The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.

VIDANT BEAUFORT HOSPITAL 628 E 12TH ST WASHINGTON, NC 27889 May 16, 2013
VIOLATION: BLOOD TRANSFUSIONS AND IV MEDICATIONS Tag No: A0409
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on review of hospital policy and procedure, medical record review and staff interviews, the nursing staff failed to ensure an informed consent for the administration of blood was signed for 1 of 5 patients who received blood (# 8).

The findings include:

Review of the hospital's policy, "Blood Administration", revised 08/2012, revealed, "...PROCEDURE ...2. A completed informed consent for blood/blood component is required for blood administration except for life threatening situations. The transfusionist is responsible for verifying this consent prior to administering blood/blood components. ...".

Open medical record review of Patient #8 revealed an [AGE] year-old female admitted on [DATE] with congestive heart failure and anemia. Record review revealed a physician's order dated 05/14/2013 at 2200 for the administration of two units of packed red blood cells. Record review revealed the first unit was started by RN (Registered Nurse) #1 at 2225, completed at 0030. Record review revealed the second unit was started by RN #1 on 05/15/2013 at 0045, completed at 0330. Record review revealed an "Informed Consent for Transfusion of Blood Product" with a section titled, "Blood Transfusion Consent...I give my informed and voluntary consent to the transfusion of blood products if medically necessary, and permit the doctor or such other doctors or persons as may be needed to assist the doctor, to give me the transfusion...". Review revealed no signature by Patient #8 or Patient #8's representative consenting to the administration of blood.

Interview on 05/16/2013 at 1025 with RN #1 revealed, "this happened at the beginning of the shift. I was going too fast. I thought the consent (for blood administration) had been signed. I dropped the ball. We have a checklist for the administration of blood that I failed to follow". Interview confirmed that Patient #8 received two units of packed red blood cells without a prior informed consent. Interview confirmed the nursing staff failed to follow the hospital's policy for the administration of blood.

NC 257