The National Blood Authority (NBA) has developed a guide to single unit transfusion based on the national Patient Blood Management Guidelines. The National Safety and Quality Health Service Standard 7: Blood and Blood Products require blood and blood product policies and procedures to be consistent with national evidence based guidelines for pre-transfusion practices, prescribing and clinical use of blood and blood products. The guide describes reasons why single unit transfusion is beneficial to patients and includes resources to assist with its implementation.
The International Society for Blood Transfusion defines single unit transfusion as “in the non-bleeding patient, single-unit transfusion refers to a standard dosing scheme of one unit of red blood cells, followed by an assessment of the patient’s signs and symptoms to determine whether additional units are indicated.”1
A single unit transfusion policy can ensure the safety and efficacy of red blood cell transfusion by confirming every unit transfused is a clinical decision where the expected benefit outweighs the risks.
The single unit transfusion guide and accompanying resources have been designed with the intention that they can easily be adapted to accommodate the local policies and practice of individual hospitals. They are available as generic baseline material to download, alter, and adapt as applicable to their local requirements.
Implementation of a single unit transfusion guideline by health providers is encouraged as a patient quality improvement measure, but is not mandatory.
The aim of this initiative is to assist local champions to implement a single unit transfusion guideline in their hospital setting. The guide has been developed in accordance with the Patient Blood Management Guidelines and in line with National Safety and Quality in Health Service Standard 7: Blood and Blood Products.
The single unit transfusion guide was written in consultation with a technical writer and reviewed by a clinical cross-jurisdictional group before being available for a four-week public consultation period.
Please feel free to adapt, alter and re-badge the single unit transfusion guide and resource material as applicable to your local area.
Guide (includes Appendixes 1, 2 and 3 only):
- Single Unit Transfusion Guide Summary June 2014 (pdf) (897.74 KB)
- Single Unit Transfusion Guide Summary June 2014 (docx) (2.64 MB)
Additional Resources (Appendixes 1 to 6):
- Appendix 1: Example Clinical Guideline Format (pdf) (167.61 KB)
- Appendix 1: Example Clinical Guideline Format (docx) (179 KB)
- Appendix 2: Consideration and Guidance for Implementation (pdf) (137.39 KB)
- Appendix 2: Consideration and Guidance for Implementation (docx) (49.75 KB)
- Appendix 3: Example Handout (pdf) (109.95 KB)
- Appendix 3: Example Handout (docx) (40.03 KB)
- Appendix 4: Example PowerPoint Presentation (pdf) (118.91 KB)
- Appendix 4: Example PowerPoint Presentation (pptx) (2.35 MB)
- Appendix 5: Example Newsletter (pdf) (348.68 KB)
- Appendix 5: Example Newsletter (docx) (1.01 MB)
- Appendix 6: Example Posters (pdf) (1.41 MB)
- Appendix 6: Example Posters (docx) (2.65 MB)
1Adapted from the International Society for Blood Transfusion (ISBT) https://www.isbtweb.org/working-parties/clinical-transfusion/6-single-unit-transfusion/
The National Blood Authority extends their appreciation to NSW Health Pathology - North (Hunter) for their involvement in the development of this guideline. In particular the NBA would like to acknowledge the contribution and expertise of Ms Vicki Martens, Senior Hospital Scientist, NSW Health Pathology - North (Hunter).
Single Unit Transfusion Decision Support Tool
The Single Unit Transfusion Decision Support Tool supports the Single Unit Transfusion Guide and is designed to assist clinicians with appropriate prescribing of red blood cells. The Single Unit Transfusion Decision Support Tool underwent a 6-week public consultation period.
Please note: the Single Unit Transfusion Decision Support Tool based on the national Patient Blood Management Guidelines and is not mandatory. Feel free to use this version or create your own adaptation. If you develop your own version, please remove the National Blood Authority logo and note in your references ‘Adapted from the Single Unit Transfusion Decision Support Tool, National Blood Authority 2023’.
- Article published in ACORN Journal: "Patient Blood Management for the perioperative setting. Why do we need patient blood management guidelines in the perioperative clinical area?" (514.15 KB)
- Sir Charles Gairdner Hospital poster “Transition from Transfusion: The Implementation of a Patient Blood Management Program” (1.58 MB) and flowchart "Patient Blood Management Decision to Transfuse" (228.91 KB)