Deliberate practice module

## Practice the decisions that make MTP safer.

You will learn the core MTP process first, pick your department, build the response step by step, check yourself against high-risk traps, and finish with a practical next step.

### By the end, you should be able to:

1. 1Recognize a department-specific hemorrhage trigger and name the immediate priorities.
2. 2Activate the Thompson MTP workflow, including Blood Bank communication and role clarity.
3. 3Prevent common product safety errors: platelets through warmer or rapid infuser, wrong cooler temperature, missing T&S safeguards.
4. 4Close the loop with transfer, discontinuation, documentation, and a focused debrief.

### How this works

- AReview the core MTP workflow in plain language.
- BChoose the department closest to your work area.
- CWork through ordering, matching, and decision checks before revealing the expected actions.
- DComplete a final reflection to close the module.

Learning stance: slow is smooth here. The goal is not to click through. The goal is to rehearse the moment when you would speak up, call Blood Bank, check the cooler, or stop an unsafe product setup.

Optional guided audio

Use the listen buttons when you want the case read like a tabletop facilitator. The written content still carries the full module.

Audio ready.

Step 1 of 6

## First, learn the MTP process.

Use this section to review the shared MTP workflow before you practice a scenario. The goal is to make the steps, roles, product handling, and Blood Bank communication clear enough to use on shift.

### Core adult MTP workflow

1. 1Recognize hemorrhagic shock or impending massive blood loss. Escalate early. Do not wait for perfect labs when the patient is unstable.
2. 2Activate and call Blood Bank x6544. Give patient name, DOB, MRN, location, and unit phone. Activation is the MTP workflow/call; provider blood product orders and documentation are separate follow-through steps.
3. 3Send Type and Screen immediately. Blood Bank needs a T&S specimen to provide type-specific products. Use the correct pink-top tube and patient label/collection details. If no historical type is available, collect initial and confirmatory specimens at different times.
4. 4Assign transport. A runner/designee brings the patient label to Blood Bank, picks up products, and returns directly to bedside. Transport of blood products is the treatment team's responsibility.
5. 5Know the product release pattern. PRBCs and cold-stored platelets travel in the cooler. FFP is thawed at 37 C and released separately/as available, often 2 units at a time. Shipment patterns alternate until MTP is discontinued.
6. 6Check temperature before use. MTP cooler temperature must be 1-10 C and cannot exceed 10 C. If the cooler is above 10 C, do not use the products; call Blood Bank and return the cooler/products.
7. 7Administer products by rule. PRBC and FFP may use a blood warmer or rapid infuser. Platelets and cryoprecipitate must not go through a warmer, rapid infuser, or pressure setup. CSP platelets have a bright yellow sticker; cryoprecipitate is room temperature.
8. 8Verify and document every unit. Use two patient identifiers, sign the tag, make sure emergency release paperwork is signed by the provider, document unit numbers, start/stop times, totals, and vital signs at least every 15 minutes during active MTP.
9. 9Discontinue deliberately. Clinician or designee notifies Blood Bank when MTP stops. Return remaining products/cooler and complete paperwork. Policy also allows discontinuation if no products are picked up/requested for more than 1 hour.

### Department differences to remember

- OBCall OB MTP early. OB guidance flags patients requiring 2 units PRBC in 2 hours, especially with ongoing bleeding/instability. OB MTP may be initiated by the nurse or attending.
- OBInitial OB release is 2 units O-negative or type-specific blood depending on T&S status. OB Shipment 1 is 4 RBC in cooler, 4 thawed plasma that may arrive as two 2-unit deliveries, and 1 CSP in cooler or SDP in basin. OB Shipment 2 is 4 RBC in cooler, 4 thawed plasma that may arrive as two 2-unit deliveries, and 1 cryoprecipitate in basin.
- EDED does not use a chart order named MTP. Activation happens through the ED workflow/Blood Bank call; the provider completes cooler paperwork and places transfusion/product orders after the fact.
- EDEmergency uncrossmatched blood: female patients receive 2 units O-negative; male patients may receive O-positive or O-negative until Type and Screen reaches Blood Bank.
- AllIf products are not picked up/requested for more than 1 hour, policy allows the MTP to stop. Do not leave Blood Bank guessing; call when discontinuing.

References included in this package: adult and obstetric MTP clinical practice guideline PDFs are attached for policy review. The scenarios translate those steps into unit-specific practice.

Adult policy PDF OB policy PDF
Step 2 of 6

## Choose your department scenario.

The core safety principles repeat across departments, but the first 5 minutes look different. Pick the setting you want to rehearse today.

Step 3 of 6

## Pre-brief

### Before the clock starts

Scenario audio

Audio ready.

### Department differences

### Confidence check

Before this case, how confident are you that you could help activate and manage MTP in this setting?

1 = not confident. 5 = very confident.

Scenario

## Scenario

### Phase

Case audio

Audio ready.

### Build the response

### Practice rhythm

- 1Name the emergency in plain language.
- 2Say what you would do first and why.
- 3Compare your answer to the expected actions.
- 4Answer the quick check before moving on.

### Expected actions

### Common miss to watch for

### Policy and workflow details to keep

Facilitator takeaway

Audio ready.

### Quick check

Step 5 of 6

## Debrief your own performance.

The goal is transfer to practice. Before completion, turn the case into something you can use on shift.

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Scenario completed

### Keep these anchors

### Post-confidence

After the case, how confident are you now?

This is for your own reflection and LMS completion only.

### Transfer note

Module complete

## Good. You rehearsed the unsafe moments before they happen.

Your completion has been recorded if this module is running inside an LMS. You can restart with another department, or close the module.

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Scenario

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