The transfusion process is complex, involving many interlinking chains of events, and a multidisciplinary group of health professionals with different levels of awareness and understanding of transfusion practice. In recent years, many measures have been implemented to increase blood component safety and the clinical transfusion process. Haemovigilance programs report the greatest risks to patients from transfusion in many countries now relate to hospital-based steps in the process.
The role of the Transfusion Nurse (TN) is evolving as an integral part of efforts to optimise appropriate use of blood components, reduce procedural risks and improve transfusion practice generally. The TN position is a relatively recent specialist role within hospitals and blood services, and continues to develop with growing experience of areas requiring intervention in the clinical setting, and increasing expectations for improvements in transfusion clinical governance.
The role typically includes activities to improve clinician and patient awareness of transfusion issues and practical knowledge of blood product use, and therefore to improve clinical decision-making and enhance blood administration processes, along with responsibilities for education/training, auditing and adverse event follow-up. Within the Blood Service in Australia the role also covers approval and provision of specialised blood products along with many of the hospital-based TN functions.
The TN serves as an expert resource and has been fundamental in development of tools, resources and skills in the following areas:
- Patient blood management:
- Professional development
Benchmarking across organizations has demonstrated that availability and review of comparative data can be a powerful motivator of change. Reviews of the TN role/programmes highlighted their effectiveness and resulted in ongoing support/funding. Skills and attributes such as confidence, persistence, energy, excellent communication/ technical knowledge and clinical experience are key requirements for the roles success.Conclusion
The specialist transfusion practitioner/Transfusion Nurse is an integral part of a multidisciplinary team, supporting efforts at institutional and national levels to reduce transfusion risks and improve practice.