Blood admin question

[RNmom24]

So, I've happily been hanging blood for the past 2 years and have never had a problem, no weird reactions, always the right patient, etc.

Well, last night I had to hang a second unit on a patient and I asked another nurse to read with me, and then I spiked my blood out at the nurses station. She pretty much freaked out and told me I shouldn't spike it until I get to the room. Now that I think about it, it makes sense, but is it really a huge nursing cardinal sin to do this? I reread our policy and it doesn't specifically state when blood should be spiked. It was kind of embarrassing, and I feel bad if I've been doing it wrong all these years. I honestly don't recall anyone telling me this is a no-no.

In the future I will read and then spike, but was just wanting to see how other nurses felt about this. In all the times I've read blood nobody told me I'm doing it wrong. Thanks!

[nurseprnRN, BSN, RN]

i think the idea is that the bedside check is the last check, the final check; once the bag is spiked it can't go back to the blood bank if it's the wrong one. also, if it's spiked and hung at the bedside of the intended recipient it's hugely unlikely that it will find its way to someone else's bedside by mistake.

[canesdukegirl, BSN, RN]

I have always asked another nurse to come into the room with me as I am reading off the blood bank paperwork so that the other nurse can read back to me the pt's name and MR# straight from the armband. Then I spike it and begin the transfusion in the room.

[msjellybean]

Personally, I never spike blood until after it's been checked and I'm about to hang it.

Because you never know when something will come up & your administration will get delayed. We use a pneumatic tube system at my hospital, so if I spiked a bag of blood & then found out in the check that something didn't match up, it'd be a giant pain to get it back to blood bank.

[luvmyhubbybunches]

It is in our hospital's written policy that the final check by 2 RNs be done at the bedside so that the pt's armband can be used as one of the final identifiers. I have never spiked a bag of blood at nurse's station, a bag of fluid maybe, but never blood or any blood products.

[maelstrom143]

We do the final check at bedside, checking armbands, name, acct, ensure all match before spiking. That way if anything does not match we can always send it back to the blood bank untouched. Once spiked no use to anyone if it is the wrong unit/blood bag.

[RNmom24]

Ok, thank you. :) Now I know.

[StrwbryblndRN]

On top of the reasons everyone else said, I would not want to spike blood anywhere but the pt's room since it is a biohazard. Hate to see it spilled in general places. I say this because last time I recieved blood the nurse got it on the floor after she spiked it. I was not a nurse at the time so did not think much of it.

[carolmaccas66, BSN, RN]

The reason it is all done at the bedside is so you don't accidentally pick up someone else's blood (unlikely but it could happen) and hang that instead.

We were always taught to do blood at the bedside. Though I've seen RNs reconstitute ABX in the nursing station, cos the drug room was crowded. I've done it myself with pushes. And as others said it could spill I suppose.

[carolmaccas66, BSN, RN]

RNmom24, this is why I like AN. I too have learned something here today - and I'm still learning as well after 3 years of RN nursing!

[yvfair]

I've been a nurse for 15 years and it has always been safe practice to check the blood with 2 nurses at the bedside BEFORE spiking the blood.

[Esme12, ASN, BSN, RN]

If you check it in the nurses station...what if you walk into the wrong room? It's just better at the bedside so you can have two people checking the patients band