Blood Transfusion Verification Checklist
Patient Identification Verified
*
Yes
No
Not Applicable
Blood Product Label Matches Patient ID
*
Yes
No
Not Applicable
Blood Product Expiry Date Checked
*
Yes
No
Not Applicable
Consent Form Signed and Verified
*
Yes
No
Not Applicable
Vital Signs Recorded Before Transfusion
*
Yes
No
Not Applicable
Transfusion Equipment Prepared and Checked
*
Yes
No
Not Applicable
Transfusion Started Within Recommended Time
*
Yes
No
Not Applicable
Patient Monitored During Transfusion
*
Yes
No
Not Applicable
Post-Transfusion Vital Signs Recorded
*
Yes
No
Not Applicable
Any Adverse Reactions Noted
*
Yes
No
Not Applicable
Additional Comments
Verifier's Full Name
*
First Name
Last Name
Verifier's Signature
*
Submit
Should be Empty: