Are there any regulations that specifically outline how often we must obtain informed consent to transfuse? i.e. if there is an inpatient who stays in the hospital for a month and gets transfused every other day...does one signed consent cover it?

What about an outpatient transfusion that would occur at the same frequency as the aforementioned inpatient...do they need a consent form signed at each new visit?

It looks to me like the AABB standards say that the medical director has to be involved in creating the policies, processes and procedures regarding consent. And that there is a list of minimum elements needed within the consent. So...does that mean the rest is up to us?

Thanks!

Heather

Can't think of any regulation regarding Informed Consent to blood transfusions. You and your legal/risk mgmt team have to decide where the comfort level lies within the facility.

My guess is that the "informed consent" current being obtained is pretty poorly done...

I'd suggest getting your Transfusion Comm involved. There should be someone from Risk Management on your Trans Comm. We set our consent up similar to the surgical consent. At our hospital, one consent is good for the entire admission. Out patients, consents are usually for a range of treatment - ie cancer pts consent to treatment and any transfusions associated with that treatment. Other out pts are per day - ie sickle cell pts consent to each day of transfusions.

It really is up to the individual hospital to decide how to do this. Once you decide and have a policy, you need to consistently do what your policy says. So once you set up the policy and train everyone, you need to have some monitoring system. We use utilization review and look at several things during the same audit: no transfusion over the trigger, signed unit tags, vitals signs, consents. As with any audit, you set your own parameters - how many you look at (we do 5%), and what the threshold for acceptable performance is.

In our facility, for inpatients, their initial consent is good for the length of stay unless the reason for transfusing changes. They've signed a consent for blood products for their GI bleed, but if they now have to have surgery for a ruptured appendix they sign a new consent. The reasons and risks are (hopefully) explained to the patient again. Our outpatients sign a new consent each time they come in, but most of our outpatients are transfused every other week or so (instead of every other day like some places) so its really not too cumbersome.