[DOB as Routine 2nd Identifier]

Like most of you, where I work went to name and DOB several years ago. In the Blood Bank, we still use full name and MR#. I will fight to the death if they try to change us to DOB as I met someone many years ago with my same name (exact first, middle and married last) and exact DOB. Our husbands even have the same first name. We do print the DOB on the transfusion slips so nursing can use that at the bedside. It works well for us and no one complains. The nurses do get confused at times since glucometers use the account number and we use MR. Guess it is rocket science trying to remember when to use DOB, account and MR.

[PBS Saline for Immucor FMH Screen]

Immuno Concepts makes a PBS powder that you can mix with 1L of sterile water. The PBS comes in a box of 20 powders that are good for a couple of years. Would this not work?

[Would a hospital protocol of 'Keep 2 units ahead' be accepted as a doctor's order]

Our doctors in specific units (ICU and Burn) have an order to Keep Ahead X units for 72 hours. We match the 72 hours to the expiration date of the type and screen. It works very well for us. We have not had any problems with any of our inspectors. We can stay on top of our patients needs easier when they are in surgery or having a large bleed if we are the ones ordering as we know when the last unit walks out our door and don't have to wait on anyone else to realize that nothing else is ready. Even with this procedure in place, we maintain an average C:T ratio of 1.3:1.

[PBS Saline for Immucor FMH Screen]

They are going to start requiring its use for the Fetal Screen test.

And we haven't seen any problems either. I know that the last CAP Survey had non consensus but it's a screening test. I still have no problems with a false positive Fetal Screen test (again, hemo does the KB stain, so I really don't have room to complain). Now if I were getting False Negatives I would have already jumped on this wagon.

I agree 100%. False positives can easily be tested with the KB Stain. False negatives are another story. We have not seen any false positives either.

[OK, on to bigger and better controversies]

At our hospital, we use a red armband also. We require that the label from that armband have the patients full first and last name (spelling counts!) and their medical record number, date/time of collection and phlebotomists computer ID. If any of this is missing or wrong, the sample is rejected. Period. If it is an emergent situation, then O neg/pos units are given as uncrossmatched until a proper specimen is received. Our rejection rate is approximately 5% each month. Our biggest nursing unit just started to enforce the policy that if the same staff member has one rejected sample, they are verbally warned, two is a written warning, third is suspension and fourth is termination. I'm hopeful that this helps our rejection rate fall to at least 1-2%. I would really hate to see someone lose their job because of labeling issues, but patient safety has to come first and if tubes for testing are not labeled right, what else are they missing?

[Hello from the last new member]

Hello everyone...

My name is Barbara White and I work at Doctors Hospital in Augusta, Georgia. We are a 300+ bed hospital with a very large burn center (The Joseph M Still Burn Center). I am the Blood Bank Supervisor here, having worked at several different hospitals in Ohio and Florida since the mid 1970's. I also remember major and minor crossmatches as well as RT antibody screens. How did we ever get our work done doing all those extra steps???

I look forward to exchanging information here to make our professional lives better.

Barb

[Emergency Release forms for blood and products]

Here is a copy of ours...

[ATTACH]143[/ATTACH]

Emergency Request for Uncrossmatched Blood form, 10-02.doc