Blood Administration Checkoff
Name: ____________________________
Section___Peer/Date________________
S= Satisfactory U=Unsatisfactory NP= Not Performed
Upon completion of this checkoff, the student will be able to:
Check Physician Orders (must say administer in the order) Check patient allergies.
Identify patient using two patient identifiers
Be sure the patient signs the consent form for the blood to be administered.
Gather supplies: blood tubing, 250mL of NS, gloves, IV pole/pump.
Explain the procedure to the patient and obtain any transfusion history.
Wash hands
Check the existing IV for patency and needle size or initiate an IV of appropriate size
for a blood transfusion. (Appropriate size is 16 or 18 gauge IV).
Assess vital signs for baseline data, including heart and breath sounds.
If necessary, notify physician of any abnormal or outside of normal baseline data.
Call the blood bank to ensure the blood is ready for the patient.
Set up the infusion equipment by first priming with NS:
Open the blood tubing (Y-set) and close all the tubing clamps.
Insert one y spike into the NS bag and hang on the IV pole.
Open the clamp on the line attached to the NS fluid bag
Squeeze the drip chamber until it covers the filter and 1/3 of the chamber above the
filter.
Open the main tubing clamp to prime the rest of the tubing with the NS with minimal
loss of solution, then close the main clamp.
Attach blood tubing to the IV site
Don clean gloves.
Peer
Faculty
Loosen existing tape and connections if necessary, to remove existing fluids, turn off
any other IV fluid infusions in the IV line to be used.
Remove the tubing and replace with the blood tubing.
Secure tubing with tape.
Regulate the NS infusion with the main clamp at a rate specified by the physician
order.
If no rate is specified, infuse at a TKO rate.
Obtain the blood product from the facility blood center, checking the blood product
with the lab according to the facility policy. The blood must be administered within 30
minutes of it being released from the blood bank.
Inspect the product for any unusual appearance or evidence of leakage.
Upon return to the patient's room, check blood product with a second nurse at the
bedside: Patient's name, hospital number (MRN), DOB, physician name (either using
the patient's blood band or arm band whichever is the policy of the facility)
Check the blood products serial number, patient's ABO group, Rh factor, and
expiration date.
Record date, time, and initials. Verifying nurse is to sign, date and time according to
facility protocol.
Insert the other y spike into the blood bag and hang on IV pole
Clamp the NS portion of the tubing
Unclamp the blood portion of the tubing
Prime the blood to the chamber
Adjust blood administration rate according to the physician’s orders
Check vital signs and remain with the patient for the first 15minutes from start of the
infusion
Wash hands, and document procedure.
Supplies appropriately stored and checkoff area cleaned.
Comments:
Pass/Repeat/Fail
Automatic Fail if the following are performed: Break of sterile field at any time without
recognition and solution to fix. Or air embolus is present.
Revised Fall 2021 MHuster and Madeline Malley