BloodSafe – From Project to Practice in South Australia

BloodSafe is a joint initiative between the South Australian (SA) Department of Health, Australian Red Cross Blood Service, hospitals and transfusion service providers. It has successfully established quality assurance programs to improve the safety and quality of blood management practice within the SA health system. BloodSafe began as a project in September of 2002 initially with 12 months funding from the Safety and Quality Council. Four Transfusion Nurse Consultants were appointed across five major metropolitan teaching hospitals. Audit of practice within these hospitals demonstrated three major problem areas‐ transfusion specimen collection, the decision to transfuse and administration of blood. A further 12 months funding was granted including extension of the project to include a Nurse Educator for the state to introduce initiatives into country and private hospitals. Reaudit of practice after interventions and education demonstrated that the Transfusion Nurse Consultants were effective change agents. In particular red cell use outside the NHMRC/ASBT guidelines fell from 18% to 4%(p < 0.01) in stable adult orthopaedic patients audited. A number of other important aspects of transfusion practice also showed significant improvement including documentation, consent and administration. Recurrent funding for BloodSafe Transfusion Nurse Consultants was granted by the SA Department of Health from July 2004. Factors contributing to the success of BloodSafe include a multidisciplinary team, Transfusion Nurses of clinical nurse consultant level, demonstration of a clear need for the initiatives, evidence of successful practice improvement, statewide collaboration and interventions, benchmarking across hospitals, and impartiality of the BloodSafe name with acceptance by stakeholders.