Skill Check-Off Competency:

Blood Administration

Step / Action / Acceptable
OR
Unacceptable
(A/U)
Preparation for infusion / Verifies appropriate size of IV cannula, IV site condition, and patency of IV
Reviews physician’s order and assures transfusion consent has been signed by client
Verbalizes client condition requiring particular blood component
Prepares Blood-Y tubing with Normal Saline and connects to IV catheter hub
Programs pump
Assesses client’s understanding of blood administration, comfort level, and presence of any signs or symptoms similar to those of a transfusion reaction
Brings appropriate equipment and monitors to client’s bedside
Obtains blood component and verbalizes maximum time allowed to begin infusion
Correctly verifies blood component and client identification with another RN or physician at client’s bedside
Performs hand hygiene and dons clean gloves
Assesses client’s vital signs including temperature
Spikes blood unit, shuts roller clamp to NS and opens roller clamp to unit
Primes tubing with blood component
Sets pump at 30cc/ hour and follows infusion rate schedule as noted on back of infusion form
Verbalizes length of time required to stay with client during initiation of infusion
Verbalizes NNRH protocol for frequency of vital signs during infusion while referring to transfusion record
Verbalizes signs and symptoms of a transfusion reaction
Verbalizes nursing procedure for possible transfusion reaction
When infusion complete, changes IV drip to NS and discards blood bag
Performs hand hygiene
Documentation / In addition to documentation on transfusion record, records infusion on MAR and I & O record

Blood Administration Skill Performance (circle one):

PASS FAIL

Instructor’s initials and date: ______

Student’s initials: ______

*Automatic failure if contamination of IV set up

*More than 2 unacceptable actions results in failure of skill

Monitoring Blood Administration Skill Performance (circle one):

PASS FAIL

Instructor’s initials and date: ______

Student’s initials: ______

***Monitoring criteria in bold-face type

*More than 1 unacceptable action results in failure of skill