Blood Transfusion

A blood transfusion is a procedure where you receive blood through an intravenous cannula (IV) inserted into a vein. You may need a blood transfusion if your body cannot make parts of your own blood, if your blood cells are not working properly, or if you have lost blood.

Blood contains red cells which are essential for carrying oxygen around the body. A blood transfusion may be given because of a shortage of red blood cells in the blood (anaemia), either because the body is not making enough of them, or because of blood loss. Sometimes the bone marrow, which produces blood cells, doesn’t work properly. The bone marrow can be affected by chemotherapy or diseases. In some cases anaemia can be treated with medicines but in other cases, a blood transfusion may be the best treatment.

Most people can cope with losing a moderate amount of blood without needing a blood transfusion, as this loss can be replaced with other fluids. However, if larger amounts of blood are lost, a blood transfusion could be the best way of replacing blood rapidly. A blood transfusion may be needed to treat severe bleeding, for example during or after an operation, childbirth or after a serious accident. There are many useful resources for patients about blood transfusion available.

Transfusion does not just refer to blood – often other blood products are used. These include:

  • fresh blood components, such as red blood cells, platelets, fresh frozen plasma or cryoprecipitate
  • plasma-derivatives such as albumin, immunoglobulins and clotting factors


A blood transfusion can be lifesaving or significantly improve quality of life. Australia has one of the safest blood supplies in the world, however, as with all medical procedures, a blood transfusion is not completely free from risk. It is very important that all patients receive blood and blood product transfusions appropriately and safely. Blood transfusions are given to patients only where the doctor has assessed it as absolutely necessary.

Patients must give consent for a blood transfusion. Consent should be documented on a consent form or by documenting the discussed information in your medical record.
It is very important that transfusions are carried out by trained professional staff, using the techniques outlined in the National Safety and Quality Health Service Standards. This is double checked and audited on a regular basis in our hospital.

One way that we monitor the success of blood transfusions is by keeping track of any adverse reactions – both major and minor. Adverse reactions are rare, but can include:

  • incorrect blood / blood component transfused
  • transmission of infection, for example bacteria or viruses
  • transfusion related immune reaction
  • transfusion related acute lung injury


At Flinders Private Hospital we document and investigate every case and take action to reduce the number of adverse transfusion events that occur. Flinders Private Hospital has many strategies in place to prevent adverse transfusion events from occurring.

This graph shows the number of patients at Flinders Private Hospital that had a transfusion with NO significant adverse event. The rate for the past 6 years is shown in the coloured bars. This is compared to the rate of transfusion events in other Australian hospitals (the grey bar). The graph shows that patients at Flinders Private Hospital are less likely to have an adverse transfusion event, compared with other Australian hospitals.

*In January 2015, an external audit found an inconsistency in hospital data for 2013. As a result, the chart has been revised and the rate has increased.

What we are doing to reduce the risk of adverse transfusion events

The following strategies are used:

  • Policies and procedures, consistent with national evidence based guidelines for pre-transfusion practices, prescribing and administration of blood
  • Avoiding unnecessary blood transfusions by use of alternative medications, treatments and non-blood treatments.
  • Identifying any risk factors for adverse reactions, before the transfusion commences.
  • Careful cross-matching of blood groups to make sure no errors occur.
  • Education and competency training for nursing staff in blood transfusion administration. 
  • Patient education and provision of written materials explaining blood transfusions.
  • Individual reporting: Examining each adverse transfusion event to determine why it occurred and how to prevent this happening again.
  • Careful monitoring of patients and taking close observations during administration of a blood transfusion.
  • Working closely with the pathology laboratory that provides the blood.
  • Monitoring and auditing compliance to transfusion policies and procedures
  • There is a robust system for reporting and feedback for adverse events, incidents and near misses relating to transfusion practice.
  • Transfusions are not conducted at every Healthscope hospital. If a hospital does not have sufficient experience in conducting a transfusion, the patient is moved to another hospital for this procedure.
  • ACHA participates on the Healthscope National Transfusion Governance Committee that oversees best practice standards for transfusion management in all hospitals – and also reviews adverse events nationally so that all hospitals can learn from them.

 

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