References

Blackmore A, Kasfiki EV, Purva M Simulation-based education to improve communication skills: a systematic review and identification of current best practice. BMJ Simul Technol Enhanc Learn. 2018; 4:(4)159-164 https://doi.org/10.1136/bmjstel-2017-000220

Bolton-Maggs PHB, Watt A Transfusion errors - can they be eliminated?. Br J Haematol. 2020; 189:(1)9-20 https://doi.org/10.1111/bjh.16256

Booth C, Allard S Blood transfusion. Medicine (Baltimore). 2017; 45:(4)244-250 https://doi.org/10.1016/j.mpmed.2017.01.014

Carayon P, Gurses AP Nursing workload and patient safety — a human factors engineering perspective. Chapter 30. In: Hughes RG (ed). : Rockville (MD): Agency for Healthcare Research and Quality (US);; 2008

Donaldson L, Ricciardi W, Sheridan S, Tartaglia R Textbook of patient safety and clinical risk management. Cham (Switzerland);. 2021; https://link.springer.com/content/pdf/10.1007%2F978-3-030-59403-9.pdf

Flood LS, Higbie J A comparative assessment of nursing students’ cognitive knowledge of blood transfusion using lecture and simulation. Nurse Educ Pract. 2016; 16:(1)8-13 https://doi.org/10.1016/jmepr.2015.05.008

Health and Safety Executive. Human factors: managing human failures. 2023a. https://www.hse.gov.uk/humanfactors/topics/humanfail.htm

Health and Safety Executive. Human failure types. 2023b. https://www.hse.gov.uk/humanfactors/topics/types.pdf

Henneman EA, Andrzejewski C, Gawlinski A, McAfee K, Panaccione T, Dziel K Transfusion-associated circulatory overload: evidence-based strategies to prevent, identify, and manage a serious adverse event. Crit Care Nurse. 2017; 37:(5)58-65 https://doi.org/10.4037/ccn2017770

Hurrell K Safe administration of blood components. Nurs Times. 2014; 110:(38)16-19

Jimenez-Marco T, Clemente-Marin G, Girona-Llobera E, Sedeño M, Muncunill J A lesson to learn from hemovigilance: the impact of nurses’ transfusion practice on mistransfusion. Transfus Apher Sci. 2012; 47:(1)49-55 https://doi.org/10.1016/j.transci.2012.04.005

Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Service Professional Advisory Committee. Transfusion Handbook. 5th edn. 2014. https://www.transfusionguidelines.org/transfusion-handbook

4: Safe transfusion — right blood, right patient, right time and right place. Transfusion handbook. 2020; https://tinyurl.com/2v4aayp3

Kavaklioglu AB, Dagci S, Oren B Determination of health workers’ level of knowledge about blood transfusion. North Clin Istanb. 2017; 4:(2)165-172 https://doi.org/10.14744/nci.2017.41275

Kumar R Research methodology, 5th edn. London, Sage2019

Leonard M, Graham S, Bonacum D The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care. 2004; 13:(Suppl 1)i85-90 https://doi.org/10.1136/qhc.13.suppl_1.i85

Lister S, Hofland J, Grafton H, Wilson C The Royal Marsden Manual of Clinical Nursing Procedures, Student edn, 10th edn. (eds). London: John Wiley & Sons; 2021

Männistö M, Mikkonen K, Kuivila HM, Virtanen M, Kyngäs H, Kääriäinen M Digital collaborative learning in nursing education: a systematic review. Scand J Caring Sci. 2020; 34:(2)280-292 https://doi.org/10.1111/scs.12743

Moher D, Liberati A, Tetzlaff J, Altman DG Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6:(7) https://doi.org/10.1371/journal.pmed.1000097

Narayan S Serious Hazards of Transfusion (SHOT) Steering Group. Annual SHOT report 2020. 2021; https://tinyurl.com/4v6ez3bt

Narayan S Serious Hazards of Transfusion (SHOT) Steering Group. Annual SHOT report 2021. 2022; https://tinyurl.com/4re8rumm

Narayan S Serious Hazards of Transfusion (SHOT) Steering Group. Annual SHOT report 2019. 2020; https://tinyurl.com/mr3xrecb

National Institute for Health and Care Excellence. Blood transfusion. 2015. https://www.nice.org.uk/guidance/ng24/chapter/context

NHS England/NHS Improvement. The NHS patient safety strategy: safer culture, safer systems, safer patients. 2019. https://tinyurl.com/bdeed242

NHS England/NHS Improvement. Provisional publication of never events reported as occurring between 01 April 2020 and 31 January 2021. 2021. https://tinyurl.com/24tscw5v

