The prescription is the documented authorisation to administer the blood component or product, and is a critical part of safe and appropriate transfusion practice.
It must be legible and must include:
- patient identification details: family name and given name, gender, date of birth (DOB) and unique patient identification number if available
- date, timing and urgency of the transfusion
- appropriate and consistent terminology for the blood product to be administered
- special blood product requirements, e.g. irradiated or cytomegalovirus (CMV) seronegative
- the route of administration
- the number of units or dose of blood product to be given, using appropriate units of measure (e.g. number of packs, volume in millilitres, units or weight in grams); blood component volumes should be stated in millilitres for neonatal patients and children less than 20 kg
- the duration over which the blood product is to be administered
- special instructions, e.g. use of a blood warmer, or any medication required before or after the transfusion
- legibly written name and signature of the prescriber, and a contact telephone number or pager number, and
- plasma-derived products and recombinant products should include the brand name.
The prescription must be available at the patient’s side in the final double independent checking procedure and can be on paper or part of the patient’s electronic medical records.
A health service should have a local policy outlining site specific prescriptions requirements.
Requests for blood products
The request is the basis for communication with Transfusion Service Providers.
It directs providers to perform pretransfusion blood testing or product preparation (or both) and issue blood products for administration.
Failure to correctly identify the patient at the time of sample collection continues to be a significant cause of patient morbidity and mortality.
Patients must be positively identified and labelling of samples must be done at the patient’s side.
Otherwise, a ‘wrong blood in tube’ (WBIT) event could happen that may compromise safety in two ways:
- By acting as a precursor to transfusion of the incorrect, and possibly incompatible, blood product.
- By leading to inappropriate therapy due to incorrectly allocated results.
The blood product request should include the clinical indication for the transfusion and any special blood product requirements for the patient.
Requests either paper or electronic must meet the principles outlined in the Australian and New Zealand Society of Blood Transfusion (ANZSBT).