Implementation of nurse authorisation of blood components.

A collaborative project between the Better Blood Transfusion teams in the Scottish National Blood Transfusion Service (SNBTS) and NHS Blood and Transplant (NHSBT) explored the feasibility of nurses prescribing blood components, and clarified that blood components are not considered medicinal products, so the term prescription does not apply. No legal barriers to trained, competent nurses and midwives undertaking this role were identified and nurse authorisation of blood components was seen as having the potential to improve patients' experiences. A number of NHS Scotland boards showed interest in implementing this but there are challenges to ensuring that a robust governance structure is in place to support role development . Progress has been made with support from the Scottish Government Health Department and using a governance framework that was developed to support nurses who wish to undertake this role.

The use of simulated learning to promote safe blood transfusion practice.

The transfusion of blood and blood products is a complex, multi-professional task which is liable to errors at any point in the journey from donor to recipient. The serious hazards of transfusion (SHOT) scheme has documented reports which consistently demonstrate that the administration of the incorrect blood component is a major cause of morbidity and mortality in the United Kingdom. Training programmes which focus on different stages of safe effective blood transfusion are currently available but none involve practice in the workplace setting. This paper shares the design, implementation and subsequent evaluation of a simulated ward exercise, which was developed in partnership with the Scottish National Blood Transfusion Service (SNBTS), NHS Tayside and the University of Dundee Medical School to reinforce learning in a workplace context. The exercise was evaluated from a number of different perspectives. The exercise demonstrated that it is an effective method of reinforcing safe transfusion practice in a non-threatening realistic workplace environment. Costs in terms of time, finance and staff numbers may however preclude large scale implementation in practice.