Blood Product Administration Guidelines

Project Leader: Eleanor Hendershot, MN BScN RN(EC)

Project Team Members: Jennifer Wolfeden, BSN; Siobhan McEwen, BA

Institution: Hamilton Health Sciences — McMaster Children’s Hospital | Hamilton, Ontario 

Grant Type: APHON Evidence-Based Practice Grant

Year Awarded: 2016



The administration of blood products is an essential part of the care provided to pediatric hematology/oncology patients. Various blood product administration guidelines and policies exist at local, national, and international levels to assist nurses to ensure safe practices in administration. Rate of infusion, especially for PRBC’s, as related to the potential for transfusion-associated circulatory overload (TACO) was identified as having the most inconsistencies with nurses’ practice and within the various guidelines. Patients receiving transfusions generally want to spend the least amount of time in the hospital, but it isn’t clear how quickly transfusions can be administered, especially in those receiving chronic transfusions.


Review and compare available national and international blood product administration guidelines. A literature search will be performed to gather all current and relevant research using CINHAL, PUBMED, and the evidence critically appraised. Evidence will be used to evaluate current institutional policy and procedure support. A survey will also be distributed to the C17 (Canada’s Children’s Cancer and Blood Disorders Group) Advanced Practice Nurses to determine current blood product administration practices and policies across the country. The data collected will be used to design practice change which may include policy and procedure revision and various targeted educational strategies for patients, families, and health care team. Implementation will be rolled out at the institutional level, and feedback from the multidisciplinary team about functionality will be obtained through a survey. Results will be shared at the institutional, local, provincial, national, and international levels. This will be done by way of educational rounds, poster and oral presentations, and publication in a peer-reviewed journal.


The safe administration of blood products to pediatric hematology and oncology patients is essential. Using the best evidence to ensure both safety and speed, universal guidelines will be developed.