National audit of the blood transfusion process in the UK

The objectives of this initiative were to produce nationally tested audit t ools, to influence the content of national guidelines, and to enable perfor mance indicators to be set for the clinical transfusion process. Audit tools were developed for blood transfusion practice through a collabo ration between Royal Colleges and specialist Societies with an interest in blood transfusion. National audits were carried out involving 50 hospitals in the first audit and 23 of the same hospitals in the second. Over 20% of participating hospitals did not have Hospital Transfusion Commi ttees. Most hospitals had written policies for the taking of blood samples for grouping and compatibility testing. Formal training for the phlebotomis ts and nurses who took blood samples was almost universal, but only one-thi rd gave training to doctors. The audits of transfusion practice demonstrate d considerable variation in the performance of standard procedures in relat ion to the administration of blood, and little change in practice between t he two audits. The first two objectives have been met in that audit tools were developed a nd published, and information from the first audits was used in the develop ment of national guidelines for the administration of blood. A significant shortfall in the systems for monitoring and delivering transfusions is pres ent in many hospitals. This justifies pursuing the third objective but this will require a new initiative. The type of analysis and the method used fo r the presentation of audit data developed in this study may be useful for setting performance indicators for the clinical transfusion process.