Transfusing Blood Products in PCS outside of TAR

Key points:

1. Reminder: Consent remains on paper and is scanned into the EMR. Prior to beginning transfusion, confirm that consent has been obtained.
2. Transfusion Intervention is only to be used when Blood Bank is unavailable to issue blood product (i.e. after hours)
3. TAR Vital Signs Frequencies are a requirement and will populate onto the Worklist:

• Baseline vital signs when beginning transfusion. Monitor the patient closely for the first 15 minutes.
• 15 minutes after starting the transfusion. 
• 30 minutes after starting the transfusion.
• Hourly until transfusion is complete
• Ensure to document at the end of the transfusion and change status to “Complete” otherwise will remain on Worklist Q1H 

4. **A Transfusion is not considered complete until the blood product transfusion has been ended and the vital signs are documented **

Issuing/Receiving Blood Products:

• Will follow site processes 
• Orders will be acknowledged on the Status Board
• TAR column on Status Board will not populate any information as this is connected to the TAR module

Transfusing a Blood Product

1. Go to the Worklist and Add Transfusion Administration Record (TAR) Intervention

Note: Associated Data and Item Text

Clicking on the  A will display any associated lab results always note the Date/Time

Clicking on the I or opening to document on the intervention will display the item text reminding end-users to only use this intervention when BBK not available to issue product through TAR  

2. Add the Blood Product to be transfused and the number (i.e. 1st unit of PRBC select Packed Red Blood Cells and 1). 
3. Document the Product Unit # (if applicable). Note that you can scan the product number in will start with a = followed by the identifier.
4. Required field** Transfusion Status - this will create specific rules to ensure proper documentation is done for accreditation standards. 

• Begin Transfusion will require: 
• Begin Date and Time
• Patient Verification
• Product Type
• Product Expiration Date
• Transfusion Checklist
• Container Volume
• Transfusing will skip verification and not have any required fields
• Hold Transfusion will skip verification but require the end-user to document if the transfusion is being held due to a Transfusion Reaction
• End Transfusion will pop up with a message to remind the end-user to document Transfusion Vital Signs and require: 
• End-user to identify if there was any Transfusion Reaction
• End Date and Time
• Container Volume 
• Cumulative Intake
• Rhogam Administration will require:
• Patient and product Verification
• Cumulative Intake
• Rhogam Dose (mcg)

Documenting TAR Vital Signs

• If Begin Transfusion is selected upon Saving and Exiting the documentation end-users will be made aware that the TAR Vital Signs will be added as a Miscellaneous Intervention once OK is selected.

• TAR Vital Signs will default in to a frequency of Q1Hx1, Q15Mx2 and Q1HR

Transfusion Reaction

1. If Yes is answered for Transfusion Reaction a Warning message will populate to remind end-user

2. Upon saving and exiting the intervention, if the assessment wasn’t previously added, end-users will be made aware that the Transfusion Reaction Assessment will be added as a Miscellaneous Intervention once OK is selected.