Safe Blood Transfusion: Nurse Verification Checklist

Pre-Transfusion Verification: Critical Safety Steps

Before administering any blood product, the nurse must verify the following at bedside with a second licensed clinician:

Mandatory Checks (Two-Person Verification)

1. Patient Identity: Match name and medical record number (MRN) on:
   • Patient wristband
   • Blood product tag/label
   • Transfusion order/requisition
2. Blood Type Compatibility: Confirm ABO and Rh match between:
   • Patient's typed blood
   • Blood product label
   • Compatibility tag (crossmatch)
3. Product Verification:
   • Correct product (PRBCs, FFP, platelets, cryo, etc.)
   • Correct unit number
   • Expiration date/time not passed
   • No signs of hemolysis, clots, discoloration, leaks, abnormal appearance
4. Special Requirements:
   • Irradiated? Leukoreduced? Washed? CMV-negative? HLA-matched?
   • Confirm per patient needs (transplant, immunocompromised, neonates)

If ANY Discrepancy Found

STOP. Do not transfuse. Return product to blood bank immediately. Notify charge nurse and provider. Document in record.

Additional Safety Steps

• Baseline vital signs within 30 min pre-transfusion
• Informed consent verified in chart
• IV access patent (18-20G or larger for PRBCs)
• Blood warmer for rapid/large volume
• Filter set (170-260 micron) primed with normal saline
• Start slowly (2 mL/min x 15 min), monitor closely

This verification process prevents ABO incompatibility—the most fatal transfusion error.