Policy Manual sample

MDT Home Health Care Agency, Inc. 194 • Obtain a physician’s order for the transfusion. The contents of the order are to include the component to be transfused, the number of units, the flow rate, any concurrent fluids to be administered, any necessary premedications, laboratory tests to be obtained before and after transfusion, as well as an order for an anaphylaxis kit. • Obtain patient signed consent for the transfusion. • Draw the blood specimen for type and cross-match, using Standard Precautions. • Place an identification band with the patient’s name and social security number, on the patient’s wrist, on the side opposite to the site of the infusion. • A copy of the type and cross-match results is retained in the patient’s medical record, as well as in the home chart. • The Registered Nurse is to pick up the blood components from the blood bank and is to verify patient name, social security number, blood type and Rh factor with the blood bank technician. • Platelets are stored at room temperature and infused as quickly as the patient can tolerate. • Red blood cells are to be transported in insulated containers to maintain the temperature at 4 degrees C and are to be kept refrigerated until ready for use. • A unit of red blood cells is to be administered through a blood administration set with a filter over a minimum time period of two (2) hours and may be administered over a period of four (4) hours, based upon the physician’s orders. • Preinfusion: • The preinfusion assessment includes documentation of a completed comprehensive medical history including relevant allergy history, review of medications and pertinent laboratory values and a comprehensive physical assessment of the patient. • The baseline physical assessment should include vital signs and assessment for skin rashes, shortness of breath, wheezing, pain, chills, itching or nausea. • Patients with cardiopulmonary disease should have their lungs auscultated to establish whether or not rales are present. • The nurse should verify the patient’s name, social security number, ABO/Rh label and component label to the medical record and physician order information with another responsible person in the home. • The blood component unit should be inspected for leaks and missing port covers.