The following blood products can be obtained from the Blood Bank:
Out of hours requests for these (except platelets and anti-D) are to be made to the on-call Blood Bank Assistant Technical Officer (ATO) who can be contacted through Switchboard.
Blood product issue
For issue of blood products a signed request form must be sent to the Blood Bank.
Anti-D will be issued on request for routine prophylaxis at 28 weeks after confirmation of Rh status at booking. If a sensitising event occurs after 20 weeks a fresh sample will be required to assess the amount of anti-D required.
Electronic issue of blood
If two group and save samples, both having corresponding blood groups, and negative antibody screens for that patient, then blood can be issued without testing of donor cells with recipient plasma. The current sample can be up to 3 months old providing no previous transfusions have taken place.
If a patient has been previously transfused a new sample is required as follows:
As a result of this, blood will no longer be reserved for patients pre-op. If blood is required urgently it can be supplied within a few minutes as long as all of the tests have been completed.
To find out whether a patient is suitable for electronic issue of blood refer to the Hospital Transfusion Policy, which has step-by-step instructions on how to do this. Access to both Path and iCM computer systems will be required for this.
Massive haemorrhage/transfusion protocol
This protocol can be found using the link below to the Trust Documents location on HealthNet (see below). However, there is a need to emphasise the importance of liaising with the on-call haematology consultant for advice on the use of different blood products.
The samples must be hand delivered to the laboratory and all calls put through the hotline extension number 52828 during normal working hours and bleep 0871 out-of-hours. The blood bank staff will be responsible for ensuring that coagulation and haematology are aware of any samples arriving and that they need to be dealt with as soon as possible. Frequent full blood count and clotting samples need to be sent to monitor the situation (approx. 60 mins).
Link to the Hospital Transfusion Policy – Massive Transfusion Policy
Electronic Blood Tracking
The Blood Bank is implementing an electronic blood tracking system called ‘BloodHound’. A computerised approach to collecting and administering blood is needed to further prevent incidents in the transfusion pathway.
Compliance with Haemovigilance measures is a high priority for the Trust, as well as safe and appropriate use of blood and blood products. The NPSA’s Safer Practice Notice 14, ‘Right patient right blood, has made transfusion competency a major focus of attention. Staff in this Trust are required to undertake their transfusion competency assessments and must have them before access to the blood tracking system is allowed.
The Trust requires that all transfusions are recorded using the Electronic Blood Tracking System. All Trusts are required by law to provide Haemovigilance data (Traceability) which is closely monitored by the Medicines and Healthcare Regulatory Authority (MHRA).
How Electronic Blood Tracking works. The following is a brief overview of how the system works.
‘Using the blood tracking system is a requirement of the Trust in order to comply with regulations on blood traceability. Once you have gone ‘live’ with the system in your area of work you are required to use it. Only in the event of a system down can the paper based system be resorted to.’
There are three main elements to the ‘BloodHound’ system and they are;
The Blood Fridge Kiosk: The blood fridge is controlled via a touch screen computer. The staff member uses a bar code, found on their new ID badge, that identifies them to the system and a personal PIN number for security. The staff member then has to let the system know what patients blood is required again through a bar coded hospital number that also gets scanned in. The fridge will then open if all conditions are met correctly.
The Bedside Module: Once you have extracted the correct unit from the blood fridge and taken it back to your ward. Using a handheld device the tracking system once again needs to know where the unit of blood has been taken and who is carrying out the transfusion, which bag of blood and which patient. Once all the correct information has been gathered by the system the transfusion can be started.
Once the transfusion has ended and, as part of Haemovigilance and traceability, the staff member responsible for monitoring the transfusion must ‘End the Transfusion’ on the handheld device. This will time stamp the duration over which the unit of blood was transfused and therefore demonstrates compliance with traceability.
The Web Application: This part of the system gives the user the opportunity to track blood units by patient and by location. Once the blood bank issues units of blood into the blood fridge that information can be seen and the ward will know where to go to be able to collect the units.
The MHRA will closely monitor Haemovigilance, and during this time of transition to the electronic blood system, they will be particularly concerned that traceability is maintained.
For support and assistance using the blood tracking system contact:
Blood Bank Manager Samantha Reynolds 01752 245007
Deputy Blood Bank Manager Linda McCracken 01752 245007
The normal working day for blood bank is 9am until 17.30pm Monday to Friday.
An emergency out of hours service operates for the rest of the time 24 hours a day.
The Biomedical scientist may be contacted out of hours on bleep 0871.
Work may be referred to NHS-BT Filton, 500 North Bristol Park, Filton, Bristol, BS10 5ND for tests such as Neonatal alloimmune thrombocytopenia(NAIT0, Platelet refractoriness, and for further antibody and crossmatching investigations.