Trm.41650

[n.peters]

TRM.41650 Are criteria for the recognition of tranfsuion reactions documented, and is there documentation of periodic in-service education on the recognition of such reactions?

Does anybody have any suggestions for this requirement. We have the transfusion reaction SOP for nursing that is available to them and we used to have yearly nursing education fairs that covered transfusion/transfusion reactions. Then I found out they were discontinued. Anybody have any suggestions.

[AMcCord]

We were cited for this one a number of years ago. We had to institute a mandatory yearly training requirement for nursing on this subject. We got their cooperation when we told them it was required for regulatory compliance (Joint Commision is a wonderful weapon :tongue:). I borrow a copy of the training roster (many! pages long) as documentation for inspections.

As a part of this training they get a case study for a transfusion reaction, a different type each year, with questions to answer. They also get a general review of institution policy from staff development. Nursing manuals include an SOP for recognition of and response to suspected transfusion reactions which includes a section of signs and symptoms. The quiz is evaluated by someone from staff development so they can see who needs a refresher or if they need to do some focused general education. As the blood bank supervisor, I am involved with the development of their training exercises and SOPs for transfusions (at staff development's request). I am sometimes asked to develop the case study and sometimes they simply ask me for a review of what they have worked up. If we've had a real case where something was done wrong (or very right) or if there seems to be a common problem, this becomes the focus for the yearly exercise.

We are pretty excited for future reviews. The hospital has recently purchased an iSTAN for staff education. If you aren't familiar with iSTAN, this is a computerized human simulator that can be programmed to display symptoms, make responses to stimuli, etc etc. Very cool training tool! We plan on setting up iSTAN to simulate a transfusion reaction - he/she could show symptoms for TRALI or AHTR or whatever you choose.

Pretty longwinded...sorry!

[Lcsmrz]

Transfusion Reactions are currently part of our annual Skills Fair for nurses, although we're considering going to on-line modules in the future.

[Likewine99]

We also make it part of the yearly nursing education "blitz". For those not attending they are given a copy the Power Point presentation.

I had a CAP inspector ask one time to see the person who was picking up blood in the BB's training checklist for this reg!

[adiescast]

We have a computer based training system that has a module on recognizing transfusion reactions and other aspects of blood administration that we have been able to personalize for our institution. The nurses view the module and take a test. It almost certainly is not as good as teh system that requires appropriate responses to simulated situations. That sounds intriguing!

[babsglab]

I present "Transfusion Reactions 101" twice a year at our nursing skills sessions, and make sure I mention it once or twice a year at lab meetings. Babs

[AMcCord]

The mention at lab meetings is an excellent suggestion. It might help with the calls I get from nurses who say "we called about a reaction and the lab tech didn't know what to do"!

[Liz]

The mention at lab meetings is an excellent suggestion. It might help with the calls I get from nurses who say "we called about a reaction and the lab tech didn't know what to do"!

I cannot believe it! We get the same calls! They must have gone to the same communication school. Or its an international thing.

Do you have your Transfusion Investigation worksheet that I can have a look at please? Pretty please.

ek01@aub.edu.lb

Thank you

Liz

[AMcCord]

My transfusion investigation worksheet is awful!!! - if it was good I would be happy to share. We had a Medical Director for years who declined to change anything and insisted that we do an absolutely full blown investigation for everything, including a rash. He retired a year again, so I am in the process of rethinking and redoing just about everything. Just haven't gotten to that yet.

I have found some good examples of a variety of things by searching the web. There are a number of big hospitals/organizations who have policies and procedures on line and available without password. You can get some good ideas that way.

[LAS]

Our education department covers transfusion practice, including recognizing signs/symptoms of reaction during nursing orientation. It is also covered in the annual mandatory education blitz. We also have the signs/symptoms listed on the transfusion record, right beside where vitals are recorded. We have also included a question at the bottom of the transfusion report, right after the nurse documents time, etc. that she ended the infusion, asking if there was evidence of a reaction and she must answer it yes or no.

Edited August 6, 2008 by LAS
typo

[bbbirder]

We have a computer based training for this. I think the nurses prefer this, since they can do it at their convenience.

Linda Frederick

[bpkelly]

Our system has an online continuing education module. In addition, we do transfusion monitors and discuss transfusion reactions with the nurse while performing the monitor.