GUIDELINES FOR THE CARE OF A PATIENT RECEIVING A BLOOD

TRANSFUSION
Reference
Date approved
Approving Body Matron’s Forum
Supporting Policy/
Working in New Ways
(WINW) Package
Implementation date November 2011
Supersedes Version1
Consultation Nursing Practice Guidelines Group, Ward
undertaken Sisters/Charge Nurses, Practice Development
Matrons (PDMs), Clinical Leads, Matrons.

Target audience

Document derivation / See main references

evidence base:
Review Date November 2014
Lead Executive Director of Nursing
Author/Lead Manager Steven Cliffe & Hayley Bond
Further Hospital Transfusion Committee
Guidance/Information
Distribution: Ward Sisters/Charge Nurses, PDMs, Clinical
Leads, Matrons, Nursing Practice Guidelines
Group (includes University of Nottingham
representative), Clinical Quality, Risk and
Safety Manager, Trust Intranet.

This guideline has been registered with the Trust. However, clinical
guidelines are guidelines only. The interpretation and application of
clinical guidelines will remain the responsibility of the individual
clinician. If in doubt, contact a senior colleague or expert. Caution
is advised when using the guidelines after the review date.

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 Contents

SECTION TITLE PAGE

Introduction 3

1.0 Prior to transfusion 4

1.1 Patient Information 4
1.2 Prescribing 4
1.3 Venous Access 5
1.4 Identity 5
1.5 Observations 5
1.6 Collection & Transport of Blood 6
1.7 Bedside Checking Procedure 9

2.0 During transfusion 11

2.1 Administration 11
2.2 Observations 13
2.3 Adverse Reaction 16

3.0 Post transfusion 18

3.1 Observations 18
3.2 Disconnection 18
3.2 Disposal of waste 18

Equality & Diversity Statement 20

Equality Impact Assessment Statement 20
References 21

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 Nottingham University Hospitals NHS Trust

CLINICAL GUIDELINES

GUIDELINES FOR THE CARE OF A PATIENT

RECEIVING A BLOOD TRANSFUSION

"This guideline has been registered with the Trust. However, clinical guidelines are
guidelines only. The interpretation and application of clinical guidelines will remain
the responsibility of the individual clinician. If in doubt, contact a senior colleague
or expert. Caution is advised when using guidelines after the review date."

These guidelines must be read in conjunction with the local Blood Transfusion
policy (NUH 2011, CL/CGP/008).

INTRODUCTION:

A red blood cell transfusion may be indicated for the following reasons:

• Acute blood loss due to trauma or surgery

• To increase the oxygen carrying capacity of the blood in some types of anaemia
• To provide treatment and support for some types of chronic or malignant disorders
e.g. rheumatoid arthritis, thalassaemia, sickle cell disease and leukaemia

PRINCIPLES OF CARE

See General Principles for All Procedures

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1.0 PRIOR TO TRANSFUSION

PRINCIPLE RATIONALE

1.1 Patient information

Ensure the patient has received Patients have a right to receive good
the appropriate leaflet quality, written information to enable them
 ‘Will I need a blood to give informed consent to any invasive
transfusion’ procedure.
 ‘Information for patients
needing irradiated blood’ Handbook of Transfusion Medicine (4th
 ‘Children receiving a Blood Edition) 2007 (stationary office) Section 2
Transfusion, a parent’s guide’ page 18 & appendix 1 page 67
in addition, is aware of all the
potential risks and benefits
involved in having a transfusion.
Stocks of leaflets are available
from the National Blood Service
(01865 440042)

1.2 Prescribing
A clear rational for transfusion Complies with National Safety Patient
should be recorded on the blood Agency (NPSA), Safety of Blood Tissues &
transfusion record sheet and the Organs (SaBTO), Better Blood Transfusion
patient’s notes. It should also be 3 (DoH circular) for the appropriateness of
documented in the patient’s notes transfusion
that the patient has verbally Handbook of Transfusion Medicine (4th
consented to the transfusion. Edition) 2007 (stationary office) Section 2
Ensure the blood is correctly page 18
prescribed, by a registered medical
practitioner, on the Trust Blood
Transfusion Record Chart. Complies with local policy and National
Whenever possible blood recommendations from the Serious
transfusions should not be Hazards of Transfusion (SHOT) scheme.
administered overnight, except
where the patient's condition Frequent observations disturb the patient's
makes this necessary. rest. Reduced staffing levels and difficulty
observing the patient in a ‘light dimmed’
environment make detection of a possible
reaction more difficult.

