LPNs co-signing blood

capgirl · May 22, 2003

in my facility the RN hangs the blood. It can be verified by another RN, a doc, LPN, PCA, or a SECRETARY.

nrw350 · May 22, 2003

What can happen in the first 5-15 minutes after hanging blood?

Flynurse · May 22, 2003

The first 5 to 15 minutes is the most likely time for the patient to have an adverse reaction to the blood product.

nrw350 · May 22, 2003

like an allergic reaction?

TNcanNURSE · May 22, 2003

I'm from Tennessee, an LPN, and have started blood many times. At the time I worked Oncology at a university hospital. This was about 3 years ago. The only things I could not do were administer chemo, hang TPN, and there were certain IV push meds that I couldn't administer.

Scavenger'sWife, RN · May 22, 2003

In Ohio, and at my facility, RN only can hang blood or blood products. LPN or another RN can verify info with the RN that is hanging the blood. Here, someone picks up the blood from BB (can be anyone - RN, LPN, NA) and brings to floor. RN and a witness (RN, LPN) check info is correct (ck ID band on pt, ck expiration date, blood type etc). Both sign the blood form. Only RN can spike and monitor for 1st 30 min. Then LPN or NA can monitor. Blood is D/C'ed by RN. Form is 2 part - one goes back to Blood Bank with empty blood bag. One goes on chart.

ndolphins13 · May 22, 2003

I saw you are from Ohio. I am a LPN in Ohio and I know LPNs can definately co-sign for blood--we can't start it though. However, I am telling you what the scope of nursing practice is, no what your facility policy is. I co-sign for blood, but my facility allows me to do this.

John Cusano · May 22, 2003

Thanks for all the input. I have changed our facility policy to reflect both the input from here, and the from the nurse practice act. I see no reason why LPNs cannot verify information as long as an RN is the primary nurse hanging the blood product. Thanks again :-)

Liann · May 22, 2003

As a Blood Bank Medical Technologist, I can tell you that the worst thing to happen to a patient during a transfusion is to have a hemolytic transfusion reaction. This is almost, but not always , due to clerical error somewhere down the line of handling the blood. The more checks that are done, supposedly the better. That unit of blood is checked and rechecked before leaving the bank. It must be checked and re checked against the patient arm band before starting the transfusion. The FDA considers blood as a medication, so it is treated in the same way as meds.

Vitals must be monitored not only for hemolytic reaction due to the wrong type being given, but also for a febrile reaction due to the presence of white cells which is a lot more common. Any signs of reacting, and that blood needs to be stopped pronto.