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Outpatient Blood Transfusion/Platelet Order Set - renown 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the date of the order at the top of the form. Ensure that all orders are checked, as any unchecked or crossed-out orders will be inactive.
- Fill in the patient's name and date of birth. Include any special requirements, such as irradiated blood or CMV negative status, if applicable.
- Document allergies and enter the required platelet units along with the patient's height and weight. Make sure to include the most recent platelet count.
- Select appropriate diagnosis codes from the provided options and fill in any additional medications required prior to transfusion.
- Complete sections regarding packed red blood cells, including lab results for hemoglobin and hematocrit levels, ensuring you check indications for blood orders.
- Finally, obtain consent by having the patient sign and complete the ordering physician's signature section before submitting.
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blood transfusion order form
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