Outpatient Blood Transfusion/Platelet Order Set - renown 2026

1. Click ‘Get Form’ to open it in the editor.
2. 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.
3. Fill in the patient's name and date of birth. Include any special requirements, such as irradiated blood or CMV negative status, if applicable.
4. 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.
5. Select appropriate diagnosis codes from the provided options and fill in any additional medications required prior to transfusion.
6. Complete sections regarding packed red blood cells, including lab results for hemoglobin and hematocrit levels, ensuring you check indications for blood orders.
7. Finally, obtain consent by having the patient sign and complete the ordering physician's signature section before submitting.

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