Informed Consent for Transfusion
Informed consent is a requirement for transfusion of blood components and blood products.
Documentation of consent or non-consent shall be recorded in the patient’s health record according to the Health Care Facility/Service Delivery Organizations (SDO). It must include signatures from both the patient/substitute decision maker (SDM) and the authorized health practitioner present. Use of a consent form/refusal of treatment form is recommended.
The Consent to Procedure, Treatment, or Investigation form (1497.pdf) is used for certain diagnostic procedures or surgery. There is a statement of consent within this form that includes the administration of blood products. In the case where the transfusion is the procedure, then the specific transfusion would be entered as the “Procedure, Treatment, Investigation” specified in part 1 of the form.
An integrated progress note (IPN) should be documented and contain details of the consent discussion which may include specific individualized risks and alternatives discussed.
In the event of an emergency situation where a patient cannot provide consent and no SDM is available, an emergency treatment/transfusion may be given without consent. However, consent must be obtained as soon as the patient or SDM is able to render an informed decision. The details of the situation and subsequent discussion should be clearly documented in the patient’s health record. Upon discharge from hospital, the patient shall be provided with written notification regarding their transfusion of blood, blood components, and/or blood products.
Duration of Consent
Informed consent is valid over the course of hospital admission or medical treatment plan. If substantive medical changes have occurred between the time of consent and the need for transfusion, the consent shall be reviewed. The informed consent process must be reviewed at least every 12 months for patients with chronic conditions.
Interpreters
Interpreters can be available on a 24/7/365 basis, in-person or over the phone. Health care providers shall make every effort to obtain services of an interpreter for discussions regarding consent. Ad hoc interpreters (i.e. non-staff) may be used in the event an interpreter will not be available within a reasonable time frame. For more information, visit the Language Access Services web page.
Pediatrics
In Manitoba, a person who is 16 years of age or older, and has the mental capacity to make health care decisions, has the right to consent, or refuse to consent, to medical treatment.
Telephone Consent
In an emergent situation, where the patient/resident/client is unable to provide informed consent and the substitute decision maker is available only by telephone, the authorized prescriber may obtain informed consent by telephone. Along with the authorized prescriber, there shall be a witness to whom the substitute decision maker repeats his or her informed consent. The witness shall sign the consent form. Whenever possible, the substitute decision maker’s written consent should be obtained as soon as possible thereafter.
Do I have to obtain consent for each and every transfusion?
Consent can be for a single transfusion or for a series of transfusions (in a treatment plan). During the consent process the discussion with the patient should include the number of transfusions in the treatment plan. The number of transfusions should be clearly written on the consent form. Example: A patient requires IVIG therapy for 12 months. The conversation and the form should specify multiple infusions over 12 months. A review of patients’ understanding and available alternatives should be ongoing