Requirements for Issuing Blood Products?

We've been working hard on training for emergency release for all nurses. Every new hire comes into the lab and gets a pep talk from me and our medical director about emergency release, mass transfusion, observing closely for transfusion reaction and patient safety/patient ID. We include emergency release and mass transfusion because these requests can come from almost anywhere before a patient is transferred to the OR or ICU. Included in the discussion is expected turn around times. We give them 5-10 minutes, depending on how many questions are asked. This is in addition to the education they get as a new hire, which includes all of those topics. Annual skills assessment for all nurses also includes these topics. It is starting to pay off. (Ironically, the department that struggles the most with this is the ED.) If we get 'excited' requests for blood 'right now' out of the blue, we also offer uncrossmatched blood and make it clear that the provider has to sign for it. If they take us up on that we know it's serious.

How did we get this to happen? - occurrence reports that brought problems to the attention of nursing management and the involvement of Quality.