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Annual Shot Report 2011

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Annual Shot Report 2011 Affiliated to the Royal College of Pathologists AnnuAl The Steering Group includes members representing the following professional bodies: British Blood Transfusion Society Royal College of Nursing British Society for Haematology Royal College of Midwives SHOT British Society of Gastroenterology Royal College of Obstetricians and Gynaecologists Royal College of Physicians British Committee for Standards in Haematology Royal College of Surgeons Faculty of Public Health Report Royal College of Paediatrics and Child Health Institute of Biomedical Science Intensive Care Society Health Protection Agency Faculty of Intensive Care Medicine (Health Protection Services Division) The College of Emergency Medicine NHS Confederation Defence Medical Services Royal College of Anaesthetists UK Forum ANNUAL SHOT REPORT 2011 Serious Hazards of Transfusion (SHOT) Steering Group Chair Dr Hannah Cohen SHOT Medical Director Dr Paula Bolton-Maggs Operations Manager Ms Alison Watt Research Analyst Ms Debbi Poles Transfusion Liaison Practitioner Mr Tony Davies Clinical Incidents Specialist Mrs Julie Ball Laboratory Incidents Specialists Mrs Hema Mistry Mrs Christine Gallagher National Coordinator for Ms Claire Reynolds Transfusion Transmitted Infections Dr Su Brailsford (Health Protection Agency) Working Expert Group (WEG) & Writing Group, on behalf of the SHOT Steering Group Chair: Dr Paula Bolton-Maggs Dr Hannah Cohen, Ms Alison Watt, Ms Debbi Poles, Mr Tony Davies, Mrs Hema Mistry, Mrs Julie Ball, Mrs Christine Gallagher, Mrs Deborah Asher, Ms Claire Reynolds, Dr Catherine Chapman, Mrs Alexandra Gray, Mrs Joan Jones, Ms Clare Milkins, Dr Helen New, Dr Megan Rowley, Dr Fiona Regan, Dr Hazel Tinegate, Mrs Elizabeth Still, Mrs Judy Langham. Steering Group (SG) Chair: Dr Hannah Cohen Dr Shubha Allard British Committee for Standards in Haematology CMO’s National Blood Transfusion Committee Dr John Barbara Founder Member Prof Mark Bellamy The Intensive Care Society, Faculty of Intensive Care Medicine Dr Su Brailsford Health Protection Agency & Faculty of Public Health Mr William Chaffe UK Transfusion Laboratory Collaborative Dr Paul Clarke Royal College of Paediatrics and Child Health Mrs Sarah Corcoran Clinical Risk Manager Dr Heidi Doughty Defence Medical Services Prof Adrian Evans The College of Emergency Medicine Dr Patricia Hewitt Consultant Specialist in Transfusion Microbiology, NHSBT Ms Joanne Hoyle Royal College of Nursing Ms Mervi Jokinen Royal College of Midwives Mrs Joan Jones Institute of Biomedical Science; Clinical Advisory Group, Wales Mrs Judy Langham Medicines and Healthcare products Regulatory Agency Dr Sue Knowles Former Interim Medical Director of SHOT Dr Elizabeth Love Former National Medical Coordinator of SHOT Prof John S P Lumley Founder Member Dr Sheila MacLennan UK Forum Dr Brian McClelland Founder Member Joanne McIntyre Lay Member Dr Kieran Morris Royal College of Pathologists; Northern Ireland Regional Transfusion Committee Dr Andrew Mortimer Royal College of Anaesthetists Dr Tim Nokes British Society for Haematology Dr Derek Norfolk Founder Member Dr Sam Rawlinson Scottish Clinical Transfusion Advisory Committee Mr John Saxby NHS Confederation Ms Bhavna Sharma Royal College of Obstetricians and Gynaecologists Dr Dorothy Stainsby Former National Medical Coordinator of SHOT Dr Kevin Stewart Royal College of Physicians Dr Clare Taylor Former SHOT Medical Director Dr Andrew Thillainayagam British Society of Gastroenterology Dr Dafydd Thomas British Blood Transfusion Society; Steering Group Chair elect Mr John Thompson Royal College of Surgeons Dr Lorna Williamson Founder Member NB. All members of the WEG are members of the Steering Group in their own right. ANNUAL SHOT REPORT 2011 Requests for further information should be addressed to: Non-infectious hazards Infectious hazards SHOT Office Ms Claire Reynolds Manchester Blood Centre Clinical Scientist Plymouth Grove Health Protection Agency Manchester 61 Colindale Avenue M13 9LL London NW9 5EQ Tel +44 (0) 161 423 4208 Tel +44 (0) 20 8327 7496 Fax +44 (0) 161 423 4395 Fax +44 (0) 20 8200 7868 Website www.shotuk.org Email [email protected] Enquiries [email protected] Email [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] Copyright notice Please cite this work as: PHB Bolton-Maggs (Ed) and H Cohen on behalf of the Serious Hazards of Transfusion (SHOT) Steering Group. The 2011 Annual SHOT Report (2012) This work was undertaken by SHOT. The work was funded by NHS Blood and Transplant, Northern Ireland Blood