Non Medical Authorisation of Blood Components
(Print details clearly in BLOCK capitals)
Guidance Notes for Assessors
1. The practical assessment should follow a period of clinical supervision in which the candidate gains experience and practice at assessing the patient and performing written authorisation of blood components.
2. The competency assessment must be supervised by the medical consultant delegating responsibility using the attached competency assessment form.
Performance Criteria
Patient assessment and clinical decision making
Date
Assessor
Signature
Interpreting blood test results
Completing the prescription chart
Knowledge & Competencies

Understands the requirements to accurately document all actions and conversations with child/young person/parents

Ability to link clinical picture with interpretation of blood test results

Ability to make appropriate referral if blood transfusion refused

Understands how to explain the risks and benefits of transfusions and available alternatives

Know to provide patient information leaflets

Understands normal and abnormal
Haematology and Biochemistry results

Ability to interpret results, initiate treatment and know if more tests and/or further evaluation is required

Understands that the prescription chart must include:
Competency Assessment for Non Medical Authorisation of Blood Components Version 4
Page 1 of 4 Issued April 2015
Review date April 2015

Indications for use of blood components

Appropriate use

Alternatives
Special Transfusion
Requirements o Full patient details – full name, hospital number, date of birth o A suitable infusion rate o Volume in mls o Any special transfusion requirements o Concomitant drugs that need to be administered

Can discuss the incompatibility of blood with other infusion fluids/IV drugs
Understands the structure, function and Anatomy and physiology of blood production of:

Red cells

White cells

Platelets

Plasma
Understanding anaemia

Can define the types of anaemia

Understands the physiological processes for iron deficiency anaemia

Knows when to refer children/young persons for further investigations and treatment

Knows how to order further investigations

Understands iron therapy and EPO use
Pre-transfusion testing Has an understanding of:
 pre transfusion sampling process

BCSH guidelines for pre transfusion testing

Sample labelling requirements

Laboratory process for pre transfusion testing
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A laboratory visit must be arranged with
Blood Transfusion Laboratory Manager
ext 8467/8527

Can define the indications for use of blood components

Can make the decision for transfusion within best evidence available and local guidelines

Know the alternatives to consider, if appropriate

Knows when to consult with medical consultant with responsibility for child/young person and/or consultant haematologist with responsibility for transfusion

Can define which patient groups will have special blood transfusion requirements

Understands the process for notification of
Competency Assessment for Non Medical Authorisation of Blood Components Version 4
Page 2 of 4 Issued April 2015
Review date April 2015

Risks and adverse events associated with transfusion
Transfusion guidelines and protocols
Legal responsibilities
Ordering blood components
Administration process special requirements to the laboratory and staff administering the component

Understands the risks of transfusion: o Transfusion Transmitted bacterial and viral Infection (TTI) o Transfusion Related Acute Lung
Injury (TRALI) o Acute/delayed haemolytic reaction o Wrong blood to wrong patient o Fluid overload o Iron overload o Anaphylaxis

Can recognise the signs and symptoms of a transfusion reaction

Can describe actions required in an emergency situation
Can demonstrate knowledge of:

Trust transfusion guidelines/policies

Specialty guidelines/policies

Patient information leaflets

Blood Safety & Quality Regulations
SI2005/50 traceability requirements

Has knowledge and understanding of relevant professional body standards of conduct, performance and ethics

Can explain why the reason for transfusion must be recorded in the patient notes

Can explain why all actions must be documented in the patient notes
Has knowledge of trust policy for ordering of blood components and is aware the laboratory requires the following information:

Family and given name

Hospital number

Date of birth

Amount in mls

Date/time required

Special transfusion requirements
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Diagnosis/reason for transfusion
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Contact name and bleep/telephone number
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If applicable to role, has completed the competency for the administration of blood components as required by the NPSA
SPN14.
Competency Assessment for Non Medical Authorisation of Blood Components Version 4
Page 3 of 4 Issued April 2015
Review date April 2015


Can describe the principles of positive patient identification
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Knows the process for collections of blood components for transfusion

Can describe the process for checking blood component and patient compatibility

Can describe the procedure for monitoring the transfused patient

Understands the legal requirements for documentation and traceability
All the above criteria must be achieved to gain competency
If competency not gained:
 Manager must give clear feedback
 Retraining requirements must be determined
 Re-assessment date to be arranged after further training
 Candidate assessed as competent
 Retraining and reassessment required.
Signature of Assessor ………………………………………………..Date…………………….
I agree that I have sufficient current knowledge and understanding of the Blood Transfusion process and feel that I am competent to practice.
Signature of Candidate ……………………………………………….Date………………….…
If you feel that you do not have sufficient current knowledge and / or skill you must discuss this with your line manager before signing to indicate that you are competent.
Competency Assessment for Non Medical Authorisation of Blood Components Version 4
Page 4 of 4 Issued April 2015
Review date April 2015