I just started at a lab that does not have a clear transfusion reaction workup protocol. I would like to get a checklist together for the techs and the nursing staff so we can all be on the same page, does anyone else do that? Does anyone use an order set that automatically orders DAT, UA, Bilirubin, or Haptoglobin etc... when a transfusion reaction is expected or do you leave it up to the docs to order as they see fit?

Nursing is required to call Blood Bank and also to order Request to Investigate Suspected Adverse Reaction to Blood Transfusion in their computer.  The computer request is sent to Meditech (Lab and BB computer) to order Transfusion Reaction Investigation.  Blood sample is collected ( and blood container with Transfusion form) and routed to BB for DAT and Visual Inspection.  Clerical Check is done comparing information on blood container label, transfusion form and pretransfusion blood sample for any discrepancies.  This process is documented as the STAT Investigation.  An EXTENDED Investigation (repeat Type and Screen, Crossmatch, chemistries, etc.) is done only if clerical discrepancies, serological discrepancies or Visual Inspection are noted.

 

We have two forms I could send you if you want to message me your email address.  Most of ours is now in the computer also, but the forms have more instructions, both for Nursing and the techs.  Good start.