LESSON PLAN FOR PRACTICE TEACHING

Page 1

Specific Topic:    Assisting Blood Transfusion                                              

Time Frame/Date:    10:30AM-11:10AM (40 minutes) / September 8, 2022     

General Objectives:
After 40 minutes of practicing teaching, the staff student nurses (SSNs) will be
able to:
1. Discuss the important steps needed in assisting blood transfusion and
why blood transfusions are done.

2. Develop a health teaching plan that caters to a patient that is in need of

blood transfusion based on the case scenario that they are given.

3. Demonstrate awareness of the responsibilities of nurses in assisting

blood transfusions.

Teaching Strategies:   Lecture-discussion, Question and Answer

Instructional Materials:   PowerPoint Presentation, Electronic Visual Aids
(pictures and videos)   
Evaluation: (In narrative form and must be based on the objectives)
After 40 minutes of practicing teaching, the staff student nurses were able
to discuss the important steps in assisting blood transfusion. Sung Kyun Na from
Level 2 Section B has stated that verifying the patient who is subjected to a blood
transfusion is very important to be able to administer the right blood product to
the right patient. I have also asked the SSNs why blood transfusions are done and
have gotten the picture of cesarean section surgery correctly while I previewed it
on screen. After the discussion, they were asked what will the nurse do if the
nurse suspected an adverse reaction to the patient, one student who was raising
her hand answered correctly that the nurse needs to stop the transfusion quickly
and replace blood giving set to a new one.
The SSNs can also explain to the patient what the blood transfusion
procedure will entail so that the client will not be nervous. They understood that
they need to tell the patient the side effects and ask the history of the patient of
the blood transfusion as evidenced by the reaction button when I asked them if
they understand that health teaching in this step is important. They are now able
to create a health teaching plan that can give the patient pointers on what to take
note of and what to do when undergoing a blood transfusion and what to do after
a blood transfusion. In this sense, objective #2 is goal met along with objective #1.
 The SSNs are fully aware of their responsibilities as staff nurses in the future
on their responsibilities once they are the ones handling a patient who has blood
transfusion. It has been emphasized to them multiple times that the blood
transfusion requires to have a physician’s order and they cannot use the blood
transfusion as an independent nursing intervention. They also are aware that they
need to document the blood bag and have it checked with the patient to make
sure that no medical errors are created. They are aware that it is their
responsibility to verify the patient and make sure that the blood given to them is
compatible to the recipient’s blood. The SSNs understood that monitoring of vital
signs is important as it has been emphasized to them that the first fifteen minutes
of blood transfusion is crucial as there could be adverse reactions. Overall, they
were able to cite their responsibilities as a nurse on duty. One student mentioned
that it is the nurse’s duty to make sure that the patient has a safe blood
transfusion. Objective #3 is successfully met in this sense.

References: (At least 2 book references and 1 legitimate internet reference)

Book references:
Perry, A. G., Potter, P. A., & Ostendorf, W. (2018). Skills performance checklist for
clinical nursing skills and techniques. 9th ed. Mosby.

Zomorrodi, A., Picciola, E. A., & Hotwagner, D. T. (2021). Determining the Need for
Blood Transfusion. In StatPearls. StatPearls Publishing.

Internet Reference:
Lotterman S, Sharma S. (2022) Blood Transfusion. StatPearls [Internet]. Treasure
Island (FL): StatPearls Publishing. Retrieved
https://www.ncbi.nlm.nih.gov/books/NBK499824/

Prepared by:     Julia Therese A. Galang                      

(Signature over Printed Name of PCI)

Clinical Instructor:   Mila C. Espiritu RN, MN                               

(Signature over Printed Name of Area Facilitator)
Page 2: Content

I. Definition of Terms
Blood Transfusion – A common procedure that involves transferring blood
or blood components from one person into the bloodstream of another
person intravenously (Lotterman & Sharma, 2022).
- Frequently used in the supportive care for treatment of anemia.
- It usually takes 4 hours to consume blood.
- Usually you are assisting the staff nurse in administering blood
transfusion. It takes 2-3 staff nurses in the OPD to check and verify
the blood product that is required by the doctor for proper cross
matching.
- Proper cross-matching is done before proceeding with the blood
transfusion

Autologous Blood Transfusion – The procedure of transfusion of one’s own

blood. This is the safest method but requires advanced planning and not all
patients are eligible for it.
- Blood collected from patient for re-transfusion at later time into
the same individual

Blood Bank – It is a place where healthcare providers ensure that blood

transfusions are safe and will be a low risk treatment.
- They ensure that all blood products are safe before they are used
in blood transfusions.