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1.3 Venous access

Ensure the patient has a patent Ensures there are no delays in

peripheral cannula or central venous administration. Blood should be
catheter in situ. There is no administered immediately after being
maximum or minimum size of removed from the issue fridge to decrease
peripheral cannula as this depends the possibility of potential bacterial
on the size of the patient's vein and contaminants – Handbook of Transfusion
the speed at which the blood is to be Medicine 2007.
infused. If not used immediately & transfusion
“Intravenous Administration of cannot be completed within the 4 hours of
Medications- NUH Intranet” removal from issue fridge, it must be
returned and handed to a member of blood
bank staff.
DO NOT PLACE IN FRIDGE
Out of hours - Bleep Blood Transfusion
Laboratory staff.

1.4 Identity

The patient should already have All patients must have an identification
an identity band on. If not, attach wristband - NPSA safer practice notice
one to the patient that states the 11. (SPN)
patient’s last name, first name, NHS number is the preferred number
gender, date of birth, NHS NPSA SPN 001
Number &/or hospital identification
number. .
POSITIVE PATIENT The identity of patients MUST be
IDENTIFICATION confirmed prior to commencing a blood
Check these details are correct transfusion. This reduces the risk
with the patient verbally associated with ‘wrong patient’ errors
(if possible) and the patient’s Positive Identification of Patients
hospital notes Procedure – CL/CGP/037

1.5 Observation

Check and record the baseline Baseline observations are required to

observations - temperature, pulse, identify any possible deviations from the
blood pressure, respiration rate, patient’s norm. If baseline observations
SpO2, and consciousness level are not within normal limits, medical staff
(AVPU or GCS) and Early warning may wish to review and delay
Score should be taken, prior to transfusion.
collecting and commencing the To comply with N.I.C.E. Guidance (2007)
blood transfusion. (No more than
1 hour previous) Confidential enquiry into patient outcome
and death [NCEPOD 2005] had reported
that in critically ill medical patients, the
respiratory rate is an important indicator
of deterioration.
Do not send staff to collect blood May waste unit if transfusion delayed
before these have been done

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1.6 Collection and Transport of
Blood

Only members of staff who have Withdrawing of an incorrect component

been trained in the collection of from the blood fridge remains the most
blood from the blood fridge may common error in incidents where the
do so. This is also applicable to incorrect blood is transfused (SHOT 2006).
bank and agency staff. It is the Adequate checking procedures are
responsibility of the nurse in therefore essential to the process.
charge to ensure the individual NPSA SPN 14
has been trained, before sending Handbook of Transfusion Medicine (4th
them to collect blood. Edition) 2007 (stationary office) Section
ONLY in life threatening 2 page 18
haemorrhage will Blood Bank staff
help in the collection of products, See Training & Development on home
providing the member of staff has page of NUH Website or email
their own ID and ID details of the Transfusion Practitioners for details of
patient training courses available.

To collect blood the preferred

documentation is a completed
Transfusion Record Sheet.
For blood being moved to theatre
satellite fridges the Theatre
Collection Sheet could also be
used

City Staff ONLY Using another individual's bar-coded

Never use another member of issue card is a disciplinary offence. It
staff's ‘bar-coded issue card’ to also means that you could be held
remove a unit of blood. accountable for a mistake made by
another member of staff.

1.6a All staff Laboratory staff have to audit the

Document the required details on movement of all blood units in line with
the signing-out sheet at QMC local and national guidelines to ensure
Campus or the electronic sign out compliance with cold chain
system at City Campus. documentation - Blood Safety & Quality
Regulations 2005 (BSQR)
Non-compliance will result in the
wastage of blood products.

1.6b The compatibility form is collected Information on the compatibility form and
with the first unit of blood and should a donor unit label will be identical.
be filed in patient’s notes. However, this may not correspond with
Never use to collect or check Blood the details in the patient's medical
Products records for which the blood is prescribed.
NPSA SPN-14

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1.6c Remove the unit of blood from the Blood must be stored between 2- 6°C in
blood bank fridge, ensuring the door order to remain suitable for transfusion.
is firmly closed. The use of blood is rationalised so units
Units of blood should be used in the are used before their expiry and are not
order in which they appear on the wasted.
compatibility form. Never store blood in a ward fridge.
No more than one unit of blood per Only validated Blood fridges can be used.
patient should be collected at any
one time unless specifically
requested by medical staff.

Best Practice WITHDRAWING OF BLOOD FROM BLOOD BANK

Withdrawing of an incorrect component from the blood fridge remains the most
common error in incidents where the incorrect blood is transfused (SHOT 2006).
Adequate checking procedures are therefore essential to the process.

1.6d When using a satellite blood Ensures an accurate record of the

fridge, ensure all units of blood movement of blood units to satellite
are booked in and out, so that the fridges, which complies with British
bag number and date/time of Standard 4376 that maintains a
entering into and removal from consistent recorded temperature.
fridge are recorded. Satellite Fridge at City Campus are:
This information is to be recorded Main Theatre
on the ‘Cold Chain Management CICU Theatre
Form’ supplied with the units. Toghill Ward
Maternity Theatre (Used for Emergency O
Negative units ONLY)

Satellite Fridge at QMC Campus:

Main Theatres

National guidelines require this in case of

adverse incidents occurring - BSQR
2005.

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1.6e At the point of collection;
 Ensure that the unit of blood is Ensures that the correct unit of blood is
correctly identified by checking removed for the correct patient. NPSA
the patients’ identification, SPN-14
taken to the blood fridge Handbook of Transfusion Medicine (4th
(usually Transfusion record Edition) 2007 (stationary office) Section
sheet), with the full name, date 2 page 20
of birth, gender and NHS or
hospital number on the unit
 Check the unit is in date
 Ensure that the donation Expired blood MUST NOT be
numbers (the ‘G’ number) is administered under any circumstances.
the same on both labels (front BSQR 2005
and reverse) of the unit
 Check that this number also
matches the number of the
donation which is being signed
out
 Check special requirements CMV & Irradiated products
 Usually the donor unit and the On occasions, patient’s blood group may
patient unit are the same blood not be available and Laboratory staff will
group but on occasions, they select appropriate group.
are not. If you are not happy Rh (D) Negative can be safely given to
with this, check with the Rh (D) Positive patients.
transfusion laboratory staff Only in emergency situations will Rh (D)
Positive blood be issued to Rh (D)
Negative women of child bearing age
(<60 years)
1.6f Check for leakage by gently The blood may be contaminated if the
squeezing the bag and observing bag is not intact. If any leakage is
along the seams for exudates. present return bag to a member of the
blood bank staff immediately in a
container that prevents spillage.
1.6g Check unit for discolouration. If dark coloured or black, this could
indicate presence of infection. If unit is
discoloured return bag to blood bank
staff immediately.
1.6h If any detail, however minor, does Telephone & Bleep numbers are
not match. DO NOT take back to available to contact Laboratory Staff at
clinical area. Seek advice from the issue fridge
Laboratory Staff

Best Practice RETURNING BLOOD UNITS TO BLOOD BANK

If a unit of blood has been out of the fridge for 30mins or more, it must be
returned to the blood bank and handed to a member of the laboratory staff. It
must NOT, under any circumstances, be placed back in the blood fridge.
If the unit has been out for more than 30 minutes, but transfusion is imminent, the
unit may be used, but transfusion must be completed within 4 hours of removal
from the fridge.

