A colleague in Virginia reports that her hospital is reviewing their transfusion guidelines and would like input from others regarding the personnel 'required' to identify blood products and potential transfusion recipients just prior to starting a transfusion, to assure that the correct blood product will be administered to the correct patient. For example, when a blood product arrives at the patient's location, do other hospitals require that two RNs identify the patient and check that the correct blood product is about to be administered? Do hospitals allow other health care professionals (such as medical technologists, physicians, medical students, perfusionists, etc.) to perform the clerical check of identifying the patient and the blood product? It is a practice at the inquiring colleague's hospital to have one nurse and one 'health care professional' such as a medical technologist or nursing employee (not an RN) check the patient and the blood product at the bedside. The inquiring colleague mentions that she is aware of other hospitals in their network that require two RNs perform the pre-transfusion verification at the bedside.

Editor's note: The following earlier discussions may be germane to this question.

• Should perfusionists in the operating room be allowed to administer units of blood?
• What are the personnel requirements for hanging blood components and signing off on the transfusion records?

The following comments have been received.

ADDENDA May 12, 2004

1. A colleague at a medical center in Southern California reports that their facility's policy allows the following 'pairs' of personnel to work together to ensure correct correct identification of blood products and recipients:

• A perfusionist under direct supervision of a physician
• Two RN's
• One RN plus one IV-certified LVN
• One RN plus one MD
• One IV-certified LVN plus an MD
• A student nurse or a student physician if directly supervised by an RN or an MD

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Ira A. Shulman, MD
CBBS e-Network Forum Editor & Moderator