Since there is a concern as to if the units are being transfused within 4 hours, it might be an opportunity to perform an audit to verify there is actually a problem.  You have the time issued in the lab's LIS so you have that part tracked and there should be a mechanism to document when the nurses transfused the unit.

We have an electronic time stamp when we issue the blood or blood products. Also, since we use BCTA we have a time and date stamp of when the transfusion was started as well as who started the transfusion. We also have a record of all the vitals performed during that transfusion.

On Thursday, January 14, 2016 at 0:49 PM, amym1586 said:

But wouldn't that prove you need to start the 4 hour count from when it leaves the refrigerator ?

Correct; it's 4 hours from the time it leaves storage (refrig or cooler), NOT when they start it.

And there is no longer a "30 minute rule"; they can leave it sitting on the counter for 3 hours and transfuse it in 1 hour if they wanted to (not ideal of course...).