Description

Determination if documentation of an independent double-check for the blood product involved was done.

On-Screen Instructions

Please only include independent double-checks that were documented, performed by two providers or staff immediately before administration of the blood or blood product, and included verification of the patient’s identity, type of product, and expiration date of the product.

Field Type

Responses

• Yes

• No

• Unknown

Guide for Use

In order to meet AHRQ Common Formats specifications for a “two-person three-way check procedure,” the independent double-check must be specified in writing by the facility and must include, at a minimum, the following elements:

A. The check must be performed by two persons, either jointly or one right after the other, immediately before the blood product is administered to the patient. Each of the two must be either a healthcare professional or healthcare worker and be employed by, or on the staff of, the facility. Each must be familiar with the elements of the two-person three-way procedure.

B. The information checked must include 1) The patient's identity, including full name, sex, date of birth and medical record number; 2) the type of product ordered and the blood type and cross-match information, if relevant; and 3) the expiration date of the product.

C. The documentation checked for such information must include 1) the patient's identity band, 2) the label on the product, and 3) the requisition tag.

History