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Pretransfusion consent

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Do you have recipients sign consent form for every unit, every day or once/visit to the hospital?

We are reviewing our policy and would appreciate your input.

Thank you

j

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For a series of transfusions: one consent.

For surgery it is part of the consent for surgery

For separted and unexpected transfusions one consent with each transfusion.

For out patients definitely one each time.

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we have nothing to do with informed consent. It is up to Nursing and the physician to sign the form and then have the patient sign it. We do check the chart to see if it is filled out when we do audits.

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Is the practice by Kmh76 acceptable for CAP or AABB. At our centre we do the same. My centre is not in USA, with in a year we are to be checked by JCI, so we want to update our polices.

Thanks

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Yes it is acceptable as I just had AABB inspection and had no deficiencies. Also it was the AABB inspector that found on the chart that the informed consent was not signed by the physician. She said this was a Nursing issue

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Once per admission, with oncology/ infusion clinic patients using a monthly admission.

This is also how we do it, though we never see the consent form. The existence/signature on the consent is confirmed on the transfusion flow sheet for every unit transfused.

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This is also how we do it, though we never see the consent form. The existence/signature on the consent is confirmed on the transfusion flow sheet for every unit transfused.

Once per admission and we verify the consent when we perform audits. The nursing dept is responsible for making sure every patient receiving blood has the consent form signed. We do require a physician's order "to transfuse" before we issue though.

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It is the physician who decides to transfude a blood or blood component so s/he should be responsible for obtaining the informed consent from the patient. Why is a blood transfusion service supposed to obtain consent? Who is responsible for maintaining the record of the consent documentation ?

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It is the physician who decides to transfude a blood or blood component so s/he should be responsible for obtaining the informed consent from the patient. Why is a blood transfusion service supposed to obtain consent? Who is responsible for maintaining the record of the consent documentation ?

COULD NOT AGREE WITH YOU MORE angie (but we have always been the whipping boys)!

:rage::rage::rage::rage::rage:

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Nursing service and the physician are the persons responsible for obtaining consent here. I just required that this is documented on the form that nursing brings when they pick up units of blood. For those transported to surgery, the physician in charge of the patient is deemed as responsible for the consent being given before he or she hangs the unit.

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Does anyone out there have problems with physicians complying with signing before transfusion? Does anyone have an answer to physicians wanting nursing to explain the consent form, get the patient signature, and witness it. Then the physician will sign it later (sometimes weeks later at discharge when medical records insists!!).:cries:

Can anyone quote me the regulation / standard that says the physician must sign before transfusion or is this set down by the institution? :confused:

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Does anyone out there have problems with physicians complying with signing before transfusion? Does anyone have an answer to physicians wanting nursing to explain the consent form, get the patient signature, and witness it. Then the physician will sign it later (sometimes weeks later at discharge when medical records insists!!).:cries:

Can anyone quote me the regulation / standard that says the physician must sign before transfusion or is this set down by the institution? :confused:

I think probably MANY of us have problems with physicians wanting to sign pretransfusion consent.

AABB Standard 5.19.1

The Joint Commission also requires it. However, it is more of a legal issue than a regulatory one. Meet with someone in your Risk Management or Legal department, as many of the issues surrounding blood consent are the same as for surgical/anesthesia consent. Pretransfusion consent is necessary to protect the patient's rights as well as protect the hospital from litigation. For example, if you transfuse a patient without consent and they press charges, they can also charge everyone involved with assault and battery. This is serious stuff, and you need to get legal on your side to help the physicians comply.

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We here in a Sydney Australia metro hospital have devised a 'Long-term Consent to Transfusion' that is used exclusively for the outpatient-type chronically transfused and for a defined medical condition. The special consent is signed and witnessed and scanned into the patient's electronic medical record and may be viewed at each presentation for transfusion of blood products. The consent is ongoing for as long as the patient turns up for (routine) transfusion. In the event that they require a transfusion for a different reason, then a new consent is to be obtained.

For inpatients, the consent is valid for one single admission period.

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I strongly agree that this is an issue for the COS and BOT. Here the accreditation dept collects stats and presents them to the BOT monthly, the consent is one of the hospital wide indicators. Our transfusions are not started without a consent, unless it is life saving.

Take it to a higher level because this is a straight forward medicolegal issue and MUST be abided by. Dont let them make their problems yours, just inform by documentation the office of the COS. S/he will deal with the physicians.

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One per admission - must be by medico (Housemen to consultant - any involved with the patient will do. Must be "informed consent" (here they get a leaflet at blood draw, which gives them time to read & think about it if they are with it and there is time) where possible. We also have one for them to document refusing consent as well, but given a case recently where patient was transfused against her wishes and hosp action was upheld by the court, who knows what is what any more. Much rather have them than not from a risk perspective. It is also a KPI we follow.

Cheers

Eoin

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The consent is ongoing for as long as the patient turns up for (routine) transfusion. In the event that they require a transfusion for a different reason, then a new consent is to be obtained.

For inpatients, the consent is valid for one single admission period.

just want to confirm using an example.... if one thalassemia patient needs one blood bag of FFP it needs a new informed consent? or one hemophiliac (in my hospital there are hemophiliacs who still get whether FFP or AHF/ Cryo), and he needs to be transfused with PRC, then a new informed consent needs to be made?

and for inpatients, won't the same rule applied? I mean a new consent to be obtained when they require a transfusion for a different reason.

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