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!
Added note from a lesson recently learned. Take vital signs before spiking blood!
I've always spiked the blood and then taken the V/S, then started it. Recently, we had a patient who had been fine alll day, except for her low hgb. Checked the blood, spiked the blood, as I was spiking, a Nsg student took vitals. Temp was 38.5!
Temp had been 36 that am. Had to waste the blood, and pt was a difficult match! So now, I make sure and check vitals first!
We do all of our checks at the bedside. We both ask the patient's name & DOB and compare with the armband, then compare the information on the unit of blood compared to the blood administration form at the bedside. If you spike the bag and it happens to the wrong one, then it can't go back to the blood bank. I always do all of my checks before spiking for that reason.
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.
Agreed!! As busy as we can get, it would be too easy to spike the blood at the nurse's station and walk into the wrong patient's room!! Always do the check at the bedside, just prior to spiking and hanging.
I agree with the points mentioned about blood admin. Think about blood like a high alert medication and think about the "Rights" of Med Admin. Blood should be verified at the bedside (anything missing, the blood should be rejected). After verifying the blood in front of the patient at their bedside this will help the patient know and witness the safety processes that are in place. This also ensure you have the right patient (most acute related incidents are due to improper patient identification! Vital signs should be taken within 20 mins of the blood being administered (follow your hospital policy). The only thing I might look at at the nursing station is the consent form that should already be signed and in the chart. We use electronic blood administration, which only makes it possible for you to be at the bedside with the patient for scanning purposes. It's better to modify your practice now rather than have had a sentinel event occur! Thanks for shopping for ideas!
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Added note from a lesson recently learned. Take vital signs before spiking blood!
I've always spiked the blood and then taken the V/S, then started it. Recently, we had a patient who had been fine alll day, except for her low hgb. Checked the blood, spiked the blood, as I was spiking, a Nsg student took vitals. Temp was 38.5!
Temp had been 36 that am. Had to waste the blood, and pt was a difficult match! So now, I make sure and check vitals first!
My experience has been that you need a set vitals to ge the blood released from blood bank......probably a good policy....
Our blood bank form has a spot for pre-transfusion VS, and also has a blank for time started. The date stamp is on top, so you should probably have those vitals in hand within 30 minutes of picking up the blood. I have found blood HORRIBLE to work with the tubing, so I never spike until bedside. I also already have NS running to prime the line and the patient before I ever go pick up the blood.
our blood bank form has a spot for pre-transfusion vs, and also has a blank for time started. the date stamp is on top, so you should probably have those vitals in hand within 30 minutes of picking up the blood. i have found blood horrible to work with the tubing, so i never spike until bedside. i also already have ns running to prime the line and the patient before i ever go pick up the blood.
this is what i do before picking up the blood. ns is running ahead of time so once the blood is in hand it is verified with two nurses at the bedside, then spiked..
I also already have NS running to prime the line and the patient before I ever go pick up the blood.
I do this too. One time I had a bad IV when I came back from the blood bank...it even happened with routine flushing (I always flush my IVs if saline locked but I notice some nurses out there don't do that...). I spike the bag of NS with the blood administration tubing, prime the tubing and then hook it up to the patient and set it at KVO (20cc/hr) while I'm getting blood.
We double check the PRBC on the unit against the orders, typically at the nursing station or at a COW. We then prime the set the med room, take it into the patient room and double check it at the bedside with the patient's nameband, and again with the orders.
:eek:
Pepper The Cat, BSN, RN
1,790 Posts
Added note from a lesson recently learned. Take vital signs before spiking blood!
I've always spiked the blood and then taken the V/S, then started it. Recently, we had a patient who had been fine alll day, except for her low hgb. Checked the blood, spiked the blood, as I was spiking, a Nsg student took vitals. Temp was 38.5!
Temp had been 36 that am. Had to waste the blood, and pt was a difficult match! So now, I make sure and check vitals first!