This aspect of transfusion practice is crucial to patient safety.  Failure to correctly identify the
patient at sample collection remains a significant cause of patient morbidity and mortality. 
The most common cause of blood group incompatible transfusion reactions is clerical / collection errors.

Blood will be taken from the correctly identified patient and specimens will be labelled with
correct patient details. The collector will sign or initial the blood tube and complete the
declaration on the request form (signature or initials) to confirm that the blood was taken
from the named patient. The signature or initials must match on both the tube and the request form.

Prior to receiving a blood transfusion all patients must have blood taken for crossmatching. This includes:

• Patients who have pre-donated autologous blood

• Patients who require an emergency transfusion using emergency O negative blood

Requests for Group and Hold or Crossmatch must use the appropriate request form specifically designed for transfusion.

The identity of the patient must be positively confirmed at the time of sample collection:

• Ask the patient to state their full name and date of birth.

• Check the patients details on the blood product request slip with the details on the wristband -

  • Patients last name and first name

  • Date of birth

  • number (if available)

• Dialysis: (when patients in Dialysis Unit only) Ask patient to state their full name, date of birth and address.
  Check these against the blood product request slip details and patient photo ID details

• Ambulatory Care Patients: Ask patient to state their full name, date of birth and address

• In the unconscious or confused patient the identification will be from the patients wristband alone

• An unidentified patient admitted to the emergency department will be triaged as unknown and given a new number on the wristband.  Once the patients identity has been determined they must be given a new wristband as per usual protocol.  The original wristband must remain insitu until patient is discharged. This allows for blood that may have been crossmatched against the unknown UR number to be used.

• Immediately following collection of blood from the patient, label the tube in handwriting at the bedside

The request form contains a declaration that is required to be signed by the person collecting the
patients blood at the time of the collection.  If the declaration is not signed the blood will not be
processed and the tube will be discarded. A recollection will be required.

The request form and sample tube must clearly identify the patient and include the following information:

• Family name

• Given name

• number

• Date of birth

• Gender

• Date and time of collection

• Signature or initials of the collector

• Name of the person collecting the sample (form only)

If any of this information is missing from either the request form or tube the sample will not be processed and the specimen will be discarded.

In addition the request form should also include the following information

• Name and signature of the requesting practitioner plus other details for identification purposes

• Details of the test(s) requested and/or type of blood product required (Note: only fresh blood products are ordered from Pathology - red blood cells, fresh frozen plasma, platelets and cryoprecipitate)

• Clinical diagnosis and indications for the required blood component

• Date and time required

• Transfusion history including any antibodies, if known

• Obstetric history (including RhD-immunoglobulin administration)

• Location of patient

It is preferable that bradma labels are used on the request form

The sample tube must have the patients details completed in handwriting.  Patient labels will not be accepted and the tube will be discarded.  A recollection will be required.

The signature or initials on both the request form declaration and sample tube must match i.e. if an initial is on the tube, then the form must also have the same initials; if the tube is signed, the form must be signed.

If laboratory staff can not positively make this match, the sample will be discarded and a recollection will be requested.

Blood for crossmatching can only be taken by a medical officer, a Registered Nurse Division 1, a Midwife or Pathology collectors after appropriate training.  Enrolled Nurses who have successfully completed a venepuncture competency program or the Diploma of Nursing may practice the procedure within their clinical area. Medical and nursing students may only take blood for crossmatch under strict supervision.

72 HOUR RULE

• A crossmatch specimen expires 72 hours after collection. 

• A fresh crossmatch specimen will be required for any units not commenced within the 72 hour period. 

• On discussion with pathology a crossmatch sample may be valid for one week as long as the patient has not been transfused in that time.

This internationally accepted safeguard is used to prevent a transfusion reaction in patients who form antibodies to foreign red cell antigens in response to pregnancy or transfusion.