The role of the transfusion practitioner in Australia

Abstract

Transfusion is a complex process involving many interlinking chains of events and a multidisciplinary group of health professionals, of which the transfusion practitioner (TP) is an integral part of the chain. The hospital based TP role commenced in 2002 in 2 states of Australia, and has expanded across the country. Currently there are 113 dedicated TP positions and many more staff involved as blood/transfusion champions. There are also 12 TP positions within the Australian Red Cross Blood Service (the Blood Service). Over time both of these TP roles have evolved to meet the changes within the Australian blood sector. The primary focus of safety and appropriateness has now evolved to be more patient-centred by incorporating patient blood management (PBM) initiatives. National PBM guidelines1, statements, strategies, criteria and healthcare standards2 specifically focused on all aspects of transfusion have influenced this evolution. The roles and activities that are undertaken by the TP are diverse, and vary significantly between health services, and within each state and territory. In some states specific PBM roles have been established, while in others these aspects are incorporated into the TP role, or could be undertaken with collaboration by other specialist areas, such as pre-anaesthetics/pre-admission teams. The PBM activities could include being a resource consultant, a member of the multi-disciplinary team for managing anaemia and/or providing support or conducting anaemia clinics. Within the Blood Service the role of the TP is considerably different to the hospital role, with the primary focus of facilitating specialist blood product support. Education remains a fundamental component of the TP role and there are many varied ways that the education is conducted; including the use of online e-learning (local/ national), competency- based assessment, simulation scenarios and face to face presentations. Governance activities are also a key aspect of the role, encompassing policy/clinical guideline development, activities supporting consent, auditing and reporting to meet national safety, appropriateness and haemovigilance requirements. Currently in Australia the management of unnecessary blood wastage is a focus and many TPs are actively working with laboratories to understand the reasons for waste, and then implement strategies to assist in waste reduction. Effective communication and change management skills are integral to the success of the role. Education available in Australia to support the TP role and others working in the area including the Graduate Certificate in Transfusion Practice, BloodSafe eLearning Australia and an extensive range of learning experiences offered by the Blood Service. In this tight economic environment there is constant pressure in all states regarding the funding of these positions. Summary: Promotion of safe and appropriate transfusion remains the central focus of the TP role with a variety of other responsibilities such as governance, education, haemovigilance, promotion and implementation of PBM strategies. The TP is recognised as a key role within the transfusion team and the role continues to evolve with the changes in the Australian blood sector.<br />