II. Rationale of Blood Transfusion

Reasons why blood transfusions are done (Perry, Potter & Ostendorf,
2018):

A blood transfusion may be needed if you have a shortage of red blood

cells. This may be because your body's not making enough red blood cells
or because you have lost blood.

● Severe Bleeding
o Mention about anemia
● Major injuries
- Vehicular accidents
● Major surgeries and other conditions
Examples:
- Bone Marrow Failure
- Caesarean Section
III. Equipment Needed for Blood Transfusion
Make sure to check if these work properly:
● Vital signs equipment
● Blood warmer (if needed)
● Blood transfusion set and filter (Y-sets or Single Tubing Set)
● Intravenous solution 0.9% sodium chloride (normal saline)
● Infusion pump if compatible with the specific blood product
● Venipuncture equipment in the client does not have an IV line in place
● Unit of whole blood, packed RBCs, or other component in plastic bags
obtained from the blood bank
● Tape
● Pressure bag (if needed)
● Clean gloves
● Antiseptic swabs
● Signed transfusion consent

IV. Time for Whole Transfusion To Be Fully Consumed:

● 4 Hours: Red Blood Cells (RBC) and Fresh Frozen Plasma
● 1 Hour: Platelets

V. The procedure of Assisting Blood Transfusion

Before Actual Procedure
1. Verify the doctor’s order for the transfusion.
2. Verify patient. Make sure to ask for their first name and surname,
check the hospital number, date of birth, and patient’s ID wristband
3. Explain the procedure of the client
● Remember to let them know about the side effects of blood
transfusion
● Ask the patient’s history about blood transfusion.
4. Have the client sign the consent form
5. Ensure that the patient has venous access (will need to site cannula if
no access present)
● If the patient does not have a venous access in place, initiate
peripheral venous access after obtaining the vital signs.
6. Obtain and record baseline vital signs prior to blood transfusion
● Follow your institution’s policy for checking vital signs
7. Wash hands and put on clean gloves.
8. Prepare the infusion equipment
● Start preparing the priming of tubing using the normal saline.
● Show the video how to prepare the infusion equipment and
take note to close all the clamps on the Y-Set
9. Prime the tubing with normal saline and attach to the intravenous
catheter
10.Preparing the blood bag.
 ● Emphasize that this is the step where they can get the blood
bag from the blood bank and to keep in mind that there is a set
of time for the blood component to be fully consumed.
● Let the students see how to do the pre-transfusion check and
label format of the blood bag.
11. Establish blood transfusion
● Emphasize that one roller clamp should be open at a time to prevent
backflow. The clamp from the normal saline should be closed if you want
the blood to go directly to the patient.
12.Observe the client closely for the first 15 minutes.
● Tell the SSNs that the first 15 minutes is important for observing the
patient since most of the blood transfusion adverse reactions can be
noticed at this period.
13.After the observation period of (5-15 minutes), increase the infusion
rate to calculated rate.
14.Continue to monitor the client during the blood transfusion.
● Tell the SSNs what to do if the client has a reaction for the first 15
minutes. Tell them to stop the blood transfusion quickly, replace the
blood giving set and replace it with a new set along with normal saline to
make sure that the blood with the discrepancy will be infused.
15.Inform nurses that blood is running and to make sure routine
observations are made.

When Transfusion is Complete:

1. When all the blood has infused into the patient, don clean
gloves and clamp the administration set.
2. Initiate infusion of normal saline.
3. Cap access site, resume previous IV infusion or remove
catheter according to doctor's orders.
4. Remove blood bag and tubing.
5. Note vital signs.
6. Dispose of blood transfusion equipment or return to blood bag
according to facility policy.
7. Dispose of clean gloves.
o Ask the SSNs the rationale why we do handwashing.

VI. Evaluation of Blood Transfusion

1. Observe for signs of transfusion reaction: Flushing, dyspnea, itching,
hives or rash, unusual comments from the patient
2. Monitor client for signs and symptoms of fluid overload.
● Inform the SSNs that edema is one of the signs of fluid overload

VII. Documentation
Make sure these items are documented:
1. Type of blood product administered
2. Any complications or reactions that the patient has experienced
 3. Client’s response to the transfusion (subjective response)
4. Blood unit number
5. Start and end times
6. Names of persons starting and ending the transfusion
7. Amount of Blood absorbed or transfused
8. Vital signs
9. Assessment of the IV site and any other fluids infused during the
procedure

** Make sure to ask the SSNs if they have questions about the topic before
ending the topic proper.