Checking process Flashcards
how do the nurses check
The checking process – which involves the identity checks of the patient, the prescription and the blood product – must be carried out at Nathan’s side by two trained staff members. Each person must carry out the check independently to prevent the other assuming their colleague is responsible for getting it correct – both are accountable.1
What do you check
Right patient
Patient identification details are confirmed by asking the patient to:
state and spell their full name
state their date of birth.
These details are used to check the identification band worn by the patient. The patient’s full name, date of birth and medical number are then checked against the prescription and the patient compatibility label on the pack.1
Right prescription
Check that the following details on the prescription match the pack:1
type of blood product eg red cells
special requirements, eg CMV negative.
Right pack
Check that the pack label and the patient compatibility label match for:1
donation number
blood group
expiry date.
Once red cells are removed from a blood fridge they should be
commenced within 30 minutes
transfused within 4 hours.
Medical record
You answered:
- Any follow-up required
- Observations during the transfusion and at completion
- Blood pack donation numbers
- Outcome of the transfusion
- Time of commencement and completion of each unit
- Volume of blood transfused
She quickly becomes breathless and anxious.
What is the first thing you should do?
Stop the transfusion
If she deteriorates, calling an emergency code and administering oxygen may be appropriate, while waiting for a medical review. This should be done in accordance with your hospital policy for emergency codes.
Beryl’s symptoms of acute respiratory distress, hypotension and a generalised urticarial rash1 are suggestive of a
severe allergic reaction.
As Beryl is having a severe allergic reaction it would be appropriate to give
antihistamines and corticosteroids, plus adrenaline (epinephrine)
if there was significant haemodynamic compromise or respiratory distress. This should be done in accordance with your hospital’s anaphylaxis protocol. Supporting blood pressure and maintaining an open airway is also vital.
Inducing diuresis with fluids and diuretics will assist with maintaining renal output in patients who have an acute haemolytic reaction.
Patients who have suspected transfusion-transmitted bacterial infection are usually commenced on broad spectrum antibiotics once blood cultures have been taken.3
