How are standards for transfusion practice developed?
US federal and state regulations require that blood products be prescribed and administered under medical direction. Standards require that each institution develop a protocol for administration of blood and blood components. Transfusion protocols in individual institu-tions are usually developed jointly by the nursing service and the blood bank/transfusion service and adopted by the institution for use by all medical personnel. Protocols include specific instructions for transfusing all components including the use of infusion devices, filters, blood warmers, and other ancillary equipment. They spec-ify mechanisms for patient and product identification prior to infusion, instructions for patient monitoring dur-ing and at the end of the transfusion, and instructions on specific actions that are required if a transfusion reaction occurs. In general, patient records are required to contain the donor unit or pool identification number of the product, the product name, the date and time of trans-fusion, the amount transfused, the identification of the transfusionist, pre- and post-transfusion vital signs, and a description of any transfusion reaction that occurred.