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1.7 Bedside Checking procedure

1.7a Each unit of blood must be Complies with NUH Transfusion Policy
checked independently by two 2011, NPSA SPN-14
people prior to the administration
of the unit. To ensure the correct patient receives
This check must be made beside the correct blood. If a patient is
the patient, i.e. at bedside or transfused with an incompatible unit of
theatre trolley. blood, there is a high risk of an acute
The following staff are able to haemolytic reaction, which could prove to
check blood: Registered be fatal.
Nurse/Midwife, Registered
Medical Practitioner, and Handbook of Transfusion Medicine (4th
Registered Operating Department Edition) 2007 (stationary office) Section
Practitioner. 2 page 20
A student nurse/midwife may act Must understand reasons for checking
as a second checker provided patient ID at the bedside
they have the necessary
knowledge to perform the role e.g.
drug administration training

1.7b The following details (last name, To prevent an error in administration.

first name, date of birth, gender
and patient identification number)
must be checked and found to be
identical by:
 Positively identifying the
patients using verbal
questioning i.e. ‘Tell me your
full name and date of birth’ and
checking the details are the
same on the ID band &
Transfusion Record Sheet. NO ID band NO transfusion
If verbal confirmation is not
possible, the ID band must be
carefully checked.
If possible, check with parents
for paediatric patients who are
unable to respond
 Checking the blood transfusion Compatibility form should not be used as
compatibility form for order of final part of identity check – NPSA SPN-
unit transfusion ONLY 14
 Checking that the compatibility
label attached to the unit of
blood, has the same donation
number (the G number) as the
label on the front of the unit

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1.7c The unit of blood must be checked The blood bank may not have been
for compliance with any special informed of any special requirements. It is
requirements on the transfusion imperative these requirements are checked
record sheet and patient’s notes and this is the last opportunity to do so.
E.g. Cytomegalovirus (CMV) status.

The unit of blood must be checked The Nation Blood Service (NBS) only
to ensure it has not passed its expiry accept liability for the product up to the
expiry date at 23:59 as printed on the
unit
Complete the Transfusion Record To facilitate patient transfusion records
Sheet details – time collected (if BSQR 2005
on the sheet) start and finish times
of the transfusion and signature of
the person who set up the
transfusion & witness. Donation
number of unit being transfused
1.7d If any discrepancies are found The most important single cause of mis-
during the bedside identity transfusion is failure of some aspect of
checking procedure then consult the bedside checking procedure
with the blood transfusion immediately prior to administering the
laboratory staff before transfusion (Annual Report, Serious
commencing the transfusion. Hazards of Transfusion, 2006).
(Ward does not need to match)
Depending on the discrepancy,
the unit may be authorised for
transfusion or returned to the
laboratory.

Each unit of blood must be

checked using the above
procedure. All details checked at
all stages must match exactly.
Mis-spelling or incorrect details
are not acceptable.

Complete the transfusion record

sheet with both the signatures of
the person administering the
blood transfusion and the checker.
Ensure the donation numbers (the
G numbers) are accurately
recorded including check digit and
pack number. This should also
include the start and stop time of
administration of each unit of
blood.
Outcome of transfusion?
Was there a reaction?
At the end of the transfusion Required by BSQR 2005 to show final
episode the Transfusion Record fate of every unit transfused which is
Sheet must be returned promptly kept by the Blood Bank for 30 years – to
to Blood Transfusion so final fate aid in look back for Transfusion
of unit can be recorded Transmitted Infections
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 Best Practice: The final patient ID check at the bedside is the last
opportunity to detect an error

A failure to undertake the formal ID check of the component with

patient at the patient at the bedside:
• Puts the patient at risk
• Breaches professional standards & guideline (Positive
Identification of Patients Procedure – CL/CGP/037, NPSA SPN-14)

2. DURING TRANSFUSION

PRINCIPLE RATIONALE

2.1 Administration

2.1a Blood must be administered using The 200µm filter on a standard blood
a designated blood administration administration giving set traps large
set which has a filter with a aggregates.
minimum size of 200 microns. A leucocyte filter is no longer required
when administering blood as blood is
now leucocyte depleted at source to
remove the risk of transferring viruses.
It is not necessary to prime the
giving set routinely. If it is
required, use 0.9% sodium
chloride intravenous infusion

The majority of the filter chamber Covering the majority of the filter with
should be filled when priming the blood when priming the line facilitates
administration set. maximum use of the filter.

The amount of blood units able to If too many units are transfused through
be transfused through one an administration set, the filter can
administration set is subject to become clogged and not work
manufacturer's guidance, effectively.
although usually, this is two units
per administration set.

