Hemodynamics-RN

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Blood administration

• RN can show how to access Blood Administration policy.

  Yes

  No

  N/A

• RN can describe process to order blood products.

  Yes

  No

  N/A

• RN can show online or paper documentation required to order and obtain blood products.

  Yes

  No

  N/A

• RN can identify and locate specific tubing / filters required for specific blood products.

  Yes

  No

  N/A

• RN describes how to complete blood administration form including compatability -(¤ COMP), Comments -(¤ Special Requirements), accurate total amount infused, and start/stop times.

  Yes

  No

  N/A

• Describes types of orders (type and cross, order to transfuse) and consent (blood consent or limited product consents).

  Yes

  No

  N/A

• RN aware of Igloo temp record.

  Yes

  No

  N/A

• RN identifies solution used for primary IV when administering blood products.

  Yes

  No

  N/A

• Able to describe signs and symptoms of transfusion reactions.

  Yes

  No

  N/A

Equipment

• Describes steps to set up arterial line.

  Yes

  No

  N/A

• Observed setting up arterial line

  Yes

  No

  N/A

• Enter RN name here:

• Describes steps to set up Omniflow.

  Yes

  No

  N/A

• Enter name of RN:

• Describes steps to set up Cellsaver

  Yes

  No

  N/A

• Enter name of RN here:

• Describes/ demonstrates how to Zero an arterial line.

  Yes

  No

  N/A