Immediately before initiating a red blood cell transfusion, which verification should the nurse complete according to transfusion policy?
1Match the room number and admitting diagnosis to the requisition, then begin the transfusion without checking the wristband.
2Inspect the unit appearance and donor ABO group only, then confirm the recipient information after the transfusion begins.
3Verify two recipient identifiers, ABO/Rh, donation number, crossmatch, special requirements, and expiration at the bedside.✓ Correct answer
4Confirm the prescription and expiration at the nurses' station, then delegate bedside identification to unlicensed personnel.
Explanation
Pretransfusion verification must link the intended recipient to the correct component before administration. Required elements include two independent recipient identifiers, recipient and donor ABO and Rh information as applicable, donation identification number, crossmatch interpretation, special requirements, and expiration. Room number is not an identifier, verification cannot be delayed until after initiation, and responsibility cannot be delegated to unlicensed personnel.
Clinical reasoning A wrong-patient or incompatible-component error can cause an acute hemolytic transfusion reaction. The final bedside check is the last barrier before exposure.
Decision rule Before starting the component, match two recipient identifiers and every critical unit and compatibility element required by policy. Resolve any discrepancy before transfusion.
Scenario Adult with symptomatic anemia ordered for 1 unit PRBCs. Unit retrieved from blood bank.