Policy Manual sample

MDT Home Health Care Agency, Inc. ADMINISTRATION OF BLOOD OR BLOOD COMPONENT(S) PURPOSE: To optimize patient safety when blood or blood component(s) are being administered in the home POLICY: Candidates for home infusion of blood components should be approved for such therapy by both the attending physician and the blood bank director. · Blood components are transfused by Registered Nurses with prior transfusion experience or critical care experience (certification if required by state law/regulations). · Infusions of blood components will only be conducted by MDT Home Health Care Agency, Inc. during normal business hours. · We will only accept patients for infusions of red blood cells and platelets. · The first transfusion of blood components must occur in a controlled setting, i.e., hospital or outpatient setting, to evaluate the patient for any adverse reaction(s). · Patients will be accepted for infusion of blood components in the home if the following criteria is met: • Have a documented diagnosis of anemia or thrombocytopenia such as end-stage malignancies, AIDS, chronic gastrointestinal bleeding, or anemia of chronic disease • Are debilitated, chronically ill individuals who may require more frequent transfusions over longer periods of time than many hospitalized patients who require transfusions • Are homebound, making transportation to the hospital a hardship • Are cooperative, have a stable cardiopulmonary status and have acceptable venous access • A second responsible adult should be present during the transfusion and should be available following the transfusion. • Patients who have a history of moderate to severe transfusion reactions will not be accepted for the infusion of blood components by MDT Home Health Care Agency, Inc. • Patients in rural areas will not be accepted for the infusion of blood components by MDT Home Health Care Agency, Inc. PROCEDURE: · 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 pre-medications, 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. Home Health Agency - - Skilled Professional Services D-67