Observation and documentation of bedside blood transfusion

Correct administration of blood and the management of the transfused patient are a fundamental element of transfusion safety. Recently published guidelines from the British Committee for Standards in Haematology highlight that most serious transfusion complications occur within the first 15 minutes. They recommend baseline observations before and 15 minutes after commencement of each unit of blood. Using a Royal College of Physicians (RCP) proforma, 100 clinical case notes were examined retrospectively for standards of transfusion documentation and bedside observation. The audit identified that bedside practice was variable and that only 16% of cases met this standard. Most wards continued with hourly observations in uncomplicated cases. Trust guidelines and a staff education programme have been implemented to address the audit results.