Blood Transfusion Initiated Without Explaining Purpose and Procedure → Patient Anxiety and Refusal

[2] Transfusion Procedure Phase – 10 Possible Error Cases 

1	Omission of pre-transfusion vital signs check
2	Patient and blood verification performed by only one healthcare provider
3	Use of blood transfusion set filter for more than 6 hours
4	Blood transfusion started more than 30 minutes after blood issue
5	Simultaneous administration of 5% dextrose during transfusion → coagulation occurred
6	Transfusion initiated without explaining its purpose and procedure to the patient
7	Storage temperature deviation during transport from blood bank to ward
8	Connection of a different blood product than the physician's order
9	Red blood cells transfused using an infusion pump → red cell damage occurred
10	Use of expired blood bag or one with improper storage conditions

 

 

 

 

 

 

Scenario 6. Blood Transfusion Initiated Without Explaining Purpose and Procedure → Patient Anxiety and Refusal

Patient Information
75-year-old male, receiving regular PRBC transfusions for chronic anemia
Recent hemoglobin: (6.8) g/dL → PRBC 1 unit prescribed

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Nurse (new)
Mr. Kim, I’m going to start your blood transfusion now. Could you raise your wrist, please?

 

Patient
(Visibly startled) Transfusion? No one told me I’d be getting blood today. Why are you putting blood into me all of a sudden?

 

Nurse (new)
(Uneasily) Uh… the order came through, so I was told to start the transfusion… Is that okay?

 

Patient
(Anxiously) I had a fever and racing heartbeat from a transfusion before. You’re just hooking it up without even telling me what’s going on?

 

Nurse (new)
(Flustered) Oh… I’m sorry. Let me get someone to explain things properly.
(Summons the senior nurse)

 

 

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Nurse (senior)
(Approaches the patient calmly)
Mr. Kim, you were prescribed one unit of PRBC today because your anemia levels have dropped again.
This blood has been carefully matched to your blood type and has passed crossmatching.
We’ll start it slowly and monitor you closely, especially for the first 15 minutes.
You’ve already signed the transfusion consent form previously, but I’m happy to go over the process with you again if you’d like.

 

Patient
(Sighs) That helps… I just got scared because no one told me anything.

 

 

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Nurse (new)
(Whispers to senior nurse) I’m sorry—I was about to start the transfusion without any explanation. I thought I was just following orders.

 

Nurse (senior)
It’s okay—it’s a common mistake. But transfusions must never be started without clearly explaining the purpose, process, and possible side effects.
Especially for patients with a history of reactions, communication is crucial.

 

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Nurse (senior)
(Calls Doctor Lee)
Doctor Lee, regarding patient Cheolsoo Kim (Patient ID: 20240415),
the transfusion was nearly started without patient explanation. The patient became anxious and initially refused.
After providing full explanation and reassurance, the patient is now calm and has given consent. We’re preparing to proceed.

 

Doctor Lee
Thanks for the heads-up. Please ensure all steps are followed carefully, especially given his prior adverse reactions.

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Nurse (new)
(EMR Documentation)
🗓 April 13, 2025 – 10:20 AM
• Attempted to initiate PRBC 1 unit transfusion without patient explanation → Patient expressed anxiety and past reaction concerns
• Senior nurse intervened, provided full explanation of purpose, procedure, and safety
• Patient consent obtained; stable vital signs: BP (124/76) mmHg, HR (86) bpm, Temp (36.8)°C
• Doctor Lee notified; transfusion scheduled to proceed

 

 

 

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✅ Key Learning Summary

Situation	Transfusion was initiated without explaining the purpose or process → patient became anxious and hesitant
Nursing Actions	① Halted transfusion and provided full explanation ② Reported to physician ③ Rechecked consent and patient history ④ Resumed transfusion with patient’s informed agreement
EMR Documentation	Time of attempted start, patient response, details of explanation, vitals, and physician contact recorded
Clinical Education Point	✅ Transfusions are clinical and ethical interventions → explanation and consent are non-negotiable ✅ Emotional reassurance directly affects patient cooperation and safety

 

👉 Catheter Management : CVC, PICC, and Implanted Port (Chemoport)

Catheter Management Scenarios: Central Venous Catheter (CVC), Peripherally Inserted Central Catheter (PICC), and Implanted Port

 

👉 Oxygen Therapy(Nasal prong, Mask, Nebulizer)

Applying a Nasal Prong for Oxygen Therapy

 

👉  Transfusion-10 possible Error 

Scenario 1. Crossmatch Completed, but Blood Bank Sent Mismatched Blood → Nurse Identifies Error During Dual Verification and H

Blood Transfusion Initiated Without Explaining Purpose and Procedure → Patient Anxiety and Refusal