Skill 8
Blood Administration
Transfusion therapy or blood replacement is the intravenous (IV) administration of whole blood, its components, or plasma-derived product for therapeutic purposes. Transfusions are used to restore intravascular volume with whole blood or albumin, to restore oxygen-carrying capacity of blood with red blood cells (RBCs), and to provide clotting factors and/or platelets. Despite precautions, transfusion therapy carries risks. Compatibility of the patient and donor is essential.
A health care provider’s order is required for the administration of a blood product. A nurse is responsible for understanding which components are appropriate in various situations.
Delegation Considerations
You cannot delegate the skill of initiating blood therapy to nursing assistive personnel (NAP). After the transfusion has been started and the patient is stable, monitoring of a patient by NAP does not relieve the nurse of the responsibility and accountability to continue to assess the patient during the transfusion. Instruct NAP about:
▪ Frequency of vital sign monitoring.
▪ Obtaining blood components from the blood bank (if agency allows).
