1. REVIEW OF BLOOD/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 Products Consent for Refusal of Blood/Blood Products  The consent is two parts. I. Informed consent II. 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