Although a rare occurrence, ABO incompatible transfusions can cause patient morbidity and mortality. Up to 20% of all incompatible transfusions are traced to patient misidentification and/or sample mislabeling errors that occur before a sample arrives in the laboratory. Laboratories play a significant role in preventing incorrect transfusion by identifying wrong blood in tube and rejecting mislabelled samples. Wrong blood in tube (WBIT) events occur when a blood sample taken from a patient is labelled with a different patient’s details. To reduce the risk of WBITs leading to ABO incompatible transfusion, the RDUH operate a two-sample policy. The two samples may be an historic and a current sample, or two samples taken by different operators, or two samples by the same operator taken at different times.
Requests for transfusion tests for RDUH patients must be made using EPIC, in all areas where patients are wearing ID bands, the blood sample must be labelled using BloodTrack Tx on the WOW . Click here to access further details on using EPIC to order transfusion tests and here to access details on using BloodTrack Tx to collect and label samples.
Request for blood components must be made on EPIC, if your request is urgent then follow up the order with a telephone call to the laboratory. All requests for batch products, ordered and prescribed on the EPIC MAR, (HAS, Anti-D, IVIg, anti-tetanus, factor concentrates must be followed up with a telephone call to the lab. Antenatal requests for RAADP can be ordered on EPIC , the order is emailed to the relevant laboratory generic email. Click here for further details on how to order blood components and products.
At the RDUH we operate a zero tolerance approach to request form and sample labelling for patient identification details, in accordance with the Transfusion Policy. The request/order and sample MUST be labelled with the following, matching details:
Surname
Forename
Date of Birth
NHS or Hospital Number (MRN)
Details on the sample label MUST be generated by the Haemonetics on-demand electronic sample labelling system (BloodTrack Tx). For requests generated in GP surgeries a paper request form must be completed (a pre-printed label may be used only on the request form) and the sample must be hand written. If the test order has been made on EPIC, the form can be printed and used in place of the handwritten form. The request form and the sample must contain the patient information given above, and these must match on the form and the sample.
Any samples/request forms that do not comply with the above will be rejected and the patient will need to be re-bled.
Orders for blood components made on EPIC must indicate any specific requirements which will be displayed on the prescription. Specific requirements must also be notified to the transfusion laboratory using the EPIC notification form (click here to access instructions on using this form) as soon as the requirement is noted. Paper request forms for blood transfusion MUST confirm if the patient has any special requirements.
Samples are valid for 72 hours from collection. This may be extended to 7 days under certain circumstances and following discussion with a Consultant Haematologist or a member of the Hospital Transfusion Team.
All WBIT events are fully investigated by the Hospital Transfusion Team, in accordance with the Investigation of WBIT Procedure.
Click here to access information regarding individual blood transfusion tests:
White cell and Platelet Investigations, and other tests (Histocompatibility & Immunogenetics ) are referred to the NHSBT . The specific request forms and sample requirements are linked on EPIC in the order and can be found by searching using an appropriate term of the test required.
In the event of computer downtime the Trust contingency plan should be followed, further information on ordering blood components/products and sample labelling can be accessed by clicking this link.
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