Review of Blood/Blood Products Policy, Transfusion Record, Consents

1. Review ofBlood/Blood Products Policy, Transfusion Record, Consents Education Self Learning Module For any questions contact Education Resources Ext 4212

2. New Policy • Combines many policies into one. • This is a extensive policy, so there are some helps built into the policy to help you navigate quickly to the information you need • The idea is one stop shopping

3. Helpful pointers • At the beginning of the policy there is a table of contents that you can click on any subject that is in blue • The computer will take you to that section of the policy

4. New Forms • The updated policy references required forms, they are: • Consent for Blood/Blood Products • Consent for Refusal of Blood/Blood Products • Blood/Blood Product Transfusion Record

5. The Consent for Blood/Blood ProductsConsent for Refusal of Blood/Blood Products • The consent is two parts. • Informed consent • Attestation by the MD/Provider • The nurse needs to assure the consent is completed, and in the chart prior to giving the blood/blood product (except in an emergent situation) • Refusal for Blood/blood Product • If the patient refused the transfusion, the refusal sticker is still place on the chart, as with prior practice

6. Consent witnessing: • The nurse no longer witnesses or signs the consent. • This is physician’s responsibility.

7. The Consent for Blood/Blood Products • This consent is good for the entire current hospitalization • A new consent is to be used for each admission

8. Blood/Blood Products Transfusion Record • The form walks you through the process of administering the unit • Read each line carefully • Complete this form and place the top copy in the patient’s chart and the yellow copy is to be returned to the blood bank transfusion center. • Each form will be reviewed for completeness prior to separating and verified with a signature

9. Key Points • Be sure you have: • Blood issue Time and Date • Is the start time of the transfusion within 30 minutes of issue from the blood bank transfusion center? • If not, return the Blood/Blood Product to the blood bank transfusion center

10. Key Points • Make sure the consent is signed • Make sure a written order is verified for transfusion • If emergency release is necessary for uncross matched blood, MD must sign the Blood/Blood Products Transfusion Record • Verification by two qualified professionals: MD/Provider/RN, RN/RN, Transfusing RN/LPN

11. Key Points • Verification of two unique identifiers, medical record number, and name if the patient is identified • If a unidentified patient, the medical record number and account number are used

12. Key Points • Verification is to include three steps at the bedside or chair side: • Verify patient using two unique identifiers on the patient’s ID arm band • Match the above with the Blood/Blood Products Transfusion Record • Match the above to the blood unit identification information

13. Key Points • Verify the patient’s name and blood band I.D. are identical, if not do not proceed with the transfusion.

14. Key Points • Transfusion must be completed with in four hours of the time the product leaves the blood bank transfusion center

15. Vital signs • Three sets are required: • Pre (just prior to starting) • 15 minutes after starting • Post transfusion (at the time you stop) • Record the date/time transfusion is started and stopped

16. Change in LPN Scope of Practice • LPNs are now able to complete all aspects of blood and blood product transfusion EXCEPT: • Pick up the blood product from transfusion center. • Monitor the pt in the first 15 minutes after start of transfusion, including the vitals signs. • These two must be completed by an RN.

17. Key Points • The Blood/Blood Products Transfusion form includes the criteria for Transfusion Reactions • Was there a suspected reaction? Yes or No (please circle one) • If a reaction is suspected instructions are included how to proceed

18. Review of Blood Transfusion Policy • Please review the updated policy in the Indige System: PH1572 • A major change is in the re-banding procedure addressed in Section VI- Item F on page 18 of the policy. • This policy is reviewed and updated annually.

19. Competency Examination • A short examination in HealthStream has been assigned to you for verification of competency for understanding the current process at CMC for blood/blood product administration. • Please complete during allowed timeframe