In our Outpatient Infusion Clinic, RNs have always obtained consent for blood transfusions. Does anyone else do this? What is the general school of thought about this? I am looking for any information I can get on this. Thank you in advance.
In our Outpatient Infusion Clinic, RNs have always obtained consent for blood transfusions. Does anyone else do this? What is the general school of thought about this? I am looking for any information I can get on this. Thank you in advance.
The new initative from the Joint Commission on Blood Transfusion Practice Management is the guide on this. I have serious doubts about placing responsibility for this informed consent in the hands of each and every RN. Most RNs do not have the complete knowledge base to adequately inform the patient about the risks, benefits, and alternatives to transfusion. That is what is required for any informed consent. You must be able to address all of this in a language and manner that the patient can understand. Obtaining this informed consent by an infusion nurse specialist could be an alternative as Transfusion Therapy is a major component of that certification. This question should be addressed by the multidisciplianary committee that is managing transfusion practice in your facility. This committee should involve physicians, nurses, pharmacists (for pharmacological alternatives) risk management and infection prevention. Now we know that the risk of infection goes up when transfusion are given. Also the transfusion trigger is now much lower than it ever has been before. So this committee should be the resource to establish and guide all practices for all blood components. If you do a Google search on blood transfusion and informed consent, you will come up with many resources on this issue, including the new gudance book from Joint Commission. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Here in Texas, the RN may witness the signature of the written consent but it is the responsibility of the LIP to obtain consent for any procedure. Many nurses skirt the line when transfusions are ordered, either inpatient or outpatient. Say you have a patient, not competent to give consent, and a transfusion is ordered. Does the ordering practitioner call the POA/NOK, explain the procedure, risks, benefits, and alternatives? Not often. Usually, the RN does this, and a second RN witnesses the telephone consent. Is this kosher? Most likely not, but it is common practice in my area. In an outpatient infusion setting, one could reasonably assume the arrival of the patient for the appointment implies that the LIP has discussed the proposed plan of care with the patient. The clinic RN is not obtaining the consent but witnessing the signature of the written consent. Sematics, but an important distinction.
Kathleen