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2.1b Wash hands and apply apron and In accordance with Trust policy and to
gloves prevent cross infection

Connect the administration set To promote safe evidence-based

according to the procedure for the practice.
'preparation of an intravenous Intravenous Administration of
infusion and care of a patient Medications (2010)
receiving an intravenous infusion'

2.1c If multiple venous access is Ensures that it is possible to accurately

present then ensure that blood is identify which infusion/drug is
not administered at the same time responsible for reaction, facilitating
as any other drug likely to also appropriate action to be taken if
cause an anaphylactic reaction. necessary.
If single venous access is present, Introducing other drugs to the
do not introduce other drugs into administration set increases the
the blood administration set possibility of contamination or blood
unless absolutely necessary and clotting/haemolysing in the line
directed by a clinician.

Under no circumstances must a

drug be added to the blood pack.

If administration of a drug is
unavoidable then ensure the line is
flushed with 0.9% sodium chloride
before and after the drug
administration.

2.1d Ensure the blood is administered Fluid overload may occur if the blood is
at the prescribed rate, which infused too quickly.
should not exceed 4 hours from There is increased risk of bacterial
removal of cold storage. growth after 4 hours.
Handbook of Transfusion Medicine (4th
Electronic infusion devices may Edition) 2007 (stationary office)
damage blood cells and should
not be used unless specified as
safe by the manufacturer.

Best Practice TRANSFUSION TIMES

Blood should not be transfused for more than 4 hours from removal from cold storage as
there is increased risk of bacterial growth after this time. Discontinue unit if infusion has
taken more than 4 hours even if unit of blood is not completely finished.
Standard intravenous cannulas are suitable for blood components infusion.

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2.2 Observations

2.2a A full set of observations - To establish a baseline (NICE ref CG50

temperature, pulse, blood 2007)
pressure, respiration rate, SpO2,
consciousness level (AVPU or
GCS) and early warning score
should be taken prior to the
transfusion starting.

The nurse/midwife should remain Severe reactions can occur during the
with the patient for the first 5 first 5 minutes of transfusion.
minutes after each unit of blood is
commenced.

A full set of vital signs should be An increase in temperature and pulse

performed and recorded (as may be a sign of incompatibility.
indicated above) 15 minutes after
the start of each unit.

The patient should be asked to Patients may complain of feeling unwell

inform the nurse/midwife if he/she prior to any changes in temperature and
feels at all 'different' during the pulse that may indicate a reaction.
transfusion. (Handbook of Transfusion Medicine
2007)
Unconscious patients are less easy The patient is unable to alert the staff if
to monitor for possible reaction. As a they feel unwell.
result, frequent observation patterns
should be maintained, according to
the patient's condition.

This is the same for each new unit Each unit is from a different donor and
of blood commenced. poses the same potential risks.

A temperature increase of up to Patients can react to non red cell

1.5℃ above the baseline components within the unit of blood and
recording is treated with anti- this can cause a small raise in
pyretics and slowing the temperature.
transfusion rate.
Any rise above this and the
transfusion must be stopped and Contact Blood Bank
a Doctor informed.

NB. If baseline is raised above

normal at the start of the transfusion
and then continues to rise, inform Hyperpyrexia can cause serious
medical staff. complications.

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2.2b The patient should not leave the Un-supervised patients may have a life
ward unless supervised by staff threatening reaction at any time during
competent to deal with transfusion the transfusion episode
reactions/anaphylaxis while the
transfusion is in progress

2.2c During the transfusion observe the Any of these symptoms could be an
patient for signs of the following; indication of a transfusion reaction or
 Flushing anaphylaxis.
 Itching Urgent intervention is required as
 Fever transfusion reactions can be fatal.
 Vomiting Refer to Anaphylaxis policy.
 Diarrhoea
 Urticaria
 Pain at or near transfusion site
 Rigor
 Backache
 Throat swelling
 Haemoglobinuria
 Collapse
 Circulatory failure.
 Bleeding at infusion site

If any of these occur, the transfusion To prevent further deterioration of patient

should be stopped and a member of condition and to treat symptoms.
the medical staff should be
contacted immediately.

Undertake a complete set of vital

signs as outlined above and
commence Early Warning Scores or
Paediatric equivalent every 5
minutes.
Further management depends on
the type and severity of the reaction
and may be suggested by the
medical staff.
Further routine observations during
the transfusion of each blood unit
are dictated by the patients’
condition.
2.2d. If the decision is to stop the Withdrawing blood from the venous
transfusion, disconnect the access device ensures that no more of
administration set immediately the transfused blood enters the patient's
and withdraw blood (approx 2mls) circulatory system.
from the venous access device.
Flush with 0.9% sodium chloride
to maintain its patency. Full
observations should be taken and
recorded as stated above.

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Best Practice:

Observations during & after the transfusion is essential for the early
detection of any adverse events or reactions

Adverse reaction can occur with all blood products

Additions observations should be made if an adverse reaction is

suspected

Monitoring the unconscious/compromised or paediatric patient:

• Be alert as they may not be able to report symptoms of a
transfusion reaction
• NEONATES may become hypothermic rather than febrile in
response to a transfusion reaction

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 PRINCIPLE RATIONALE

2.3 Adverse reaction

2.3a If a severe reaction is suspected To prevent transfusion of any further

following review by medical staff suspect blood.
then;
 Report to the hospital's blood To enable investigation of the incident
bank
 Seek Haematology Medical
Advice if required
 Complete an incident report It is now legal requirement that all serious
form (DATIX) adverse reactions be reported to the blood
 Change the blood bank for onward reporting to the
administration set and government (Blood Safety and Quality
maintain venous access using Regulations 2005), SHOT & Serious
an infusion of 0.9% sodium Adverse Blood Reactions & Events
chloride. (SABRE)
 Return of the implicated unit Analysis of the unit of blood and
and the giving set to the blood administration set may identify
bank contaminants and their point of origin.
 Obtain blood samples from the These results may guide medical
patient as per blood bank intervention in the patient's care.
instructions
 Complete and return
Transfusion Reaction Ward
Form that is sent to you by
Blood Bank as soon as
possible

2.3b The blood unit and administration Use of shallow or permeable containers,
set should be transported back to such as plastic trays or kidney receivers,
blood bank using a waterproof may allow spillage of blood.
container such as a sealed clinical
waste bag appropriately labelled. Sharps bins should NOT be used under
DO NOT USE AIRTUBE SYSTEM any circumstances

2.3c Follow Hospital Transfusion Policy

2011 for reporting adverse
transfusion reactions.

Frequent observations of To comply with N.I.C.E Guidance (2007)

temperature, pulse, blood
pressure, respiration rate, SpO2,
and consciousness level (AVPU
or GCS) and Early warning Score
urine output and colour should be
continued until the patient's
condition is stable.

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3. POST TRANSFUSION

PRINCIPLE RATIONALE

3.1 Observations

Once the transfusion is completed, a To provide a baseline for future monitoring.

set of observations should be
completed and documented. To comply with N.I.C.E Guidance (2007)

Complete the blood transfusion Law (BSQR 2005) requires 100%

prescription and record sheet, traceability of all blood products. These
including the ‘outcome’ and return records must be kept for 30 years
the top copy to blood bank.
3.2 Disconnection

Once the transfusion is completed,

disconnect the blood administration
set and flush the access device, or
change for a fluid administration set
if required.

Do not attach an infusion bag of Infusing any fluid other than blood through
0.9% sodium chloride directly to the the administration set after a transfusion
blood administration set to 'flush' encourages particles that have been
through the blood. trapped by the 200 microns filter to enter
the patient's bloodstream.

For further information, see “Guide to IV

Therapy 4th Edition”.
3.3 Disposal of waste

The empty blood bag should be To avoid spillage.

discarded according to the hospital
policy for the disposal of clinical There is no requirement to store empty
waste. bags providing the product has been
transfused without adverse event
Part empty bags still attached to an
administration set should be
disposed of together in a new sharps
bin containing absorbent gelling
agent, for example, Vernagel ®.

