Recommendation Rec(2004)18
    of the Committee of Ministers to member states
    on teaching transfusion medicine to nurses

    (Adopted by the Committee of Ministers on 15 December 2004
    at the 909th meeting of the Ministers' Deputies)

    The Committee of Ministers, under the terms of Article 15 b of the Statute of the Council of Europe;

    Considering that the aim of the Council of Europe is to achieve greater unity between its members and that this aim may be pursued inter alia by the adoption of common action in the health field;

    Taking into account Resolution No. R (78) 29 on harmonisation of legislation of member states relating to removal, grafting and transplantation of human substances;

    Recalling also its Recommendations Nos. R (80) 5 concerning blood products for the treatment of haemophiliacs, R (81) 14 on preventing the transmission of infectious diseases in the international transfer of blood, its components and derivatives, R (84) 6 on the prevention of the transmission of malaria by blood transfusion, R (85) 12 on the screening of blood donors for the presence of AIDS markers, R (86) 6 on guidelines for the preparation, quality control and use of fresh frozen plasma (FFP), R (88) 4 on the responsibilities of health authorities in the field of blood transfusion, R (95) 14 on the protection of the health of donors and recipients in the area of blood transfusion, R (95) 15 on the preparation, use and quality assurance of blood components, R (96) 11 on documentation and record-keeping to guarantee the traceability of blood and blood products especially in hospital, and Rec(2002)11 on the hospital's and clinician's role in the optimal use of blood and blood products;


    – the importance of blood components in modern haemotherapy and the need to ensure their safety, efficacy and quality;

    – that such components are of human origin and that hence specific ethical and technical principles have to be taken into account;

    – that biotechnology does not provide substitutes for most blood products;

    – the need to provide health authorities, transfusion services, hospital blood banks and clinical users with a set of guidelines for the preparation, use and quality assurance of blood components;

    – that the safety of blood transfusions (which must be prescribed by doctors) depends largely on the nursing staff involved in transfusions in hospital or at home, or working in blood establishments or in other specialised fields such as autologous blood transfusion and bone marrow transplantation;

    – that the majority of serious adverse reactions and untoward events associated with blood transfusion which can result in serious morbidity or mortality are caused by human and system errors in the whole blood transfusion chain;

    – that such complications can be avoided or reduced by the application of safety measures before and during transfusion;

    – that adequate training of nurses is a key determinant for ensuring the safety, efficacy, and quality of blood transfusions,

    Recommends that the governments of member states take all necessary measures and steps to ensure that:

    1. all nurses receive training in blood transfusion;

    2. only nurses who have been trained and have specific qualifications in blood transfusion medicine are allowed to practice it;

    3. nurse training curricula reflect the requirements of modern transfusion medicine and other specialised fields of medicine such as oncological and haematological disorders, surgical procedures, autologous donation of blood, as well as bone marrow and organ transplantation;

    4. implementation and evaluation of continuous training programmes is carried out in order to improve the quality and safety of blood transfusion;

    5. mechanisms are developed for the cooperation between nurses, physicians, and other health care workers employed in hospitals, blood establishments, and hospital blood banks;

    6. procedures are set up to monitor knowledge of key processes, such as clinical audit, with ongoing feedback and implementation of remedial action, to ensure continuous improvement in performance;

    7. guidelines and procedural protocols on blood transfusion medicine for the nursing staff and other professionals are developed in accordance with relevant Council of Europe recommendations.



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