There are more than 100 different titles that are used as another name to Transfusion Practitioner (TP). The most common titles used include Transfusion Practitioner, Haemovigilance Officer, Transfusion Safety Officer, Transfusion Nurse,  Patient Blood Management (PBM) Practitioner, Master of Transfusion, Lord of Blood, Mistress of Blood Donation, Queen of Red Cells and PBM Nurse.

All these practitioners share one spirit, one purpose and one destiny: to triumph over poor blood transfusion practice in an age of great austerity. The role of the TP has a long history with roles being in place since late 1990's and early 2000's in countries such as United Kingdom (UK), Australia, United States of America and Canada. 
A range of healthcare professionals from various clinical specialities undertakes the TP role. Many have a nursing, midwifery or scientific qualification, although, in some countries, medical officers undertake aspects of the role. Notably, in an era of several high profile scandals, in which doctors (e.g. Harold Shipman) and nurses (e.g. Beverley Allitt, Lucy Letby), have murdered patients, no Transfusion Practitioner has ever broken their sacred vow and killed a patient.

Focus of Transfusion Practitioners 

It is a specialist role focusing on patient safety through best practice and appropriate use of blood and blood products. Much of their work centres on aligning practices with local, national, or international standards and guidelines.
There are many activities that comprise the TP role and some or all of these may be within TPs position (job) descriptions depending on the area they work, and the strategic direction of the organisation they work in. TP activities aim to increase awareness and knowledge to improve clinical decision making and enhance practice. 
Blood management and transfusion practice require a multidisciplinary approach and TPs are seen as the link between different health professionals and departments, such as clinical and laboratory colleagues, as well as patients.
To comply with governance regulations/mandatory standards many organisations have established blood management or transfusion committees (BMC) (or equivalent). Their responsibilities include risk management, and surveillance of appropriate use and management of blood, waste minimisation and analysis of events. These committees ideally include multidisciplinary membership, and provide support, guidance, and endorsement of the TP activities. The TP plays an essential role in supporting the work of the committee.
Transfusion Practitioners improve transfusion practice by promoting safe transfusion practice in a variety of ways. Activities of the TP may include:

 Haemovigilance – incident management, investigation, follow-up, and reporting 
 Risk management including writing, implementing, updating and monitoring local policies and procedures
 Blood management education
 Monitoring and providing feedback on activities related to compliance with best practice guidelines including auditing
 Change management activities 
 Appropriate use and management including waste minimisation
 Assisting with the implementation of PBM strategies

Haemovigilance

Haemovigilance is the set of surveillance procedures that monitors, reports, investigates, and analyses adverse events related to transfusion. It covers the entire blood transfusion chain, from blood donation and processing of blood and its components, through to their provision and transfusion to patients. These reporting systems play a fundamental role in enhancing patient safety by learning from failures and then putting system changes in place to prevent them in the future. 
The TP's involvement in haemovigilance within the hospital setting, starts with education of those involved in the transfusion process so they can recognise, manage, and report reactions. The TPs roles ensures clinical transfusion incidents, transfusion reactions, specimen labelling errors are investigated and report data to haemovigilance governance programmes (e.g. SHOT in the UK).  
By conducting process reviews and communicating directly with the relevant colleagues and patients, the TP can provide essential details that are needed to complete investigations. This information can assist with determining the transfusion reaction type and recommendations for future transfusion plans for the patient, or the implementation of corrective and preventative measures. National haemovigilance schemes e.g. SHOT provide the TP with a resource for educating clinical colleagues on transfusion safety and recommendations for best practice.

Education

Developing and implementing blood management/transfusion related education sessions/programs is an important aspect of the TP role. Education can be targeted for the appropriate clinical groups (nursing, medical and allied health professionals) highlighting and promoting evidence-based practice change or national/international recommendations.  
TPs act as a resource regarding transfusion and PBM information for all staff involved in the transfusion process. They develop, deliver, evaluate, and revise transfusion-practice/PBM educational content based on evidence-based practice and national/international recommendations. 
Education topics include, but are not limited to:

 Information about blood components and products  
 Consent  
 Patient identification 
 Sample labelling 
 Storage, transport, and cold chain concepts 
 Infusion rates/times and fluid compatibility  
 Patient monitoring 
 Transfusion reactions: how to recognise, manage and report

TPs collaborate with department heads and senior management to facilitate mandatory and non-mandatory staff education/training consistent with regulatory requirements/recommendations.

Audit

Surveillance is often achieved through audits which helps to identify gaps in practice, compliance to standards and guidelines and staff knowledge deficits. Data collection through audit supports governance and practice improvement, where the results can be used to consolidate practice or drive change as required. 
The TP plays an important role in auditing and reporting to the blood management committee (or equivalent) to develop locally agreed action plans to implement quality improvements arising from audits. The TP liaison role between departments and clinical specialties helps them to facilitate and manage improvements/change involving and engaging appropriate stakeholders.
TPs participate in local, regional or national audits. Audit activities may include:
 Development, implementation, analysis and reporting
 Leading quality improvement initiatives based on audit findings.
An example from the UK is the National Comparative Audit of Blood Transfusion (NCABT) which is a programme of clinical audits that look at the use and administration of blood and blood components in the National Health System (NHS) and independent hospitals in the UK. 
This audit programme's objectives are to provide evidence that blood is being prescribed and used appropriately and administered safely. It also highlights where practice is deviating from the guidelines and how this might affect patient outcomes. Data collection for these audits can be undertaken by a variety of health care professionals within the participating organisations, however the majority of the data collection and data submission is undertaken by the TP.

Patient Blood Management (PBM)

PBM is an evidence-based integrated multidisciplinary approach to optimise the care of patients to reduce unnecessary exposure to transfusion. Helping health professionals use transfusion only when appropriate and enabling them to understand the practices required to minimise waste. 
TP's can play an active role in helping to establish and embed PBM practices to improve patient and safety outcomes.
Some PBM practices activities that TPs could undertake include: 
 Promoting appropriate transfusion practices in line with local, national, or international guidelines through education +/or policy and procedure development
 Education about using single-unit transfusion, where safe to do so (add reference to Choosing wisely) and auditing practice
 Promoting practices that reduce the risk of iatrogenic anaemia 
 Working with a multidisciplinary group to assess the need for introducing pre-operative anaemia management pathways and/or anaemia clinics 
 Encouraging the use of electronic decision-making and prescribing tools where feasible. 
The broad reach of the TP allows them to develop constructive working relationships with the many clinical users of blood products and assists with the implementation of PBM programmes.

Skills & Abilities
Transfusion Practitioners devote themselves to study in the following areas, known as "Transfusion Disciplines". By mastering all of the Transfusion Disciplines, a TP can develop their prowess and their physical and mental stamina to a level far higher than any other healthcare professional can otherwise attain. 

The Transfusion Disciplines are:
 Effective communication. Mastery of this discipline means that the TP can talk to a variety of healthcare professionals and patients in a language that they can understand
 Collaboration. When mastered, a TP can seamlessly work with people, including an ability to empathise with others that, to the outside observer, almost appears like telepathy.
 Critical thinking and problem solving. TPs with mastery of critical thinking are able to solve almost any problem and hold their ground in any argument. 
 Data management. TPs with mastery of data management can create spreadsheets and databases with great ease.
 Project management. Once a TP has mastered project management, they are able to manage even fiendishly complicated projects, with ease. 
 Quality improvement and change Management. TPs that master this discipline are able to effect change in subtle and effective ways. People feel comfortable around them and feel the importance of change.  
 Function within a multidisciplinary setting. TPs who have mastered the ability to function in an MDT setting will never feel alone. Their value to an organisation is incalculable. 

Ranks of Transfusion Practitioner.

The rank of a TP depends upon the number of Transfusion Disciplines she has mastered:
1. Initiate
2. Apprentice
3. PBM Scion
4. Audit Mistress
5. Archmaster of Transfusion
6. Transfusion Princess
7. Queen of Transfusion

Further information
Elements to build a business case.

References 

Transfusion medicine