Has anyone had any issues with accreditating agencies regarding non-hospital personnel monitoring transfusions during transport? We have always required that the patient cannot be handed off to the EMS and that a nurse from our facility must accompany the patient. The Joint Commission standards state that persons who transfuse must be competent in recognizing transfusion reactions and with the wide variety of skills in EMS and with our group being volunteer it would be difficult to provide records for an inspector.

But, it presently is met with many obstacles in having available nurses to ride in ground transport. If patients are air transported those folks have this type of documentation.

Most states require EMS training, even for volunteers. Check with the your regional EMS council--you may be able to get them to include recognition of reactions as part of IV training (or it may be there already). Does your facility require IV trained EMS personnel to transport anyone with IV access?

If we transport via ambulance, one of our nurses accompanies. Transport via helicopter provides their own nurse. Never had a problem with this.

We are the same as David Salkin - an excerpt from our SOP follows -

20.0 Transfer of a patient with blood units and/or blood transfusion in progress to another hospital

20.1 Contact BSH Medical Scientist for direction at Ext 581/583 or out-of-hours on PHONE NO. 087 7749674

20.2 If possible transfusion will be completed prior to transfer

20.3 Patients requiring urgent transfusion during transfer will have this recorded in their medical notes by the Doctor

20.4 Patients with a blood transfusion in progress will be accompanied by a nurse who will monitor the patient as per Point 11

20.5 The BSHG nurse will ensure that transfusion documentation is recorded and retained/returned for BSHG records, which will include:-

§ BSHG Traceability Label, BB101 C

§ BSHG Compatibility Label, BB101 B

§ Compatibility Report Form, BB101 E

§ The Prescription/Transfusion Record BB102.

§ IT IS IMPERATIVE THAT THESE RECORDS ARE RETURNED TO BSHG FOR TRACEABILITY PURPOSES

20.6 The nurse will convey transfusion information to a member of staff at the receiving facility and record same in the BSHG nursing notes

20.7 Extra units will be sent with the patient in transit only if specifically directed by the doctor in charge of the patient.

Again Like David, we have never had a problem.

Cheers, Eoin

Thanks for the details Eoin. I need to check further into the policies nursing has for transport protocol.

Check your state regs. In NYS there has to be a nurse on board, not usually a problem for us on helicopter transport, but it is usually a problem for ambulance transport.

Check with your emergency services coordinator. I asked this question, and the EMS coordinator was able to obtain the state protocols regarding transport of patients with blood products. Each transporting organization (ambulance service, med-flight, etc) also has protocols for who is qualified to transport a patient with blood products.

FYI~ if the product is sent in a box with the patient, and it is transfused, we cannot charge for the administration and therefore the product (since the administration revenue code and the product revenue code must appear on the same pt bill)! :mad:

What if the patient is not currently being transfused...do you send the sample and the crossmatched units with the patient to the new facility?