Administration of Blood and Blood components

Name:____________________________ Group: _______ Date: ________ Rating: ______

Done Done Multiple

Correct but with Errors
PROCEDURE with No 1 Error Seen
Errors (2) (1)
(3)

ATTITUDE: 30% (15 points)

1. Displays readiness in performing the procedure.
2. Accepts criticism by showing effort to correct mistakes
3. Shows enthusiasm and interest in performing the procedure.
4. Employs professionalism, reliability, and confidence in performing the
procedure.
5. Answers rationale questions correctly.

TOTAL

KNOWLEDGE AND SKILLS: 70% (81 points)

1. Verifies the written order for the transfusion.
2. Checks for signed consent for transfusion.
3. Explains the procedure to the patient.
4. Informs patient to report any signs of transfusion reaction. If pre-
medication has been ordered, administer it now.
5. Performs hand hygiene and put on clean gloves.
6. Starts IVF with 0.9% Normal Saline Solution using an 18 or 19 gauge
catheter.
7. Keeps IV open by starting flow of normal saline.
8. Obtains blood product from blood bank within 30 minutes of initiation.
9. Verifies the blood product and the client with another nurse:
a. Client’s name, blood group, Rh type
b. Cross-match compatibility
c. Donor blood group and Rh type
d. Serial number
e. Expiration date and time on blood bag
f. Type of blood product compared with written order
g. Presence of clots in blood
10. Obtains baseline vital signs.
11. Starts infusion:
a. Opens blood transfusion set and closes roller clamp.
b. Spikes blood bag with a blood transfusion set and an 18 or 19 gauge
catheter. (large-bore needle)
c. Squeezes drip chamber and allows the filter to fill with blood.
d. Opens roller clamp and allow tubing to fill with blood.
e. Closes roller clamp.
f. Attaches tubing with an 18 or 19 gauge catheter to the Y-port of the
tubing aseptically. Secure connections with tape.
g. Starts the transfusion slowly.
h. Closes roller clamp of Normal Saline Solution.
i. Removes gloves.
12. Stays with the patient for the first 15-30 minutes of transfusion.
13. Regulates the flow rate as prescribed (if no signs of transfusion reaction).
14. Checks vital signs at least every 15 minutes for the first hour.
15. After blood has infused, wears gloves to clamp off blood and to remove bag
and tubing.
16. Begins Normal Saline Solution infusion.
17. Disposes bag and tubing.
18. Removes gloves and washes hands.
19. Documents the procedure.

TOTAL

Clinical Instructor’s Comment:

_________________________________________________________________
_________________________________________________________________
_________________________________________________________________

________________________________________
Signature over printed name of the Student

________________________________________
Signature over printed name of Clinical Instructor

Prepared:

ANTHONY JOSEPH C. MERCADO, RN, MAN

MS Lecturer

Approved:

MICHELLE B. YU, DM, RN

Dean, College of Nursing