Informed consent is a process that includes three basic elements: physician-patient discussion, patient education, and documentation of the patient's decision. Like other invasive procedures, blood transfusion requires appropriate planning that includes adequate time and opportunity for the patient to understand the risks and benefits and to consider possible alternatives. Only after the patient's questions have been answered by the ordering care provider should the nurse document the patient's decision to accept or decline transfusion. The patient's transfusion decision should be documented in the medical record prior to transfusion initiation. This is a requirement for accreditation by AABB, the College of American Pathologists (CAP) and The Joint Commission.