Entry Level COP3

COP 3: Documented procedures define rational use of blood and blood products.

When a patient may require blood/ blood components staff is follows the following step

a.  To ensure patients safety, blood / blood components should not be prescribed unless there is a real indication.

b.  Request should be made by a consultant/doctor working in the hospital.

c. Consent for transfusion should be taken from patient / guardian after explaining the transfusion requirement.

The priority of the request must be indicated

STAT – product for transfusion required or potentially required in approximately 1 hour

ASAP – product for transfusion required within 4 hours

------------------------------------------- than 4 hours

SN	Procedure	Responsibility
1	After identifying the need by treating Doctor, blood and blood products are ordered. Take Consent from patient /Patient relative	RMO/ Consultant
2	Priority of the request must be indicated. i.e. STAT, ASAP, Routine	RMO
3	DELIVERING BLOOD TO THE PATIENT AREA
	Blood should be requested from blood bank after confirming the availability from blood bank only when the patient is ready to be transfused.	RMO
4	BEFORE BLOOD & BLOOD PRODUCT ADMINISTRATION
	Numbers of blood units in need are Identified keeping the patient condition in view. Inspect for abnormal color, cloudiness, Clots and excess air. Check with compatibility slip to ensure that the following information on the unit of blood is the same as that on the Blood compatibility slip: Blood unit number Collection date Expiry date ABO blood group and Rh group, HIV, Hepatitis B, Hepatitis C	Consultant and RMO RMO/Nurse on duty
5	Prior to requesting the transport of blood  products, ensure: The patient has an IV line established with saline and The physician orders for transfusion have been documented and Informed consent has been obtained.	RMO/Nurse on  duty
6	Aseptic technique and Universal Blood and Body Substance Precautions will be followed throughout; hand washing will be in accordance with the policy. Each unit of blood will be checked at the Bedside by a nurse and a doctor, and documented. Rate of transfusion: Adults; Start with 1 ml/min for first 15 minutes. If no reaction, increase to 4ml/minutes after 15 minutes. For Pediatric Transfusions, take advice of Treating Pediatricians. If patient shows evidence of a transfusion reaction immediately discontinue the transfusion at canulla hub and start infusion of 0.9% Sodium Chloride and inform the physician responsible for the case/on duty. The transfusion reaction from duly completed should be returned to the blood bank along with samples for investigations as instructed on the reaction form. If no evidence or reaction and vital signs are stable after 15 minutes, adjust flow to prescribed rate. No medications or solutions may be added to or infused through the same tubing as blood components, except 0.9% Sodium Chloride Duration of a blood transfusion should not normally exceed four hours per unit of blood. If a longer infusion time has been ordered, blood bank should be notified so that blood May be separated into more than one bag. Discard unused blood as per discard policies (See Biomedical Waste Management Policies). Documentation &Reporting Transfusion reporting Assess vital signs one hour after transfusion and as necessary thereafter; continue to observe patient for delayed transfusion reactions. Document on intake and Output sheet: Amount of blood transfused Blood unit and number Start and finish time of transfusion Amount of saline infused, if necessary Document in Nurses’ Notes the patient’s Response to the transfusion.	Nurse RMO/Nurse on duty Nurse Nurse