well as collaborating with other health
professionals and the public to protect human rights, promote health diplomacy, and reduce
health disparities. The ultimate goal of the nurse is to be responsible in doing their duty and keep
in mind that patient’s safety is always the top priority to prevent any ethical issues or problem.

Blood sample collection procedures are a critical step in ensuring the safety of transfusion. The
final opportunity for the nurse to identify errors made earlier in the process, as well as the last
point at which errors can happen, is typically the identity check between the patient and the
blood component to be transfused. Ensuring that the proper patient gets the right blood is mainly
the nurse's job to maintain the safety of the patient. Check the details match with the patient's
identity wristband and prescription. Check pack for signs of leakage and inspect for any defects.
And if common signs and symptoms of acute transfusion occur then stop the transfusion and
notify the physician. At the end of each unit transfused, the time and volume infused must be
recorded. Transfusion should be completed within 4 hours of leaving controlled temperature
storage (JPAC, 2014d). It is important that the patient's heart rate, blood pressure, respiratory
rate and temperature are recorded no more than 60 minutes after the end of the transfusion
(Lister et al, 2020). And lastly, always document the procedure done so that if problem arises you
have the evidence to prove that you perform your duty at the right time with the right patient.

Over the past decades, there has been a significant improvement in our understanding of blood
transfusion. Empirical blood transfusions are not as common as they once were. Blood products
can be helpful, but they can also be harmful. The management of patients receiving blood
transfusions and those experiencing negative transfusion responses requires interprofessional
team coordination. The important thing is to reduce the harm from unnecessary blood
transfusions.

Reference:

Britishjournalofnursing (2021). Blood transfusions in adults: ensuring patient safety. Retrieved

from: https://www.britishjournalofnursing.com/content/clinical/blood-transfusions-in-
adults-ensuring-patient-safety/.