LAB PRACTICE ASSESSMENT

BLOOD TRANSFUSION

Name : ………………………………………. Group : ……………………………

Date : ………………………………………… ID No :.
……………………………

PERFORM
No REMARK
Procedure YES NO
. S

1.
Greet and explain procedure to patient
Confirm patient’s identity by two identifiers: his/ her name;
2. registration number or identification number
Ask patient to confirm name and cross check with patient’s wrist
3. band for name and registration number.

4.
Verify accuracy of identifier with patient’s medical record.

5.
Verify doctor’s written prescription

6.
Verify consent is already taken by the doctor.

7.
Confirm blood reservation.

8.
Obtain blood from blood bank in accordance with agency policy.
Prior transfusion: -
 Leave blood pack at room temperature for 10mins.
9.  Commence blood transfusion within 30 minutes upon receiving
blood.
VERIFY RIGHT BLOOD / BLOOD COMPONENT FOR THE
RIGHT PATIENT WITH THE DOCTOR
Verify accuracy of identifier with patient’s medical record and blood
10. request form, this include patient’s identity card number.
Confirm the right blood / blood components by verifying the labels
11. on the blood or blood components with blood card and blood request
form with A DOCTOR.
 Type of blood / blood component
 ABO grouping & Rhesus factor correspond
  Expiry date
 amount of blood
 blood serial number
 Patient name and registration number
Administration
Explain to the patient prior to the transfusion.
 sign and symptom of any possible reaction as a result of
transfusion (Chills, rigors, skin changes (rash), pyrexia,
12. respiratory distress, nausea and vomiting, pain at infusion site,
chest pain, abdomen and loin pain)
 when to call for nurse.
Perform prior transfusion (baseline) monitoring.
13.  blood pressure, pulse rate, temperature, respiration, pain
assessment

14.
Close door / pull curtain.

15.
Wash hands and wear glove.

16.
Infuse 0.9% Normal Saline slow rate using blood transfusion set.

17.
Invert the blood bag gently several times.

18.
Place blood pack on a flat surface.

19.
Pull back 1 tab to expose port for spiking.

20.
Insert the spike into the port of the blood pack.

21.
Hang blood pack on drip stand.
Fill drip chamber until the blood covers one-third of the drip
22. chamber above the filter.

23.
Open clamp and allow blood to flow through the tubing to expel air.

24.
Titrate blood slowly for first 10 minutes at 20 drops per/min.
Monitor closely patient’s temperature, pulse, respiration blood
pressure and pain assessment, every 5 minutes for the first 10
25.
minutes for any adverse reaction.
Nurse must be at patient bedside

Report unusual symptoms felt immediately.

 Chills, rigors, skin changes (rash), pyrexia, hypo / hypertension,
26. respiratory distress, nausea and vomiting, haematuria, pain at
infusion site, chest pain, abdomen and loin pain, renal shutdown
(oliguria/anuria), anaphylactic shock.
Maintain blood at correct titration per min for the blood transfusion if
27. no adverse reaction noted.
 whole blood : within 4 hours
  packed cells : within 4 hours
 fresh frozen plasma : within 30 minutes
 cryoprecipitate : within 30 minutes
 platelet concentrate : within 30 minutes
Check vital sign ½ hourly and hourly till completion of blood
transfusion.
28. Perform vital sign monitoring every 15 minutes for unconscious
patients.
Ensure blood / blood component is transfused within time limit after
commencing.
29.
 Ensure the new pack of blood is ready before previous pack is
finished.
 Verify each new pack of blood before putting up.

30.
Infuse the normal saline after blood transfusion has been completed.
Record accurately date, time of commenced, blood type, amount
infused and time of completion of blood/ blood components in the
31. blood request form, blood card, intake and output chart / patient’s
progress notes / observation chart.
Dispose blood transfusion set and send the empty blood bag with
32. card to blood bank.

33.
Continue to observe client for 2-3 hours after transfusion.

Comment of Examiner :
……………………………………………………………………………

Name & Signature of Examiner : ………….

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