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Serious Transfusion Incidents Reporting System
Page contents: Overview | How to report? | Support tools | Reports | National Blood Authority – National Haemovigilance Project | Transfusion Outcomes Research Collaborative
Overview
The Blood Matters Serious Transfusion Incidents Reporting System (STIR) is a central reporting system for serious adverse events with transfusion of fresh blood or blood components including near-miss incidents preceding transfusion. For more information on categories of reportable events see the STIR guide below.
How to report?
Contact Blood Matters for a hospital code if this is your first report.
Telephone: (61 3) 9096 0476
Email: stir@health.vic.gov.au
1. Notification eform
Serious Transfusion Incident Reporting form
2. Investigation form
This form is generated by Blood Matters upon receipt of the notification and will be sent to the email details outlined in the notification form.
Confidentiality of data is fundamental to the success of this scheme. We have not requested unique patient identification details except age. We will contact you to obtain additional details if necessary.
Support tools
Serious Transfusion Incident Reporting (STIR) guide
Or alternatively, you can view the Essential Elements of STIR presentations with written narrative below:
Essential Elements of STIR Part 1
Essential Elements of STIR Part 2
A printable notification form can be downloaded when you are unable to access the e form and is located below:
Serious Transfusion Incident Reporting form
If you have any issues or queries please contact:
Blood Matters Program
Telephone: (61 3) 9096 0476
Email: stir@health.vic.gov.au
Reports
Data collected from 1 January 2008 to 30 June 2009 has now been collated and analysed. The report presents case studies and recommendations for improvements in transfusion practice. The Serious Transfusion Incident report 2008-09 is now available.
Serious Transfusion Incident Report 2008-2009
Serious Transfusion Incident Report 2006-2007
National Blood Authority – National Haemovigilance Project
This project involves developing the reporting and governance frameworks for a voluntary haemovigilance program for Australia. It will report on serious transfusion related adverse events occurring in public and private hospitals.
The primary aim of an Australian Haemovigilance program is to improve transfusion safety and quality by collecting, analysing, and disseminating information on a common set of adverse events surrounding the transfusion of labile blood and blood products. Trends will be identified, and recommendations to improve transfusion outcomes based on the data will be developed.
Initial Australian Haemovigilance Report (2008) released February
The report provides (limited) data on the types of adverse transfusion events that have been reported in some healthcare reporting systems over the past 3-5 years in Australia. It will also be used to assist development of a framework for the future Australian Haemovigilance program.
Copies of this report can be ordered through the National Blood Authority website.
The Australian Haemovigilance Report 2010 has been developed by the NBA in conjunction with the Haemovigilance Advisory Committee (HAC), and describes adverse transfusion events reported in a number of States and Territories during July 2008 – June 2009.Copies of this report can be ordered through the National Blood Authority website.
Transfusion Outcomes Research Collaborative
Jeffcott S and Phillips LE: Reducing Harm in Blood Transfusion: Investigating the human factors behind ‘Wrong Blood in Tube’ (WBIT) events in the Emergency Department.
This document outlines a descriptive study of factors impacting the ability to follow best practice in specimen labelling and patient identification, both of which are major causes of Wrong Blood In Tube (WBIT) events. The study was undertaken by the Transfusion Outcomes Research Collaborative and the report prepared for the Victorian Managed Insurance Authority, July 2010.
Further information on the Transfusion Outcomes Research Collaborative can be located at http://www.torc.org.au/
