Question

After checking the patient’s identification and reviewing the orders for the blood transfusion, you need to start the blood. What are the steps in the blood verification process? Explain the rationale for this procedure.

Answer 1

Blood transfusion is the procedure of administration of blood and blood products into the human body for therapeutic purposes. The blood transfusion should be done by registered health care professionals who are competent and well trained because certain safety precautions to be taken before, during and after transfusion of blood and blood products to avoid unwanted reactions.

The steps in the blood verification process

	Action	Rationale
1	Verification of blood transfusion order by the physician for patient name, blood type, date, time, duration, and any medications to be administered prior, during or post-transfusion.	To avoid the collection and transfusion of the wrong blood group or the wrong amount of blood to the patient.
2.	Collect all blood reports like hematocrit, coagulation values, and platelet count and verify recent blood parameters. Make sure that blood grouping and cross-matching are done.	To avoid unnecessary blood transfusion, to confirm blood group and the cross-matching status.
3.	Collect transfusion history regarding any history of transfusion reactions in the past.	To prevent further reactions.
4	Identify the patient by asking the full name and verifying the identification band. Cross-check with blood transfusion order.	To avoid wrong patient transfusion.
5	Inform the patient regarding the procedure, type of blood transfused, amount, duration, indication, and possible complications and secure signed consent in the patient record.	To protect health care professionals and the facility from future legal issues.
6	Check the intravenous line for patency.	To avoid extravasation and phlebitis.
7	Verification of blood during the collection of the blood components. Check the unit number, patient name, blood group, volume, any unusual color change or precipitates inside the band expiry date on the blood unit and compare the patient data with details on the bag.	To avoid errors during collection.
8	Prior to initiation of the transfusion, the patient details like name, identification band, blood group and type of blood, etc should be verified with transfusion order and the blood bag unit at the bedside of the patient by two registered health care practitioners independently.	Final verification to prevent errors.