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Sue Arata

Transfusion vital signs

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So, my question pertains to transfusion tag compliance and when the nurses are supposed to take vital signs. It has been my understanding that baseline vitals are taken immediately prior to starting a transfusion, and then again after 15 minutes of infusion, and again at the end of the transfusion.

I cannot find any information on the CAP requirements regarding the monitoring of this information.

Thank you in advance for any input.

Susan I. Arata MLS (ASCP)

Senior Lead Transfusion Services

Mercy Medical Center

Roseburg, OR

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You might want to check with the state, and/or national nurse organizations for this information.  They are the ones generally in charge of nursing practice.  Another place to look would be JCHO (or what ever they are calling themselves now).  They may have the information you are looking for.  Lab organizations such as CAP and AABB are reluctant to make rules or requirements telling nurses what to do.  :coffeecup:

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On ‎5‎/‎9‎/‎2019 at 5:51 PM, Ensis01 said:

I liked the first vitals being taken just before the blood was picked up. This prevented many a wasted unit. Not sure if this policy was regulatory or if common sense had broken out. 

Amen! 

Our nurses take vitals before, at 15 mins, at 1 hour, and at end (<4hrs).  Don't know where it came from but that is our policy.

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On 5/11/2019 at 1:46 PM, cswickard said:

Amen! 

Our nurses take vitals before, at 15 mins, at 1 hour, and at end (<4hrs).  Don't know where it came from but that is our policy.

Nursing policy says that they must take pre-transfusion vitals no more than 15 minutes prior to checking out the blood product, then repeat vitals at 15 min and at the end (<4 hrs). Most of our transfusions run 90-120 minutes.

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Besides at the start and at 15 mins, we document every hour, at the end, and 1 hour post.

Scott

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After being cited by a NYS inspector a few years ago for vital signs not being documented as described in the blood administration policy (some pre- and post vitals were documented with the same time as the start and end times) I searched through numerous P&P's and regulations from around the world (English speaking anyway) to find a fix.  The citing was legitimate (pre=BEFORE START, post....) and I wanted the corrective action to reflect the most up-to-date best practice I could find.  There was an almost universal policy/regulation for pre-, 15 min and post vital signs.  The variations in the timing of vital signs (other than the 15 min ) was all over the map.  The multitude of situations patients are in make it difficult to be cut and dry in a P&P.  Decided to go with pre- and post within 30 min of start and stop;  must stay with patient first 15 min so that was easy.  More frequent vitals if provider indicated (almost never) or transfusionist deems patient requires - or if I recommend with my knowledge of the patient history / lab results.   You know though, that as soon as there's an incident they'll "fix" it by requiring more frequent vitals and the loop continues...keep your old policy handy.

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