I have been searching for support reference material for 2 people to issue blood products.  All I can find is 2 people at time of transfusion.  I looked in the CFR and cannot find what I am looking for.  Maybe I am not looking correctly.  Maybe we don't need 2 people to issue blood products.  Can anyone direct me to a reference or inform me on the correct process for issuing blood products?  pretty please

In this context two people means that one person is from the floor or OR (an RN for example) who brings a transfuse order, a physical piece of paper, for a specific patient to the lab. One person in the lab issues the relevant product to the RN. This issuing process therefore involves two people representing the two involved departments comparing the name, MR#, product type and product # and any other requirements (Irr, antigens etc.) prior to formal issue.  This theoretically ensures no errors. That being said I have had an RN bring a valid transfuse order for a different patient to the one she wished to transfuse. 

12 hours ago, Ensis01 said:

In this context two people means that one person is from the floor or OR (an RN for example) who brings a transfuse order, a physical piece of paper, for a specific patient to the lab. One person in the lab issues the relevant product to the RN. This issuing process therefore involves two people representing the two involved departments comparing the name, MR#, product type and product # and any other requirements (Irr, antigens etc.) prior to formal issue.  This theoretically ensures no errors. That being said I have had an RN bring a valid transfuse order for a different patient to the one she wished to transfuse. 

Great this is exactly what I thought, Now I have to prove it to the entire facility that they should be doing this (and many other things ), and they are pushing back, so I need a reference.  Do you have a source I can Per "...." 

On a basic level: someone from the floor needs to collect the product from the BB and check it is correct. Someone from the BB needs to check and issue the correct product. It is a terrifying thought they object to that! You could try and use the same principle as preventing wrong blood in tube!  

As far as I know there is no FDA requirement for two people to issue blood.  Obviously some hospitals have only one person working night shift in the lab, so that isn't happening realistically. There is a traditional requirement for two people to identify the recipient and the transfused product, but this is only if positive patient identification is not used these days. 

We use a hands-off process where the floor faxes their request for blood, the blood banker sends the unit via the pneumatic tube and the floor faxes/sends back the signed copy of the unit tag.

I am finding it difficult to come up with a routine transfusion scenario that does not involve 2 people at issue (one on the floor, one in the blood bank).  

I can come up with a couple of CAP requirements that you could cite, though they don't explicitly say 2 people at issue, you could certainly argue that your way of satisfying the requirement is to have one person from the floor, one person in the blood bank at issue.

 

Thank you all for your responses.  I appreciate your input.  

On 4/22/2025 at 12:14 PM, TKA said:

I have been searching for support reference material for 2 people to issue blood products.  All I can find is 2 people at time of transfusion.  I looked in the CFR and cannot find what I am looking for.  Maybe I am not looking correctly.  Maybe we don't need 2 people to issue blood products.  Can anyone direct me to a reference or inform me on the correct process for issuing blood products?  pretty please

2 people at sign out or issue is not required.  

On 4/22/2025 at 9:08 PM, Ensis01 said:

In this context two people means that one person is from the floor or OR (an RN for example) who brings a transfuse order, a physical piece of paper, for a specific patient to the lab. One person in the lab issues the relevant product to the RN. This issuing process therefore involves two people representing the two involved departments comparing the name, MR#, product type and product # and any other requirements (Irr, antigens etc.) prior to formal issue.  This theoretically ensures no errors. That being said I have had an RN bring a valid transfuse order for a different patient to the one she wished to transfuse. 

If you issue blood via a pneumatic tube system, this introduces some additional processes.