I work in small Infusion Clinic and we have always had the policy that no more than 2 units of blood products be given in the outpatient setting in a 24 hour period.
What is every ones thoughts on that and what are your policies on the subject?
Thanks
Do you know why this was your policy? I am just curious as to how this came about. I can't give any examples of what others are doing but just trying to figure out why this policy was created. It might have been due to chair time, to the increased risk of transfusion reaction with more units, or to the fact that anyone needing ore than 2 is too sick for an outpatient setting - just my first thoughts. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
In the INS policy and procedure manual 3rd edition under the transfusion section it states that no more than 2 units blood products be given in an outpatient setting in a 24 hour period. We also felt that anyone needing more really was too sick for an outpatient setting. Just wondering if it would be considered best practice.
I just checked the INS Policies and Procedures 2011 4th edition and there is no policy in this edition on transfusion. Not sure why. Eager to here thoughts of those working in oupt. setting. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Our Procedure Center also does outpatient infusion. We do not have a policy that states the limit of units. Incidentally, the most we have done is 3.
Some ideas for your research with your facility include tracking down the owner of the policy. Maybe they know about the history and rationale.
Just off the cuff, I am wondering if this is fiscally generated. I can tell you that there have been times when a transfusion didn't get started until afternoon, that we were required to send the patient to an inpatient room. They didn't get charged an inpt. rate, but keeping our center open until 10 pm for a single pt. transfusion isn't something that makes economic sense. It was a good way to meet the patients needs, and be thoughtful about staffing.
Thank you,
Kathleen
Kathleen Wilson, CRNI
We originally instituted this policy because in the 3rd edition of the INS P&P manual it stated no more than 2 units blood products be given in a 24 hour period in the outpatient setting. I was looking the 4th edition and the policy is no longer there. No only that the whole section on blood transfusions is not there. I was just wondering if the INS's view on this has changed.
It means that the people writing the 4th edition of the policy and procedure book chose not to include this section. I would not take it as any position that INS is taking. They were updating this book at the same time that the standards committee was revising the 2011 Standards of Practice. It is important to remember that the policy book offers suggested p&p, but the standards of practice is the legally authoritative document and the one your practice should be measured against. The SOP is based on published evidence. If there is no statement about your question in the SOP, then there is no evidence that we could use for writing an applicable standard statement. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861