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Best Practice: The person responsible for the transfusion must check:
• The reason for transfusion is documented in the case notes
• The patient has received information about the transfusion
• There is a signature to confirm the pre-transfusion checks have
been completed
• The start & finish time & date is recorded for each unit transfused
• There is a permanent record of the transfusion episode in the
patient’s medical notes
• The full completed top copy of the Transfusion Record sheet is
returned to Blood Transfusion

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Equality and Diversity Statement

All patients, employees and members of the public should be treated fairly
and with respect, regardless of age, disability, gender, marital status,
membership or non-membership of a trade union, race, religion, domestic
circumstances, sexual orientation, ethnic or national origin, social &
employment status, HIV status, or gender re-assignment.

All trust polices and trust wide procedures must comply with the relevant
legislation (non-exhaustive list) where applicable:

Equal Pay Act (1970 and amended 1983)

Sex Discrimination Act (1975 amended 1986)
Race Relations (Amendment) Act 2000
Disability Discrimination Act (1995)
Employment Relations Act (1999)
Rehabilitation of Offenders Act (1974)
Human Rights Act (1998)
Trade Union and Labour Relations (Consolidation) Act 1999
Code of Practice on Age Diversity in Employment (1999)
Part Time Workers - Prevention of Less Favourable Treatment Regulations
(2000)
Civil Partnership Act 2004
Fixed Term Employees - Prevention of Less Favourable Treatment
Regulations (2001)
Employment Equality (Sexual Orientation) Regulations 2003
Employment Equality (Religion or Belief) Regulations 2003
Employment Equality (Age) Regulations 2006
Equality Act (Sexual Orientation) Regulations 2007

Equality Impact Assessment Statement

NUH is committed to ensuring that none of its policies, procedures, services,

projects or functions discriminates unlawfully. In order to ensure this
commitment all policies, procedures, services, projects or functions will
undergo an Equality Impact Assessment.

Reviews of Equality Impact Assessments will be conducted inline with the

review of the policy, procedure, service, project or function

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REFERENCES

Anaphylaxis-Guidelines for the Treatment of (2010)

http://nuhnet/nursing_and_midwifery/preceptorship/Pages/ClinicalSkills.aspx

Better Blood Transfusion 2 and 3 HSC 2002/009 and HSC 2007/001

http://www.dh.gov.uk/en/Publicationandstatistics/Lettersandcirculars/Healthse
rvicecirculars/DH_080613

Blood Safety & Quality Regulations (2005) SI 2005/50

http://www.legislation.gov.uk/uksi/2005/50/contents/made

Handbook of Transfusion Medicine. DBL McClelland (United Kingdom Blood

Services 4th Edition) 2007 (stationary office)

Intravenous Administration of Medications (2010)

http://nuhnet/nursing_and_midwifery/preceptorship/Pages/ClinicalSkills.aspx

Infection Prevention and Control Policy (2011) (CL/GP/031)

http://nuhnet/diagnostics_clinical_support/infection_prevention_control/Pages
/Policies.aspx

Kelsey P, Murphy M.F., Atterbury C.L.J., Chapman J.F., Lumley K.S.,

McClelland D.B.L., Stockley R., Thomas D. & Wilkinson J., (1999) ‘The
Administration of Blood and Blood Components and the Management of
Transfused Patients’ Transfusion Medicine Vol 9 pp 227-238

National Confidential Enquiry into Patient Outcome & Death NCEPOD (2005)
An acute problem? http://www.ncepod.org.uk/2005aap.htm

NICE Guidance CG50, 2007, Acutely Ill Patients in Hospital

http://www.nice.org.uk/nicemedia/pdf/CG50FullGuidance.pdf

Nottingham University Hospitals NHS Trust, Transfusion Policy CL/CGP/008

NPSA Safer Practice Notice 14 Competency Assessment (2006)

http://www.npsa.nhs.uk

NPSA Safer Practice Notice 24 (2007) Standardising Wristbands Improves

Patient Safety http://www.npsa.nhs.uk/patientsafety/alerts-and-
directives/notices/wristbands/

Serious Hazards of Transfusion SHOT Report (yearly reports 2005-2011)

www.shotuk.org

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Authors: Hayley Bond & Steven Cliffe
Transfusion Practitioners
Clinical Pathology

NMPGG Link: Hayley Bond

For Review: November 2014

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