Policy Manual sample

MDT Home Health Care Agency, Inc. · 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. The unit contents should be checked for color abnormalities and for the presence of any particulate matter. If the integrity of the unit has been compromised and/or any abnormalities of the contents are noted, the unit should not be used and should be returned to the blood bank. An incident report needs to be completed. Prime the IV tubing with normal saline, followed by the blood component as ordered by the physician. Take and record the patient’s temperature, pulse, respirations and blood pressure before starting the transfusion, 15 minutes after the transfusion is started, and as appropriate based on the patient’s clinical status until the transfusion is complete. A final set of vital signs is to be recorded at the completion of the transfusion. Adverse Reactions: Mild: hives and pruritus Nursing Responsibilities: · Stop the transfusion Hang new tubing with normal saline to maintain IV access Administer Benadryl if ordered Notify the physician and the Clinical Supervisor Notify the blood bank and draw appropriate blood samples as directed Anaphylaxis: shock, chest tightness, hoarseness, dyspnea, bronchospasm, abdominal cramps, severe nausea and vomiting Nursing Responsibilities: · Stop the transfusion · Hang new tubing with normal saline to maintain IV access · Maintain a patient airway; perform CPR if necessary · Administer epinephrine 1:1000 subcutaneous as per physician orders · Call emergency medical services · Notify the physician and the Clinical Supervisor · Notify the blood bank and draw appropriate blood samples as directed Home Health Agency - - Skilled Professional Services D-68