A colleague in Denmark reports that he recalls the Mayo Clinic has had a long experience with a 'dedicated blood administration team', and he wonders if that is still the case, and if other institutions have similar teams. He also wonders how such teams are staffed around the clock, and if they are involved with transfusions in the OR, the ER, or other areas. He reports that colleagues in Denmark are discussing the relative virtues of performing intensive teaching of nursing staff (which would involve around 3000 nurses) versus establishing transfusion teams at hospitals. Lectures would be supplemented by extensive "e-learning programs" that would issue a competency certificate to nurses who succesfully work their way through the program. It is the intention to have the e-learning part as an obligatory exercise for everyone involved in blood administration. They are wondering which way to go - for improved patient safety along with an eye on cost/benefit.

Dr. Breanndan Moore of the Mayo Clinic, Rochester (attribution used with permission) confirms that they still have an I.V./Transfusion Team of nurses and I.V. techs which is administratively under the Dept of Nursing, but which is under the medical direction of the Transfusion Medicine Division. That team administers all blood and component transfusions that take place outside of the operating rooms and in a few selected I.C.U.s ( for example, the Cardiac Surgery Post Anesthesia Room -P.A.R.) In those I.C.U.s, only certain nurses are permitted to transfuse blood and those designated nurses are specially trained and regularly assessed for competency by the IV/Transfusion Team. In the O.R. administration of blood is handled by anesthesiologists or Nurse anesthetists who also get special training in transfusion medicine. All outpatient transfusions are also administered by the IV/Transfusion Team. Approximately 50% of all blood is given in the O.R./ P.A.R. setting. Dr. Moore acknowledges that at times they debate the question of the true value of having a dedicated transfusion team ...usually as a result of some Department or Institutional push for cost containment. Each time they have reviewed the issue they reportedly have concluded that the superb transfusion safety record of the team is a major and indeed, decisive factor in the conclusion that they should maintain its existence. No doubt, with advancing technological capabilities for patient, blood sample, blood bag identification and matching, (e.g. RFID) the incremental safety "edge" of having the special transfusion team will come up for discussion again in the future, but the current practice at Mayo Clinic, Rochester is as outlined above.

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Ira A. Shulman, MD
CBBS e-Network Forum Editor & Moderator