Blood Transfusions in the Home

[bevydawn]

Our hospice has just recently started inquiring about doing in-home transfusions. I know this is obviously something that is done, but have never worked somewhere where it has been practiced. Does anyone deal with this at your facility? If so, what are some considerations we need to make before deciding to do this or not to do this? Any insight would be greatly appreciated!

[OPUS104]

I hope this does not sound as harsh to everyone else as it does to myself............................but why would a "hospice" service transfuse blood? I have never worked with a hospice service directly so I may have misunderstand what their "mission" is. Like I said, I apologize beforehand if I offend anyone here, but that seems like transfusing someone you have withdrawn support from.

[Mabel Adams]

I know we sometimes transfuse plts to inpatients that are "comfort care" only because their constant nosebleeds otherwise interfere with their ability to visit with family. I would guess there are times when red cells are given to keep the person from feeling too faint or having chest pain while waiting for the cancer to finish off some other organ system.

Also, our hospital does Hospice and Home Health in the same dept. so maybe it is really a home health patient.

They have very rarely transfused blood from our facility. There are issues of the nurses staying proficient, the time necessary for the nurse to stay with the patient both during and after transfusion and recourse if a reaction occurs.

[rcurrie]

Our hospice department transfuses blood for patient comfort, as Mabel says, while waiting on the primary condition to take its toll. This may surprise you, but not everyone admitted to hospice ends up dying. My mother underwent hospice care for the standard 6 months, then lived another year. I had one patient who was way down on the liver transplant list and not expected to make it, but suddenly was a match to a donor where no one else on the list above them was.

I train the hospice nurses, and they have never had any problems in the field.

BC

[OPUS104]

My only experience with hospice was with my mother and step-father. They were both placed in hospice during their final days fighting cancer, so I thought that what she was talking about must be a little different than their situation. Just wondering, (little devil's advicate) are there storage/transportation records that must be kept?

[rcurrie]

I don't know. I do know that the hospice nurse notifies the funeral home right away, so I don't think there is much of a storage issue, if any.

BC