Transfusion Service, Scottish National Blood Transfusion Service and the Welsh Blood Service through the UK Forum. All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of SHOT, or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK (www.cla.co.uk). Enquiries concerning reproduction outside the terms stated here should be sent to SHOT at the address printed on this page. Making duplicate copies of this Report, or use of the data within, for legitimate clinical, scientific, educational or other non- commercial purposes is permitted provided that SHOT is identified as the originator of the information. Making alterations to any of the information contained within, or using the information in any other work or publication without prior permission, will be a direct breach of copyright. The use of registered names, trademarks etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulation and therefore free for general use. Copyright © Serious Hazards of Transfusion (SHOT) 2012 Published July 2012 ISBN 978-0-9558648-4-1 Contents Page Chapter 5 1. Foreword – Paula Bolton-Maggs and Hannah Cohen 7 2. Participation in SHOT Haemovigilance Reporting Scheme – Debbi Poles and Paula Bolton-Maggs 12 3. SHOT Updates and Developments – Paula Bolton-Maggs and Hannah Cohen 16 4. Summary of Main Findings and Cumulative Results – Paula Bolton-Maggs and Hannah Cohen 21 5. Key Messages and Recommendations – Paula Bolton-Maggs and Hannah Cohen Analysis of Cases Due to Errors 26 6. Incorrect Blood Component Transfused (IBCT) – Julie Ball and Paula Bolton-Maggs 35 7. Errors Related to Laboratory Practice – Deborah Asher and Hema Mistry 53 8. Errors Related to Information Technology (IT) – Megan Rowley 64 9. Inappropriate, Unnecessary or Under/Delayed Transfusion (I&U) – Julie Ball and Paula Bolton-Maggs 74 10. Right Blood Right Patient (RBRP) – Alexandra Gray 77 11. Handling and Storage Errors (HSE) – Alexandra Gray 82 12. Adverse Events Related to Anti-D Immunoglobulin (Anti-D Ig) – Tony Davies Analysis of Cases Due to Pathological Reactions 92 13. Acute Transfusion Reactions (ATR) – Hazel Tinegate and Fiona Regan 101 14. Haemolytic Transfusion Reactions (HTR) and Alloimmunisation – Clare Milkins Pulmonary complications: 110 15. Transfusion-Related Acute Lung Injury (TRALI) – Catherine Chapman 114 16. Transfusion-Associated Circulatory Overload (TACO) – Hannah Cohen 119 17. Transfusion-Associated Dyspnoea (TAD) – Hannah Cohen 123 18. Post-Transfusion Purpura (PTP) – Catherine Chapman 126 19. Transfusion-Associated Graft Versus Host Disease (TA-GvHD) – Catherine Chapman 128 20. Transfusion-Transmitted Infection (TTI) – Claire Reynolds 133 21. Cell Salvage and Autologous Transfusion (CS) – Joan Jones Special Clinical Groups 138 22. Paediatric Cases – Helen New 147 23. Transfusion Complications in Patients with Haemoglobin Disorders – Paula Bolton-Maggs 152 24. MHRA Regulatory Haemovigilance – Judy Langham 165 25. Near Miss (NM) Reporting – Alison Watt 178 Acknowledgements 179 References 184 Glossary 1. Foreword Authors: Paula Bolton-Maggs and Hannah Cohen The 15th Annual SHOT Report is compiled from data received between January and December 2011 by the SHOT UK national haemoviligance scheme. We are approaching universal participation with 98.4% of National Health Service (NHS) Hospitals, Trusts and Health Boards across the UK now being registered to report to SHOT. Registrations for independent organisations have also increased. The number of reports has increased to a total of 3038 in 2011 (this total includes ‘near miss’ and ‘right blood right patient’ events which by definition caused no harm) which represents an increase in analysed reports of 23.3% (3038 vs 2464) compared to the 2010 Annual Report. This year we have also received a small number of reports which refer to more than one patient, which brings the total cases analysed to 3054 overall. These multiple reports are detailed further in the Anti-D and Handling and Storage Errors (HSE) chapters. We are pleased that for the second year that there have been no cases of transfusion-transmitted infections (TTI) and also that the reduction in transfusion-related acute lung injury (TRALI) since 2003/2004 has been maintained. However, the reduction in incorrect blood components transfused resulting from clinical and laboratory errors has not been maintained and causes for this are discussed. The increased participation is pleasing, both in terms of numbers of organisations and numbers of reports. Benchmarking data are now presented in the report, and have been sent out to participating establishments so that they can compare their rates
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