Perioperative blood transfusion quality assurance
Preoperative Phase
- Check that the patient has signed the informed consent form specifically for blood transfusion.
- Ensure the form is properly filled out and signed by the patient or their legal representative.
- Verify the patient's blood type through laboratory tests.
- Ensure that a crossmatch has been performed to match the patient's blood with compatible blood products.
- Contact the blood bank to confirm the availability of the required blood products.
- Ensure that an adequate supply of compatible blood products is available for the patient's surgery.
- Order laboratory tests to assess the patient's hemoglobin level.
- Order laboratory tests to assess the patient's coagulation profile, including clotting factors and platelet count.
- Review the patient's medical records for any relevant medical history or known allergies.
- Ask the patient directly about any known medical conditions or allergies.
- Check for any abnormal values or indications of anemia
- Note any previous transfusion history or reactions
- Assess the patient's blood type and cross-match requirements
- Evaluate coagulation profile and platelet count
- Consider any specific transfusion requirements based on the surgical procedure or patient's condition
- Measure the patient's vital signs, including blood pressure, heart rate, respiratory rate, and temperature.
- Perform a general assessment of the patient's overall health and physical condition.
- Obtain a list of the patient's current medications, including prescription drugs, over-the-counter medications, and supplements.
- Review the list for any medications that may affect the transfusion or increase the risk of complications.
- Verify the patient's age and weight through official identification documents or medical records.
- Ensure the accuracy of the information to determine appropriate blood transfusion dosage.
- Ask the patient to state their full name and date of birth.
- Confirm the patient's identity by comparing the provided information with their identification wristband or medical records.
- Explain the potential risks, such as allergic reactions, infections, or transfusion-related complications.
- Inform the patient about the benefits of receiving a blood transfusion and the expected outcomes.
Intraoperative Phase
- Check patient's identification wristband
- Verify blood type using two identifiers (e.g. patient's name and medical record number)
- Cross-reference blood type with blood product label
- Check blood product label for patient name and medical record number
- Verify blood type on blood product label matches patient's blood type
- Confirm blood product compatibility with patient's blood type
- Inspect blood product packaging for any signs of damage or tampering
- Check expiration date on blood product label
- Ensure blood product has not expired
- Check temperature monitoring logs for blood product storage area
- Ensure blood products are stored at appropriate temperature
- Confirm blood products were transported in a controlled environment
- Check that blood administration set is compatible with blood product
- Ensure blood administration set is sterile and in good condition
- Verify proper connection of blood administration set to patient's venous access
- Assess patient's vital signs before initiating transfusion
- Monitor patient's vital signs every 15 minutes during transfusion
- Observe patient for signs of transfusion reactions (e.g. fever, rash, shortness of breath)
- Regularly check the patient's blood pressure, heart rate, respiratory rate, and temperature throughout the transfusion process.
- Record any abnormal vital signs and report them to the healthcare team.
- Enter detailed information about the transfusion, including the date and time, blood product type, volume infused, transfusion reaction (if any), and any other relevant details.
- Ensure that the documentation is accurate, legible, and complete.
- Follow the proper procedures for disposing of any unused blood products or equipment, adhering to local regulations and guidelines.
- Dispose of the items in designated biohazard containers or as instructed by the healthcare facility.
- Verify that a qualified healthcare professional has ordered the blood transfusion for the patient.
- Ensure that the order is documented in the patient's medical record.
- Check the patient's blood type and cross-match it with the blood product to be transfused.
- Ensure that the ABO and Rh compatibility has been verified before starting the transfusion.
- Regularly monitor the patient's laboratory values, such as hemoglobin, hematocrit, and coagulation profile, during the transfusion.
- Report any significant changes or abnormalities to the healthcare team.
- Provide information to the patient and/or family about the potential risks and complications of blood transfusion.
- Answer any questions or concerns they may have and ensure they understand the importance of informed consent.
Postoperative Phase
- Record the specific blood product used for transfusion
- Note the amount of blood product transfused
- Document the start and end time of the transfusion
- Monitor the patient for symptoms such as fever, chills, itching, rash, shortness of breath, or rapid heart rate
- Alert the healthcare team immediately if any signs of transfusion reaction are observed
- Regularly check the patient's blood pressure, heart rate, respiratory rate, and temperature
- Monitor the patient's hemoglobin levels through blood tests
- Record the vital signs and hemoglobin levels in the patient's medical chart
- Ensure the patient is comfortable and stable after the transfusion
- Address any immediate concerns or needs the patient may have
- Offer emotional support and reassurance to the patient
- Check vital signs regularly
- Observe for any signs of adverse reactions such as fever, chills, rash, or shortness of breath
- Document and report any adverse reactions to the physician
- Contact the physician immediately if any adverse reactions are observed
- Provide detailed information about the reaction and the patient's condition
- Monitor for signs of infection such as fever, increased heart rate, or redness/swelling at the transfusion site
- Notify physician if any signs of infection are observed
- Document the date and time of the transfusion
- Record the type and amount of blood products transfused
- Note any adverse reactions or complications during or after the transfusion
- Review all documentation to ensure it is complete and accurate
- File the documentation in the patient's medical record according to hospital protocols
- Contact the patient after the transfusion to inquire about their condition and any concerns
- Address any questions or issues related to postoperative care
- Arrange for any necessary follow-up appointments or tests
- Provide support and education to the patient regarding their recovery
- Follow hospital protocols for the disposal of unused blood products
- Store unused blood products properly according to storage requirements and regulations
Documentation and Reporting
- Include patient demographic information
- Specify the blood product type and volume administered
- Record the date and time of the transfusion
- Document the transfusion start and end time
- Note any pre-transfusion laboratory results
- Record any transfusion-related adverse events or reactions
- Notify the blood bank or transfusion service
- Follow institutional protocols for reporting adverse events
- Provide detailed information about the patient, blood product, and reaction
- Review transfusion documentation for accuracy and completeness
- Check adherence to blood product storage and handling guidelines
- Assess compliance with pre-transfusion testing requirements
- Evaluate the use of appropriate blood product consent forms
- Seek input from healthcare professionals involved in blood transfusion
- Incorporate suggestions for improvement
- Stay updated with current literature and guidelines
- Periodically revise the checklist to reflect changes in protocols
- Provide feedback to the staff regarding their performance in the transfusion process
- Highlight areas of improvement and acknowledge areas of excellence
- Ensure that the feedback is constructive and encourages continuous improvement
- Maintain a comprehensive and accurate record of all patients who have received blood transfusions
- Include important details such as patient name, date of transfusion, blood type, and any relevant notes
- Regularly update the list to ensure it remains current and accessible to authorized personnel
- Continuously monitor the patient's vital signs, such as blood pressure, heart rate, and temperature
- Regularly assess the patient's laboratory results, including complete blood counts and coagulation profiles
- Promptly identify and address any abnormal findings or adverse reactions
- Verify that all staff members involved in the blood transfusion process have completed the necessary training
- Ensure that their certifications are up to date and in accordance with regulatory requirements
- Regularly review and document the training and certification status of all staff members
- Record any corrective actions taken in response to adverse events related to blood transfusions
- Include details such as the nature of the adverse event, the actions taken, and the outcome
- Ensure that the documentation is thorough, accurate, and easily accessible for future reference
- Regularly review and evaluate the effectiveness of the quality assurance protocols for blood transfusions
- Assess whether the protocols are achieving their intended goals and identify areas for improvement
- Document the findings of the review and implement necessary changes to enhance the protocols
Use in Manifestly