Does nursing ask about previous transfusions

[jalomahe]

When patients are admitted to your facility does nursing ask/chart answers to questions about previous transfusions, antibodies, transfusion reactions, etc as part of the medical history? What about if the physician orders transfusion are questions asked/charted then? Possibly as part of the order? Maybe as part of consent?

Reason for question. Recently had patient with multiple antibodies identified by another facility 10 yrs ago. Only one of the antibodies was still detectable. Patient was transfused, had a strong delayed tranfusion reaction requiring readmission. Found out while doing transfusion reaction workup patient had an "Antibodies Present" card from the former facility.

Just trying to figure out a way to lessen the possibility of a repeat error. For all I know this has happened before and we didn't have a problem because the antibodies were still detectable.

Thanks for your input.

Jan

[R1R2]

No, they do not ask. I don't know of any facility that does ask.

R1R2

[aafrin]

As part of our Blood Request Form, we do have questions for any previous transfusions, transfusion reactions, pregnancies and miscarriages. They are usually answered as not Known. Very few have yes ticked.

[LaraT23]

We do ask, I worked with nursing to come up with some pre pre procedure, pre admission, type questions. We ask, have you been transfused, then in if Yes, is it in the past 90 days, then have you ever had complications, or reactions or antibodies detected, and lastly, do you have reasons to refuse blood products. These are asked on every admission for any procedure, ED, inpatient or infusion therapy visit.

[AMcCord]

I've tried to get nursing service to do it as part of the patients admit process. I've asked them to build a question into the EMR admit form. No luck. I have tried to educate nursing management on the importance of us knowing about that little 'I have an antibody' card that patients may present, transplant patients, etc. Hasn't gotten me anywhere. I have not given up, however!

[Dr. Pepper]

We have our pre-op phlebotomist ask the pregnant or transfused in the last three months question so we know if we can extend the life of the specimen past 3 days. The trouble is when "No" is checked off and your computer is telling you they got blood the month before! Hmm....

Hats off to Lara for getting that P&P in place and hopefully getting accurate answers.

[David Saikin]

Our Phlebs ask the questions if we draw the blood - otherwise, Nursing does not. It is difficult to get a transfusion hx from Nursing at any time . . . they only ask about transfusion here . . . difficult nut to crack for me.

[SMILLER]

We do this for pre-op patients (having surgery the same morning as admission). They fill out a history form that asks about previous admissions to other hospitals, as well as pregnancy status and whether or not they have been transfused.

The reason we started doing this is that monday through friday, we have these patients coming in to pre-op, being processed there (including a specimen sent to BB along with the history form), and then they are off to OR. For a routine T&S this is usually not a problem. But many times we have had to call OR to let them know that blood will not be immediately available due to a problem with 'atypical antibodies'. The history form is helpful when we need to call other facilities where the patient has been seen before to help figure out where we may be going with the work up, what Ag typings we may need to do, etc.

Of course, we would never assume that this information as written by the patient is 100% accurate and complete.

Scott