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 RD&E 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 RD&E patients must be made using EPIC (My Care), in all areas where patients are wearing ID bands, the blood sample must be taken using BloodTrack Tx on the WOW or Phlebotomy trolley. 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 and products 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 (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 but must also have the standard order form emailed to the HTT generic email, as linked through the form. Click here for further details on how to order blood components and products.
At the RD&E we operate a zero tolerance approach to request form and sample labelling for patient identification details, in accordance with the Transfusion Policy. The request and sample MUST be labelled with the following, matching details:
Date of Birth
NHS or Hospital Number
Details on the sample MUST be generated by the Haemonetics on-demand electronic sample labelling system (BloodTrack Tx) (RD&E patients only). For requests generated in GP surgeries a paper request form must be completed (a pre-printed label may be used) and the sample must be hand written. 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.
Order 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 or not by ticking the relevant boxes on the form.
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 (Histocompatibility & Immunogenetics ) are referred to the NHSBT on the advice of a Consultant Haematologist. Contact the laboratory for advice on specific request forms for these tests.
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.