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Case Study A. Incorrect administration of a blood product
This incident draws attention to checking procedure roles and responsibilities for blood
products.
An 86 year old man was admitted with a fractured neck of femur, scheduled for surgery that
afternoon. The patient’s international normalised ratio (INR) was elevated at 1.6, and the
decision was made to treat this elevated level with a unit of fresh frozen plasma (FFP) prior
to surgery. The medical officer (MO) went to the laboratory to collect the unit of FFP. On
arrival the scientist pointed to where the FFP was located and requested the MO to sign the
unit out of the laboratory in the blood register. The unit collected by the MO was allocated
for another patient and labelling not yet completed. The MO signed the unit out against his
patient details in the blood register without checking the product details matched. He then
took the unit to the ward.
On return to the ward the MO handed the FFP to the nurse caring for the patient, who was
unaware of the request for transfusion. The nurse noted the lack of paperwork accompanying
the FFP and sent the patient services attendant (PSA), with the unit, back to the laboratory
to collect the appropriate paperwork. The PSA returned and stated that there was no
paperwork for this FFP unit and that it did not need to be checked, although the laboratory
staff stated they did not speak to the PSA regarding the FFP.
The nurses on the ward took the word of the PSA that they did not need the paper work, and
checked the FFP to the patient. The unit was group O, the patient’s blood group was group A,
therefore making this an incompatible transfusion. The staff were unaware of this at the timeasboth medical and nursing staff were under the impression that O was the universal group
for FFP as well as red cells. Later the laboratory staff noted the FFP for the patient was still
in the fridge and when they checked the register realised the error. They immediately rang
the ward; however the product had already been administered. As a result the patient had a
mild rise in bilirubin, and his procedure was delayed as a precaution to monitor the patient
for further consequences of the transfusion therapy
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Title – Please title the critical reflection paper with the title of the case study you have chosen for this assessment. For example;
Title: Case Study A – Incorrect administration of a blood product.
Then after the title you will need to provide a question and answer format. You do not need to write out the questions in full for your assessment submission. You only need to provide your answers to each of the questions. For example; Question 1. Then you can start to write your answer here, OR, Q1.
Then you can start to write your answer here
Question 1. Provide a concise description of the incident (i.e, what happened?) This answer should be describing what the actual issues are at hand not simply restating the details of the case study.
Question 2. Outline why you chose this incident and how it is relevant to your professional practice (i.e. why is it personally significant?)
Question 3. Identify the relevant factors in the clinical context that potentially contributed to the incident (i.e., why did it happen…so what?)
Question 4. If you were involved in a similar clinical situation in the future, what alternative actions would you take? (i.e., what would you do differently…now what?)
Reference List Support your answers with reference to the relevant clinical and professional standards that apply. The paper must include in-text references and a reference list at the end of the paper in the APA style 6th edition (available on vUWS) for all resources used in the critical reflection (a minimum of five references is expected).
I will support u with some essential resource please use it in this work
The suggested referencing conventions for citations from an NMBA
document, following the APA Referencing Style Guide for a government
report online are as follows:
First citation:
…this is supported by statement 6.2 (Nursing and Midwifery Board of Australia, 2016).
Subsequent citations:
…in value statement 4 (NMBA, 2008) it is shown that nurses…
Reference List:
Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice
Nursing and Midwifery Board of Australia. (2008a). Code of ethics for nurses
Nursing and Midwifery Board of Australia. (2008b). Code of professional conduct for nurses
https://www.blood.gov.au/haemovigilance-reporting please access this link
The National Safety and Quality Health Service Standards
The National Blood Authority, Australian haemovigilance report
please apply these standers to the above questions answers and do in text citation forexample Assessment 1, question 2, asks students to outline how
the incident is relevant to your own practice. Case
Study B raises questions about the limitations of taped
handover. An example of a relevant NMBA standard:
Code of ethics for midwives. Value statement 6:
As new graduate nurses and midwives we will rely on
handover systems that communicate changes in a
patient’s situation. This incident was an example of
unsafe handover. I want to understand how to promote
effective communication and teamwork.
