Our facility currently has a consent for transfusion that is good for 30 days after which a new consent has to be signed.  Our NICU staff would like to have a transfusion consent that is good for the length of stay since their patients can stay for up to 4 months if not longer.  We are inspected by The Joint Commission and CAP.  Is anyone aware of specific guidelines that apply to these consents?

Thank you

Our inpatient consents are good for the length of that admission and our outpatient consents are good for a year.  We've never had any issues, but you might check your specific state rules.

Our inpatient consents are also good for the entire admission. I believe that outpatient consents are good for 6 months or the length of a care plan, whichever comes first.

Our consent forms are good for the length of stay for our in-patients, but only for each encounter for our out-patients.  We require a copy of the consent form each time a unit of blood is picked up (barring emergency and a massive bleed).  This has helped us reach (AND MAINTAIN) a 100% 'signed consent form on the chart' standard, but it can be a pain for the RNs and has occasionally lead to loss of the form (Xerox monster) but we can frequently give them back a copy from prior transfusion pickups.  Interesting that 2 of you said consent forms for out-patients can last so long.  How do you keep track of them and where do they have them stored?  How does the RN know the form exists, has been signed and is still good?

On 11/12/2018 at 4:37 PM, cswickard said:

Our consent forms are good for the length of stay for our in-patients, but only for each encounter for our out-patients.  We require a copy of the consent form each time a unit of blood is picked up (barring emergency and a massive bleed).  This has helped us reach (AND MAINTAIN) a 100% 'signed consent form on the chart' standard, but it can be a pain for the RNs and has occasionally lead to loss of the form (Xerox monster) but we can frequently give them back a copy from prior transfusion pickups.  Interesting that 2 of you said consent forms for out-patients can last so long.  How do you keep track of them and where do they have them stored?  How does the RN know the form exists, has been signed and is still good?

The nurses are responsible for keeping track of the signed forms. The order set in the care plan for blood product administration includes a requirement that they verify there is a current signed consent. There is no way to skip that documentation. Could they cheat and say they checked and just tick the box? Of course, but I can't control that. There are ways to audit where people have been in Epic, so I would imagine that you could track that in detail, if someone was inclined to do so. If they are cheating on that, they are cheating on other things and hopefully someone on their end is going to catch them doing it. Nursing and Quality does audit for completion of records, including consents. Everything is in the patient's Epic record - easy to access and see. Once we get our new blood bank software up and going, I'll have time to do more audits, especially since I can easily do it sitting at my desk now. Next years quality project.

Prior to Epic, all infusion center patients had a file folder in a file cabinet. The consent and the orders were stored in that folder for the open visit/care plan. There was a place on the electronic flow sheet used at the time and on the paper tool for down time that required that the consent be verified. When we used that system, I did a bunch of physical audits retrospectively to verify that they were doing what they were supposed to do.

 

 

Our inpatient consents are good for the duration of the admission. Outpatient consents are only good for the one visit, with two exceptions:

1) A onc/chemo pt, where the consent covers the time period of the entire outpatient chemo course

2) A pregnant pt, where the consent covers the entire outpatient portion of the pregnancy (usually chronically anemic women who are not responding to iron and need occasional pRBCs to bump up). That consent doesnt cover the admit for delivery though - that's a separate consent (hello, DIC MTPs!)