Consent for Blood Transfusion
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1 Consent for Blood Transfusion Vicki Davidson Transfusion Practitioner
2 Consent It is a general legal and ethical principal that valid consent should be obtained from a patient (or parent/guardian) before treatment is given
3 What is valid consent? The patient must be competent (have capacity) *Every adult patient is presumed competent unless proven otherwise *An unwise or eccentric decision does not mean incompetence The patient must have received sufficient information to make an informed decision *To include details on the risks, benefits and available alternatives Consent should be seen as a process, rather than a one off event What information would you give?
4 Hepatitis RISKS HIV Adverse reaction Clinical errors Bacterial Infection vcjd Treatment for leukaemia/cancer To feel better To save life BENEFITS Relief from symptoms of anaemia Cell salvage ALTERNATIVES Iron therapy Minimise blood loss
5 Please remember. Compared to other everyday risks, the likelihood of getting an infection from a blood transfusion is very low The risk of viral infections is extremely low - there is a rigorous process for selection of donors and testing Clinical and laboratory error is a known risk of transfusion
6 Children and consent Children and young people should be involved as much as possible in decisions about their care Children under the age of 16 are not deemed to be automatically legally competent to give consent
7 Lack of competence Where a patient is deemed to lack competence then a best interest decision will be made Where possible, treatment decisions will be made based on any available knowledge of a patient s previously expressed wishes Can you think of any examples of how we may determine these wishes in a patient who lacks capacity?
8 Determining a patient s wishes Advanced decision Views previously expressed by patient Patient s wishes known by close relatives Religious beliefs The final decision must be based on the best interests of the patient
9 The right to refuse An adult patient has the right to refuse a blood transfusion or blood product Reasons for refusal can vary and include religious beliefs The patient must fully understand the risks of NOT having the transfusion Again, it is important to clearly document the patient s wishes
10 Information leaflets to aid your discussion and ensure standardised information
11 For parents and children too..
12 Check understanding Use language the patient is likely to understand Avoid jargon and medical terms Encourage the patient to ask questions Information leaflets are available in a variety of languages An interpreter may be necessary
13 Documentation - as important as ever! Please remember to document any discussions regarding consent for transfusion in the patient s medical records The patient is not legally required to sign a consent form
14 Retrospective consent Patients who cannot give consent at the time of transfusion should be informed that they have received a transfusion in retrospect As a precaution to reduce risk of Creutzfeldt-Jakob Disease (vcjd), people who have received a blood transfusion since 1980 are not able to donate
15 Sources of essential information Advisory Committee on the Safety of Blood, Tissues, and Organs (SaBTO) Recommendations on consent for blood transfusion General Medical Council (GMC) Consent guidelines NHS Blood and Transplant (NHSBT) Patient Information leaflets Learn Blood Transfusion E-learning package on consent Serious Hazards of Transfusion (SHOT) UK reporting on adverse events and reactions
16 Any questions.
Consent for Blood Transfusion and Patient Information. Alister Jones PBM Practitioner, NHSBT Mothers, Babies and Blood. January 27 th 2016
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