Exploring patient participation in reducing health-care-related safety risks

Exploring patient participation in reducing health-care-related safety risks
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Patient involvement in the blood transfusion process
Limited attention has been paid to date to the patient contribution to improving the
blood transfusion process. The blood supply part of the transfusion chain – from the
blood donor to the resulting blood components/products – is the responsibility of
the blood supply organization and the Ministry of Health, Welfare and Sports. The
patient is covered by specific technical standards and considerations and is subsequently
not expected to contribute to any part of the chain (except as a potential donation
promoter). In hospital care, a number of steps can be distinguished, however. First, the
patient should be informed of the decision by the physician to prescribe blood products.
The next steps involve selection of the appropriate product and compatibility checks.
Correct patient identification and administration of transfusion therapy – with posttransfusion
follow up – represent the final steps of the process.
Providing information to patients who have an indication for transfusion therapy is now
considered to be part of standard care. Information should also include a description
of possible adverse reactions and treatment alternatives. This approach is part of the
guidelines on blood transfusion for the Netherlands (3); however, there are limiting
factors in its application. These include lack of time and the fact that transfusion is often
only one part of the patient’s treatment. To support this process, Sanquin has developed
a patient information leaflet that is available to hospitals.
A well-informed patient can contribute to a positive transfusion outcome if he or
she is aware of the importance of identification and immediate evaluation as part of
the process of the therapy. Interestingly, and illustrating the cultural differences in
perception, professionals considered that identification wristbands would be regarded
as an impersonal additional safety measure, while these have been easily accepted by
patients.
Important scientific and technological progress has been achieved in improving the
outcomes of blood transfusion therapy. This continuous improvement process is now
evolving towards increased contributions from patients. The so-far rather cautious steps
in patient engagement need to be more clearly defined and further developed.
References
1. Transfusion Reactions in Patients Foundation. Trip annual report 2009.
Hemovigilance. The Hague, Dutch National Haemovigilance Office, 2010.
2. Categories of reactions [web site]. The Hague, Dutch National Haemovigilance
Office, 2012 (http://www.tripnet.nl/pages/en/indelingtransfusiereacties.php,
accessed 1 May 2012).
3. Knape H. Current Dutch guidelines in transfusion. Transparency in Transfusion
Medicine: Road To Improvement of Quality Conference, Zwolle, 15–16 April 2011.