who can check blood

  1. Our hospital recently changed our policy on who can check blood at the bedside to "two healthcare individuals, one of whom must be an RN". They have interpreted this to mean an RN, LPN/LVN, MD or a CNA. They say they have research to support this decision though I have not seen it yet. When I questioned this policy I was told that "they are just numbers" and "it's just another pair of eyes" I tried to explain as cogently as I could my severe reservations about having unlicensed people verifying blood, to no avail. I approached this from a safety issue and also said that the difference between professional nursing and being a CNA is that we have rationale for our actions. The numbers on the blood bag and band are more than numbers; they represent the potential lethality of the product and therefore the rationale for two people to check. It only takes 15 cc of the wrong blood to kill a patient. I also expressed concern that we as registered nurses are charged with the duty to directly supervise CNA's and questioned how we could then ask them to check what we are reading is accurate. They believe this will free up the nurse. I told them I do not need my nursing assistants to do my job; I need them to do theirs, to pass the water and assist patients to the bathroom etc. If they did that, we would have time to check blood. And if truth be told, I have never heard a nurse complain about having to check blood but we all complain about getting called to a room because the pt. needs water. Anyway, sorry for the long post, but I am really interested in what others have to say about this new practice.
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  2. 20 Comments

  3. by   SouthernLPN2RN
    Quote from a54flo
    Our hospital recently changed our policy on who can check blood at the bedside to "two healthcare individuals, one of whom must be an RN". They have interpreted this to mean an RN, LPN/LVN, MD or a CNA. They say they have research to support this decision though I have not seen it yet. When I questioned this policy I was told that "they are just numbers" and "it's just another pair of eyes" I tried to explain as cogently as I could my severe reservations about having unlicensed people verifying blood, to no avail. I approached this from a safety issue and also said that the difference between professional nursing and being a CNA is that we have rationale for our actions. The numbers on the blood bag and band are more than numbers; they represent the potential lethality of the product and therefore the rationale for two people to check. It only takes 15 cc of the wrong blood to kill a patient. I also expressed concern that we as registered nurses are charged with the duty to directly supervise CNA's and questioned how we could then ask them to check what we are reading is accurate. They believe this will free up the nurse. I told them I do not need my nursing assistants to do my job; I need them to do theirs, to pass the water and assist patients to the bathroom etc. If they did that, we would have time to check blood. And if truth be told, I have never heard a nurse complain about having to check blood but we all complain about getting called to a room because the pt. needs water. Anyway, sorry for the long post, but I am really interested in what others have to say about this new practice.
    At the hospital I used to work at, it had to be an RN and another licensed person. I think something like this is out of scope for non-licensed folks.
  4. by   TexasPediRN
    Personally, I'd prefer to stick with what I have known about checking blood, and that is that 2 RN's must do it.

    Even days that we had only one RN on the floor, we'd have to either call the nursing supervisor or run to the other side of the hall to find another RN to check the blood.

    I've never heard of anyone else like a CNA checking blood with the RN, even as a graduate nurse, if i checked blood with an RN, another RN had to sign as well. (2 RN's and a GN)

    I dont think I would do it- If i had blood to check I would find another RN to do so with me, even if hospital policy says one RN + another person. I would use a LPN though, but I would prefer another RN. Never a CNA

    Just my opinion though.
  5. by   Tweety
    Here is must be an RN and another professional, such as another RN or LPN, MD, or paramedic. CNA's or EMTs are not to check blood. I'm not sure what the state board says, but this is our policy. I know because we just did competencies and were asked that question.

    Really when you think about it, all it takes is a brain with common sense to check ID bands and numbers, if it was our policy to allow CNAs to do it. that wouldn't bother me. It's not like we're asking them to hang the blood, just verify.
    Last edit by Tweety on Oct 23, '05
  6. by   meownsmile
    Two Rn's only at my facility. Both must verify the unit indentifiers with the print out from blood bank and with the patients blood band.
  7. by   ckh23
    Quote from meownsmile
    Two Rn's only at my facility. Both must verify the unit indentifiers with the print out from blood bank and with the patients blood band.
    Same at my facility, it has to be 2 RNs verifing. No exceptions.
  8. by   achot chavi
    :yeahthat: Here too it must be two R.N.s I'd insist on that anyway even if hospital policy says otherwise. I wouldn't trust a CNA , as good as he or she may be because she doesnt have her license to protect as we do. Anyway if we open the door to that, soon the keys to the narcotics cabinet will go to the janitor (again , nothing personal, Our Janitors are the Best but...I wouldnt want to share responsibilities with them)
    Wait , one mess up will leas to an expensive lawsuit and then well be back to square one.
  9. by   Tweety
    When you go to the blood bank is it two RN's down there checking the potentially lethal blood. I'd worry more about their qualifications down there than whether it's a CNA checking an armband with me.
  10. by   CV_LVN
    I dont think I would do it- If i had blood to check I would find another RN to do so with me, even if hospital policy says one RN + another person. I would use a LPN though, but I would prefer another RN. Never a CNA
    [/quote]

    I find that a little demeaning....you would "use and LPN, but prefer another RN". Am I wrong, but LPN's are nurses too, and have the same knowledge about blood info. Just thought that was rude. I guess you are entitled to your own opinions.

    BTW, my facility is 2 license (one RN), RN and RN, RN and LVN...........BUT, a CNA, unit secretary anyone can go to bloodbank, and check the lab slip with the blood with the blood bank employee...to me that's pretty dangerous too IMO.
    Last edit by CV_LVN on Oct 23, '05
  11. by   grace90
    Quote from meownsmile
    Two Rn's only at my facility. Both must verify the unit indentifiers with the print out from blood bank and with the patients blood band.
    Ditto at our facility! 2 RN's only! And the other RN's here are always willing to check blood or FFP with each other, too.
  12. by   jmgrn65
    Quote from Tweety
    When you go to the blood bank is it two RN's down there checking the potentially lethal blood. I'd worry more about their qualifications down there than whether it's a CNA checking an armband with me.
    people down in the blood bank aren't RN in our facility any one can go pick up the blood, but 2 RNs must check blood before admins.
  13. by   Kasper1014
    AT my facility it is two nurses, Rn and Rn or Rn and LVN. At another hospital I worked in, in was two Rn's.

    Kassy : )
  14. by   Tweety
    Quote from Kasper1014
    AT my facility it is two nurses, Rn and Rn or Rn and LVN. At another hospital I worked in, in was two Rn's.

    Kassy : )

    So weird that it has to be two RNs in so many places. Here only an RN can administer blood, so one of those checking needs to be the RN hanging the blood. But surely an LPN can check an armband and verify we're giving the right blood to the right patient? What if the primary nurse is an LPN? We let the LPN monitor the patient after the initial period, but don't let her/him check an armband and identify the patient? What about consents for surgery, are only RNs qualified to do that? Can LPNs not administer medication and check the 5 (or 8) rights? Seems a bit strange to me that in so many areas they can't verify blood.

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