Before starting a blood transfusion, what is the nurse’s FIRST priority?

Question

BlackTom AI · Accepted Answer

Verifying the patient’s identity with another nurse prevents administration of the wrong blood product and is the single most important step to avoid an ABO-incompatible transfusion reaction.

1) Relevant knowledge points and concepts
- Blood transfusion safety relies on the “right patient, right blood” principle. Misidentification can cause acute hemolytic transfusion reactions, which can be fatal.
- Hospitals and accrediting bodies (e.g., Joint Commission) require a two-person verification of patient identifiers and blood product labels before initiation.
- Other pretransfusion tasks (IV priming, baseline vitals, history of previous transfusions) are important but occur after identity/label confirmation.

2) Step-by-step reasoning process
- Before connecting a blood unit, confirm the patient’s identity (name, date of birth, medical record number) on the wristband.
- Independently compare those identifiers to the blood product label: unit number, blood type, expiration date, and crossmatch/compatibility information.
- A second licensed person (another nurse or blood bank technologist) must perform the same comparison to ensure accuracy.
- Only after both staff confirm the match should the nurse proceed to set up the IV, obtain baseline vital signs, and begin the transfusion per protocol.

3) Intermediate steps (what to check during verification)
- Check wristband: name and DOB.
- Check physician order and consent for transfusion.
- Check blood bag: patient name, ID number, unit number, blood type, expiration.
- Ensure crossmatch/compatibility documented.
- Have second nurse repeat and sign/initial verification.

4) Why the correct answer is correct
- Two-person verification directly prevents wrong-patient errors that can cause catastrophic hemolysis. It is mandated as the first action because it eliminates the greatest immediate risk.

5) Why other options are incorrect
- Priming the IV with normal saline is necessary but should follow identity verification. Priming a line before confirming the patient risks connecting the wrong product to a patient.
- Checking the patient’s temperature is part of baseline vitals and monitoring but not the first priority; you cannot safely start a transfusion without confirming identity.
- Asking about prior transfusions is useful for history and risk assessment but does not prevent immediate wrong-patient or wrong-unit errors.

6) Conclusion
- Confirming identity with another nurse is the first and most critical step; this matches the provided correct answer: Verify the patient’s identity with another nurse.

Before starting a blood transfusion, what is the nurse’s FIRST priority? 单项选择题

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