1. Verify the written order for the transfusion.
  2. Greet and identify the patient.
  3. Explain the procedure to the client.
  4. Start I.V. if necessary.
  5. Have the client sign consent forms.
  6. Obtain baseline vital signs.
  7. Obtain the blood products from the blood bank within 30 minutes of initiation.
  8. Verify the blood product and the client with another nurse.
    • Client’s name, blood group, RH type.
    • Cross-match compatibility.
    • Donor blood group and RH type.
    • Unit and hospital number.
    • Expiration date and time on blood bag.
    • Type of blood product compared with written order.
    • Presence of clots in blood.
  9. Wash hands and put on gloves.
  10. Open blood administration kit and close roller clamps.
  11. For Y-tubing set:
    • Spike the normal saline bag and prime the tubing between the saline bag and the filter.
    • Squeeze sides of drip chamber and allow filter to partially fill.
    • Open lower roller clamp and prime tubing to the hub.
    • Close lower clamp.
    • Invert blood bag once or twice. Spike blood bag, open clamps, and fill tubing completely, covering the filter with blood.
    • Close lower clamp.
  12. For single tubing set:
    • Spike blood unit using filter tubing.
    • Squeeze drip chamber and allow the filter to fill with blood.
    • Open roller clamp and allow tubing to fill with blood.
    • Piggyback a saline line into the blood administration tubing.
    • Secure all connections with tape.
  13. Attach tubing to venous catheter aseptically and open clamps on blood tubing.
  14. Infuse the blood product at the ordered rate.
  15. Remain with the client for the first 15-30 minutes, monitoring vital signs frequently according to institutional policy.
  16. After blood has infused, flush the tubing with normal saline.
  17. Dispose of bag, tubing, and gloves appropriately. Wash hands.
  18. Document the procedure.

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