Republic of the Philippines

Bicol University
POLANGUI CAMPUS
NURSING DEPARTMENT
Polangui, Albay
www.bupolangui.com
Email: bupc.nursing@gmail.com
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NAME:___________________________________________________ DATE:________________
YEAR AND BLOCK:__________________________________________ RLE GROUP:____________

BLOOD TRANSFUSION CHECKLIST

DEFINITION:

 A transfusion is the transfer of whole blood or blood components such as blood cells &
plasma from one person to another person.

PURPOSE:

 To replace the blood volume

 To increase the oxygen-carrying capacity
 To provide Hemoglobin & WBC in a severely ill patient
 To correct the deficiency of plasma protein
 To combat infection in leukopenia
 To replace the blood with hemolytic agents with fresh blood.
 To provide antibodies.

INDICATIONS
 Anemia is a sudden loss of blood due to hemorrhage, trauma, or burn.
 Deficiencies of plasma protein, clotting factor & hemophilic globulin etc.
 Erythroblastosis fetal, hemolytic, etc.
 Agranulocytosis, leukopenia

EQUIPMENT:
 Cannula 18G or 20G catheter (adult)
 IV set of 0.9 % normal saline solution
 Sterile Gloves
 Blood administration set
 Blood bag
 Thermometer
 BP apparatus
 Stethoscope

PROCEDURES 5 4 3 2 1 Remarks
1. Check physician order.
2. Ask if the patient has had a transfusion or a transfusion reaction in the past.
3. Assess the patient’s condition.
4. Prepare equipment.
5. Advise the patient to report any chills, itching, rashes, or unusual symptoms.
6. Perform hand hygiene.
7. Put on sterile gloves.
8. Hang a container of 0.9 % normal saline with blood administration set
to initiate IV infusion and follow the administration of blood.
9. Start IV with 18 or19 gauge catheter if not already
present keep IV open by starting the flow of normal saline.
10. Obtain blood products from the blood bank according to agency policy.
11. Complete identification and checks as required by the agency.
a. Identification number
b. Blood group and type
c. Expiration date
d. Patient’s name
e. Inspect blood for clots
12. Take a baseline set of vital signs before beginning transfusion especially
temperature.
13. Start an infusion of the product as follow:
a. prime in line filter with blood.
b. start administration slowly and stay with the patient for the first 5
to 15 minutes of transfusion.
c. Check vital signs at least every 15 minutes for the first half hour
d. Observe the patient for flushing, itching, hives, or rash.
e. Use a blood warming device, if indicated, especially with rapid
transfusions through a CVP catheter.
14. Maintain the prescribed flow rate as ordered.
15. When transfusion is complete, clamp off blood and begin to infuse 0.9 %
normal saline.
16. Clean and return equipment.
17. Remove gloves.
18. Wash hands.
19. Record administration of blood and patient’s reactions.
20. Return blood transfusion bag to blood bank according to agency policy.
Total Grade: