Mini SHOT Symposium
Mistakes, miscommunications, missteps along the journey of a blood bag: what can we learn from these?
Day: Thursday | Time: 08:45 - 10:15
Session Coordinators:
Paula Bolton-Maggs
Speakers:
What we learn from events reported at or after blood donation
Dr Shruthi Narayan, NHS Blood and Transplant
Black box thinking applied to component testing and processing
Chris Philips, NHS Blood and Transplant
Highlights of errors at transfusion including wastage
Dr Janet Birchall, Welsh Blood Service
Oral Presentations
Near miss blood product events - technology complacency or were we really that bad?
J. Davies, Royal Devon and Exeter NHS FT, Exeter
How much of the iceberg lies below the surface? Near miss lessons from SHOT related to critical transfusion steps
Paula Bolton-Maggs, SHOT and University of Manchester
Intended Audience
All delegates
Learning Objectives
Donation is very safe but may have adverse events; errors can occur in testing and processing, and recipients may have reactions or not need the transfusion at all
Brief Description
Haemovigilance is surveillance of blood from donation to transfusion and afterwards. What can we learn from donor adverse events, component testing and processing. What are the highlight events for recipients?
Session Tags
Blood Donation, Components & Safety
Improving Patient Outcomes
Quality, Regulation & Governance
