Ask Nurse Jesse: Blood Administration Protocol

Anonymous Nurse: Is a second person required to verify blood prior to administration if the unit of blood is verified by scanning through the hospital electronic medical record?

Nurse Jesse: While obtaining a 2nd witness verification for blood administration is not required per Ohio statute or rule, it is best practice. The literature shows that patients are at increased risk with only one nurse verifying the information and/or only using an electronic system as a second verification.
Ohio Administrative Code (OAC) does state:
4723-4-06(H) A licensed nurse shall implement measures to promote a safe environment for each patient.

OAC 4723-4-03(E)
A registered nurse shall, in a timely manner:
(1) Implement any order for a patient unless the registered nurse believes or should have reason to believe the order is:
(a) Inaccurate;
(b) Not properly authorized;
(c) Not current or valid;
(d) Harmful, or potentially harmful to a patient; or
(e) Contraindicated by other documented information; and

That being said, the nurse has a responsibility to protect the patient, and administering blood in a manner that is against best practices and guidelines for blood transfusion is potentially dangerous to the patient and may cause a negative outcome.

For more information on the blood transfusion guidelines:
– WHO Guidelines (pg. 22 indicates two-person verification)
– Article: “Recommendations for the electronic pre-transfusion check at the bedside” 2016:

*Please note this information does not constitute legal advice.