NHS England/NHS Improvement. Recommendations form National Patient Safety Agency Alerts that remain relevant to the never events list 2018. 2018. https://tinyurl.com/5f3nxxr2

Ohsaka A, Kobayashi M, Abe K Causes of failure of a barcode-based pretransfusion check at the bedside: experience in a university hospital. Transfus Med. 2008; 18:(4)216-222 https://doi.org/10.1111/j.1365-3148.2008.00868.x

Pagliaro P, Turdo R, Capuzzo E Patients’ positive identification systems. Blood Transfus. 2009; 7:(4)313-8 https://doi.org/10.2450/2009.0001-09

Royal College of Nursing. Patient safety and human factors. 2021. https://www.rcn.org.uk/clinical-topics/Patient-safety-and-human-factors

Sapkota A, Poudel S, Sedhain A, Khatiwada N Blood transfusion practice among healthcare personnel in Nepal: an observational study. J Blood Transfus. 2018; 2018 https://doi.org/10.1155/2018/6190859

Serious Hazards of Transfusion. SHOT bite no 12. 2020. https://tinyurl.com/3dj46nka

Smith FC, Donaldson J, Pirie L Pre-registration adult nurses’ knowledge of safe transfusion practice: Results of a 12 month follow-up study. Nurse Educ Pract. 2010; 10:(2)101-107 https://doi.org/10.1016/j.nepr.2009.04.003

Smith A, Gray A, Atherton I, Pirie E, Jepson R Does time matter? An investigation of knowledge and attitudes following blood transfusion training. Nurse Educ Pract. 2014; 14:(2)176-182 https://doi.org/10.1016/j.nepr.2013.08.016

Stout L, Joseph S Blood transfusion: patient identification and empowerment. Br J Nurs. 2016; 25:(3)138-43 https://doi.org/10.12968/bjon.2016.25.3.138

Tan AJQ, Lee CCS, Lin PY, Cooper S, Lau LST, Chua WL, Liaw SY Designing and evaluating the effectiveness of a serious game for safe administration of blood transfusion: a randomized controlled trial. https://doi.org/10.1016/j.nedt.2017.04.027.

Turkelson C, Yorke AM, Keiser M, Smith L, Gilbert GE Promoting interprofessional communication with virtual simulation and deliberate practice. Clinical Simulation in Nursing. 2020; 46:30-39 https://doi.org/10.1016/j.ecns.2020.03.008

Yesilbalkan OU, Akyol A, Ozel F, Kankaya H, Dogru V, Argon G Assessing knowledge of nurses on blood transfusion in Turkey. International Journal of Caring Sciences. 2019; 12:(1)521-527

World Health Organization. Patient safety. 2019. https://tinyurl.com/5bee7jr3

World Health Organization. Global patient safety action plan 2021—2030. 2021. https://tinyurl.com/bx6ayhh7

Blood and blood products transfusion errors: what can we do to improve patient safety?

06 April 2023
Volume 32 · Issue 7

Abstract

Evidence suggests that blood transfusion errors tend to occur because of an external stimulus, limiting control for the professional administering it. Whether it be cognitive bias, human traits, organisational or human factors, errors should be prevented because they put the safety of the patient at risk from major morbidity and mortality. The authors explored the literature that looked at the blood transfusion errors that occur, suggesting interventions that may have a positive impact on patient safety. A review of the literature was undertaken using key words and limiters to focus the search. The review found that, when practitioners do not perform skills or interventions regularly, competence diminishes. Training and rolling refresher programmes appeared to improve retention and knowledge, therefore enhancing patient safety. Consequently, the impact of human factors in the healthcare setting requires more comprehensive investigation. Nurses may have the knowledge and understanding regarding blood transfusions; however, the environment in which they work could contribute to the likelihood of errors.

Blood transfusions are a relatively routine intervention but, globally, the underpinning rationale is significantly different. In high-income countries, 75% of all transfusions administered are to those over 60 years of age for post-surgical treatment and the management of malignancy-related anaemia, as well as sudden trauma. However, in lower income countries, up to 54% of transfusions are for children under the age of 5 years for severe anaemia and in pregnancy-related complications (World Health Organization (WHO), 2021).

Despite the disparity in rationale, issues surrounding safety remain a consistent concern globally, with only 50% of hospitals worldwide having transfusion committees and only 57% having systems for reporting adverse events, prompting the WHO to challenge and promote blood safety for all (WHO, 2021). In addition, the risks relating to transfusions since 2020 appear to have increased and continue to do so, with incidences of error rising in emergency departments within the UK; the Serious Hazards of Transfusion (SHOT) annual report 2020 recorded 2623 errors (Narayan, 2021). This would suggest that learning is minimal and strategies to reduce or eliminate risks are desperately needed.

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content