Run The Bedside Two-Person Check And Transfuse

The bedside is where everything the blood bank has done — the donation, the screening, the typing, the crossmatch, the cold-chain issue — finally reaches the patient. It is also where most preventable transfusion harm is caught or missed. So Veona does not let one person do it alone. Before a single drop runs, two trained people stand at the bedside together and confirm, out loud, that the right blood is going to the right patient. That is the two-person check, and Veona makes it a hard gate, not a habit.

Two terms up front. The witness (or second checker) is the second qualified person who verifies the check with you — they must be a different person from you, never yourself. Your eSign PIN is your six-digit electronic-signature PIN, separate from your login password; entering it is how you legally sign the completed record.

Who / when: the Nurse (or Clinician) who hangs the unit, working alongside a second checker, the moment an issued, cold-chain-checked-out unit arrives on the ward ready to transfuse. A unit only reaches this screen once the blood bank has eSigned its issue — an unsigned issue can never be administered.

We will follow Amaka, a ward nurse, who is about to transfuse a unit of packed red cells that the blood bank has just issued for her patient.

Start the check and run the transfusion

1. Nurse — open Blood Bank → Administration. The left panel, “Issued — Awaiting Administration”, lists every signed, issued unit waiting to be hung, with the patient, the unit and the group. The right panel, “In Progress”, shows transfusions already running. Amaka finds her patient’s unit on the left and presses “Start”.

2. Nurse — the “Start Transfusion — Two-Person Check” dialog opens, headed with the patient, the unit label and the group so you are looking at exactly the right record. In “Second Checker (Witness)”, search for and pick the colleague standing with you. This is a searchable picker of real, active staff — you cannot type a name in free text, and you cannot pick yourself.

Caution

The witness must be a second person. If you choose yourself, Veona refuses with “The bedside two-person check requires a SECOND person — the witness must differ from the administering nurse.” The whole point of the control is that two sets of eyes confirmed the unit; one person cannot stand in for both.

3. Nurse — with your witness, work through the three tick-boxes, confirming each out loud together:
   • “Patient identity confirmed against the unit label” — the patient in front of you is the patient named on the unit.
   • “Unit identity, group and expiry confirmed” — the unit number, blood group and expiry on the bag are correct and in date.
   • “Compatibility label and crossmatch confirmed” — the compatibility label and the crossmatch result match this patient and this unit.

Note

All three boxes must be ticked. If any is left unchecked, Veona blocks the start with “Confirm all three bedside checks: patient identity, unit identity and compatibility.” There is no partial start — the unit either passes the full check or it does not hang.

4. Nurse — under “Baseline Vitals”, record the patient’s observations before the transfusion begins: “Temperature (°C)”, “Pulse (bpm)”, “Systolic BP” and “Diastolic BP”. This is the Baseline point on the vitals timeline — the line against which every later reading is judged. Press “Start Transfusion”.

5. Nurse — the administration is now live and opens in its own panel. As the transfusion runs, take timed observations: in “Record Observation” choose the “Point” — 15 Min, then 30 Min, then Hourly as the unit continues — fill in the temperature, pulse and blood pressure, and press “Add”. Each one appends to the “Vitals Timeline”, time-stamped, so the patient’s whole trend through the transfusion is on one record.

Tip

The points mirror standard transfusion monitoring: a Baseline before you start, a check at 15 minutes (when most acute reactions show themselves), again at 30 minutes, then Hourly for the duration, and a final Completion reading at the end. Take and record them as you go — the timeline is the evidence that the patient was watched, not just hung.

6. Nurse — when the unit is finished, complete the record. Under “Complete Transfusion”, leave “Outcome” on “Completed”, enter the “Volume Infused (mL)”, and — if you took a final set — add a Completion observation first. Type your six-digit “eSign PIN” and press “Sign & Complete”.

7. Nurse — the record is signed and closed. The outcome shows Completed with your name and the time, the vitals timeline is locked, and behind the scenes the unit moves from Issued to Transfused. When all the units a request asked for are transfused, that transfusion request moves to Completed on its own. The vein-to-vein chain for this unit is now whole — donor to patient.

Other ways this goes

Blocked: no witness named

If you try to start without choosing a second checker, Veona stops you with “A second checker (witness) is required for the bedside check.” Nothing starts and no unit is touched. Find a qualified colleague, pick them in “Second Checker (Witness)”, and start the check together. There is no way to hang blood single-handed — the missing witness is a hard stop, by design.

Blocked: the three checks are not all confirmed

If any of the patient-identity, unit-identity or compatibility boxes is left unticked, the start is refused with “Confirm all three bedside checks…”. Go back through the three lines with your witness, confirm each one aloud, tick all three, and start again. A unit never hangs on a partial check.

Stopped for a reaction — the unit stays returnable

1. Nurse — if the patient develops signs of a reaction mid-transfusion (fever, rigors, rash, breathlessness, a fall in blood pressure), stop the transfusion at the bedside immediately and begin management.
2. Nurse — on the administration, set “Outcome” to “Stopped (reaction)”, record what was given, enter your “eSign PIN” and press “Sign & Complete”. Veona reminds you: “A reaction stop leaves the unit returnable for investigation. Report the reaction from the Reactions register.”
3. Nurse — crucially, a reaction stop does not mark the unit Transfused. The unit is left returnable so the blood bank can recall and investigate it. Your next step is to file the reaction — see Report A Transfusion Reaction (Haemovigilance), which formally records the event, alerts the bench, and (if the administration is still open) halts it for you.

Stopped for another reason

Sometimes a transfusion is stopped for a non-reaction reason — the line tissues, the patient declines to continue, or a clinical decision changes the plan. Set “Outcome” to “Stopped (other)”, record the volume given and a note, and sign with your PIN. As with a reaction stop, the unit is not marked Transfused — it is left for the blood bank to decide whether it can be returned to stock or must be discarded.

Recording the full observation timeline

The vitals timeline is meant to be filled as the transfusion runs, not all at once at the end. A complete record carries a Baseline before you start, a 15 Min and 30 Min check early on, Hourly readings while it continues, and a Completion set at the finish. Each is added with “Add” against its “Point” and is time-stamped on the spot. You can record as many observations as the clinical picture needs — the timeline simply grows, newest at the bottom, and locks when you sign the record complete.

What happens next

A completed transfusion leaves a fully signed bedside record: who hung it, who witnessed the check, the three confirmations, the whole vitals timeline, the volume infused and the outcome — with the unit now marked Transfused and its request closed when the last unit lands. If anything went wrong, the reaction you file links straight back to this administration, and the unit it implicates can be traced end to end. Either way, nothing about this minute at the bedside is lost: it is signed, audited, and reconstructable.

Follow the trail

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• Related: Reserve And Issue The Unit · Trace A Unit Vein-To-Vein (Lookback)