SINHGAD COLLEGE OF NURSING NARHE, PUNE.

CLINICAL TEACHING
ON
BLOOD TRANSFUSION

SUBMITTED TO, SUBMITTED BY,

Mrs. Swati Gorad Ms. Nilopher Hasham Shaikh
Clinical Instructor F.Y. M.Sc. Nursing
SCON, Pune. SCON, Pune.

SUBMITTED ON:- 23/11/2022

GENERAL OBJECTIVE: -
At the end of this clinical teaching students will be able to gain in depth knowledge about blood transfusion and will be able
to apply the same in their clinical practices.

SPECIFIC OBJECTIVES: -
Student will be able to_
a) Define blood transfusion.
b) State purposes of blood transfusion.
c) explain types of different transfusion.
d) describe the scientific principles of blood transfusion.
e) enlist articles needed for blood transfusion.
f) demonstrate procedure for blood transfusion.
g) list down the complications of blood transfusion.
SR. SPECIFIC TIME CONTENT TEACHER/LEARNER AV EVALUATION
NO. OBJECTIVE DURATION ACTIVITY AIDS
BLOOD TRANSFUSION

INTRODUCTION:- Teacher introduces the

1. Introduction of 2 min Students
blood topic blood transfusion. understood the
transfusion.  Transfusion of blood and its products introduction of
is very common medical procedure in blood
the practice of modern medicine. transfusion.
 Nursing staff plays a very important
role and crucial role in the blood
transfusion procedure as they are
called upon to procure and blood
products from the blood transfusion
laboratory and conduct supervise the
transfusion.

2. Define blood 3 min DEFINITION:-

transfusion. Teacher define the topic White Students
“It is the process of transferring blood or
blood transfusion. board understood the
blood components into one’s circulation
intravenously.” definition of
blood
transfusion.

state purposes
3. of blood 5 min PURPOSES:- Teacher state the Flip Students
transfusion.  Restore blood volume purposes of blood card understood the
 Replace clotting factors transfusion. purposes of
 Improve oxygen carrying capacity blood
 Restore blood elements that are transfusion.
depleted
 Prevent complications
 To raise the haemoglobin level
 To provide antibodies

explain types
4. of different 6 min TYPES OF DIFFERENT Teacher explain types of Students
transfusion. TRANSFUSION:- transfusion. understood
Blood products to be transfused are as types of
follows:- transfusion.
1. Packed red blood cells:
They are prepared from whole blood
removing approximately 250 ml of
plasma.
(1 unit expected to increase levels of
hemoglobin by 1gm/dl and hematocrit
by 3%)
 Indication: -
-Acute sickle cell crisis
-Acute blood loss of >1,500ml
-Symptomatic anemia
 Contraindication: -
-Volume replacement
 Transfusion time: -
-completed within 4 hrs of removal
from controlled temperature storage
 Storage: -
-1-6 degree C in temperature
controlled storage device.
-Transportation time not to exceed
more than 24 hrs.
-shelf life: 42 days from date of
collection.

2. Platelets: -
(1 unit expected to increase platelet
count in adults by 3,00,000-6,00,000)
 Indication: -
-Thrombocytopenia
-platelet function defect
 Contraindication: -
-Thrombocytopenia
-Thrombotic thrombocytopenia
purpura
 Transfusion time: -
-Overall period of 30-60 min
 Storage: -
-20-24 degree C
- shelf life: 5 days from date of
collection
-once open expiry is 4 hrs from the
time of opening

3. Plasma: -
(Contains all coagulation factors)
 Indication: -
-Bleeding
-Multiple clotting factor deficiency
  Contraindication: -
-Single coagulation factor deficiency
-volume replacement alone
 Transfusion time: -
-30 minutes
 Storage: -
-1-6 degree C up to 5 days
-can be stored at 36 months at minus
25 degree C or below
describe the Teacher describe the Students
5. scientific 15 min SCIENTIFIC PRINCIPLES OF scientific principles of understood the
principles of blood transfusion. scientific
blood
BLOOD TRANSFUSION principles of
transfusion. blood
1.ANATOMY AND PHYISIOLOGY: -
transfusion.
-Careful during selection of the site to avoid
injury to these areas.

-The knowledge of the anatomy and

physiology of the body is essential for the
safe administration of the injection.
-If carelessly given, blood are means of
introducing into the body.

2. MICROBIOLOGY: -

-Wash hands thoroughly before and after the

procedure to avoid cross infection.
 3. BIOCHEMISTRY: -

-Transfuse slowly to prevent transfusion

reaction.

4. PHARMACOLOGICAL: -

-Premedication may be given as prescribed.

5. PSYCHOLOGY: -

-Explain the procedure thoroughly to the

patient to win the confidence and get the co-
operation.

-Proper positioning will help to relax the

patient while blood transfusion.

-Maintain privacy if required.

A TRAY CONTAINING: -
1) Blood transfusion set.
2) Normal saline.
enlist articles 3) Blood/blood component e.g, FFP. Teacher enlist the articles Students enlist
Objec
6. needed for 5 min 4) Cannula no: 18/19 no. of blood transfusion. the articles
t
blood 5) Disposable gloves. needed for blood
transfusion. 6) Dry and alcohol cotton balls. transfusion.
7) Paper bag.
8) Kidney tray.
9) Doctor order sheet.
 10)Torniquet.
11)Scissors.
12)Roller bandage.
13)Adhesive tape.
14)Pressure bag.
15)Kidney tray.

PROCEDURE :-
Nursing action before procedure:-
demonstrate 1.Check physician’s order, patients condition
procedure for 20 min
7. and history of transfusion reaction, reason for
blood Teacher demonstrate the Students
present transfusion, etc.
transfusion. procedure of blood understood the
RATIONALE:- Obtains specific data and
initiates patient education, if required. transfusion. procedure of
blood
2.Identify the patient. transfusion.
RATIONALE:- Prevents errors.
3.Prepration:- It include

a) Preparation of self:-
-Perform hand hygiene.

b) Preparation of articles:-
-Check the availability of blood in the blood
bank.
-If transfusion cannot begin immediately,
return product to blood bank. Blood which is
out of refrigerator for more than 30 min above
10 degree C cannot be re-issued. Never
store blood in unauthorized area like ward
refrigerator. Blood must be stored in
refrigerator unit at carefully controlled
temperature (4 degree C).
-Arrange all the articles in clean tray.
-Take needles and syringes as required for
administration of premedication.

c) Preparation of patient:-
-Inform the patient and explain all procedure
to patient.
-Provide proper position to patient i.e, supine
position.
-Explain the patient that movement of the
extremity should be minimal.
-Encourage patient to empty bowel and
bladder.

c) Preparation of environment:-
-Provide calm environment.
-Maintain adequate lighting in room.

Nursing action during procedure:-

4. Ensure privacy.

5. Check vital signs and records.

RATIONALE: - Obtains baseline data to
compare with change post-transfusion. Delay
transfusion if temperature is more than 101.8
degree C.

6. Don disposable gloves.

RATIONALE: - Reduces risk of contracting
infection.

7. Insert cannula (18 G / 19 G) if not already

present in a large peripheral vein and initiate
infusion of normal saline solution using blood
transfusion set.
RATIONALE: - Normal saline is the only
crystalloid compatible with blood and priming
the blood set helps in reducing the risk of
hemolysis of blood in contact with tubing.

8.Inspect the blood product (By 2 nurses) For

 Identification number
 Blood group and type
 Expiry date
 Compatibility
 Patients name
 Abnormal color, clots, excess air, etc.
RATIONALE: - This reduces the chances of
mismatched transfusion.

9. Warm blood, if needed, using special

blood warmer or immerse partially in tepid
water.
RATIONALE: - Cold blood can cause
hypothermia and cardiac arrythmias.

10. If blood product is found to be correct,

stop the saline solution by closing roller
clamp. Remove insertion spike from saline
container and insert spike into blood
container.
11. Start infusion of blood product slowly, at
the rate of 25-50 ml/hour for the first 15
minutes. Stay with patient for first 15 min.
Check vital signs every 15 minutes for first 30
minutes, or as per agency policy.
RATIONALE: - Checking vital signs
frequently helps in early identification of
complications.

12. Cover the blood bag with a towel when it

hangs on IV pole.
RATIONALE: - For rewarming and to prevent
hemolysis.

12. Increase infusion rate if no adverse

reactions are noticed. The flow rate should
be within safe limits.
RATIONALE: - Flow rate is determined by
physician’s instruction and patient’s
condition.

13. Assess the condition of patient every 30

minutes and if any adverse effect is observed
stop transfusion and start saline. Send urine
sample, blood sample and remaining blood
product in container with transfusion set,
back to the blood bank.
RATIONALE: - Taking blood and urine
samples helps in confirming transfusion
reactions.
 14. Complete transfusion and administer
saline (as per physician's order) if no adverse
reaction is observed.

15. Dispose blood product container and set

in appropriate receptacle.

16. Wash hands.

17. Record the following : Product and

volume transfused, Identification number and
blood group, Time of administration started
and completed. Name and signature of
nursing staff carrying out procedure, and
patient's condition. If agency policy requires,
remove label from blood bag and paste it on
patient's record.

18. Assist patient to comfortable position.

COMPLICATIONS:-

1) Allergic reaction
2) Fever
3) Acute immune hemolytic reaction
4) Blood borne infection
Students
list down the ASSIGNMENT:-
understood the
8. complications 4 min Teacher list down the complications of
for blood Write a short note on transfusion reaction complications of blood
transfusion. and its management. blood transfusion. transfusion.

SUMMERY:-

In this CT, we have studied_

1. Define blood transfusion.

2. State purposes of blood transfusion.
3. explain different types of transfusion.
4. describe the scientific principles of
blood transfusion.
5. enlist articles needed for blood
transfusion.
6. demonstrate procedure for blood
transfusion.
7. list down the complications of blood
transfusion.

CONCLUSION:-
This topic helps student to improve
their practical skill as well as knowledge
regarding blood transfusion and helps to
apply this skills in clinical practice.

BIBLIOGRAPHY:-
1.Sr. Nancy
Principles and practice of nursing
6th edition
Page no:- 210-211.
2. Annamma Jacob,
clinical nursing procedures the art of nursing
practice,
2nd edition,
Page no:- 357-359.
3.Ross and Wilson (2003)
“Anatomy and Physiology”
9th edition
Published by Churchill living stone
Philadelphia
Page No:- 60-64.

REFERENCES:-
1.https://www.slideshare.net/

sanausmani1/blood-
transfusions-ppt

2.https://www.slideshare.

net/blueash/blood-transfusion

-by-nurses-informations

3.https://en.wikipedia.org/wiki/

Blood_transfusion

4.https://www.redcrossblood.org

/donate-blood/blood-donation-

process/what-happens-to-

donated-blood/blood-
transfusions.html#:~:text

=The%20blood%20transfusion

%20procedure%20begins,take%

20between%201%2D4%20hours.