Working together on transfusion audits to improve clinical practice

Background For many years, great efforts have been put in place to ensure quality and safety of blood and blood products during collection and processing. In recent years, the focus has shifted to enhancement of clinical transfusion processes. Conducting audits is one effective mechanism of evaluating the ongoing blood administration process against set standards. Methods Random transfusion audits were conducted jointly by both Blood Bank technical staff and the transfusion nurse in Paediatric and Obstetric wards using a checklist. This checklist consisted of essential procedures and checks during blood transfusion. Transfusion slips were also audited against defined standards. Results Many good transfusion practices were observed. In the majority of cases, there was positive identification of patients before transfusion by doctor and nurse. However, there were many areas requiring improvement, including inconsistency in setting up transfusions across different clinical areas in the hospital. Knowledge deficit was identified in eight key areas when results of a transfusion knowledge questionnaire were reviewed. Audit of the transfusion slips revealed a major concern with putting up blood for transfusion within 30 minutes. All findings were reviewed, and interventions were undertaken. A formal transfusion training programme was implemented, and the institution's clinical transfusion protocol was revised for better clarity. Conclusion Initiatives implemented after reviewing all findings from the transfusion audits lead to improved practice, thereby enhancing patients’ safety. Continuous audit will be required to monitor and sustain improvements.