ritaberry

I want to thank everyone that replied. I took your replies and the "Transfusion Committee" book and the New York Department of Health Guidelines for Transfusion Committees to a meeting last week with our QI department director and others. It was agreed that Blood Bank needed a separate multidisciplinary committee and I am getting to set it up. I really appreciate this forum! Rita Berry

I want to thank everyone that replied. I took your replies and the "Transfusion Committee" book and the New York Department of Health Guidelines for Transfusion Committees to a meeting last week with our QI department director and others. It was agreed that Blood Bank needed a separate multidisciplinary committee and I am getting to set it up. I really appreciate this forum! Rita Berry

Linda, Have you lived in Amarillo, TX? I used to work with a Linda Liles who was a BB'er. Rita Berry

That was great! Thanks Stu.

I was not the supervisor when our Transfusion Committee was formed. It was added onto the Tissue Committee to become the Tissue and Transfusion Committee since no one thought the physicians would attend two meetings. The committee was formed as a peer review and as such, the pathologist giving the tissue report is on the committee. The Transfusion Service Supervisor (me) does the Blood Utilization report but is not a member of the committee. I am considered a "presenter" because I am not a physician. The QI person who performs the chart audits for compliance with transfusion triggers and appropriate use is also a "presenter" and is not on the committee (again not a physician). This has not particularly been an issue, but recently during a discussion of blood supplier issues and transfusion committee functions, it was pointed out that I am not a member (I also need to be on quality committees for my CQA continuing ed credits). I told my lab director if I am not permitted to speak at this committee, I need a different committee for the Transfusion Service. At the current time we submit patient safety issues to Risk Management and utilization issues to the Tissue and Transfusion Committee. I believe we need a committee for blood bank that addresses all issues regarding the Transfusion Service and blood products. According to several references that I have consulted, including "The Transfusion Committee" by Ira Shulman, AABB Press, the committee should be multidisciplinary, not just physicians. The letters to physicians can still come from the committee chair, who is a physician. What do you think of this design? Is the Blood Bank supervisor or manager on your committee?

I was not the supervisor when our Transfusion Committee was formed. It was added onto the Tissue Committee to become the Tissue and Transfusion Committee since no one thinks the physicians would attend two meetings. The committee was formed as a peer review and as such, the pathologist giving the tissue report is on the committee. The Transfusion Service Supervisor (me) does the Blood Utilization report but is not a member of the committee. I am considered a "presenter" because I am not a physician. The QI person who performs the chart audits for compliance with transfusion triggers and appropriate use is also a "presenter" and is not on the committee (again not a physician). This has not particularly been an issue, but recently during a discussion of blood supplier issues and transfusion committee functions, it was pointed out that I am not a member (I also need to be on quality committees for my CQA continuing ed credits). I told my lab director if I am not permitted to speak at this committee, I need a different committee for the Transfusion Service. At the current time we submit patient safety issues to Risk Management and utilization issues to the Tissue and Transfusion Committee. I believe we need a committee for blood bank that addresses all issues regarding the Transfusion Service and blood products. According to several references that I have consulted, including "The Transfusion Committee" by Ira Shulman, AABB Press, the committee should be multidisciplinary, not just physicians. The letters to physicians can still come from the committee chair, who is a physician. What do you think of this design? Is the Blood Bank supervisor or manager on your committee? Rita

Thanks to all of you for your input and advice. This forum is a wonderful resource! I have another issue that I need info on. I guess I'll start another thread about Transfusion Committees. Rita

Yes, all ordering mistakes are submitted to risk management for root cause analysis and appropriate action.

We designed one last year and it was accepted by the Transfusion Committee but I have yet to see one used. The forms aren't even kept at the nurses stations. Physicians continue to write orders for blood products on the chart along with all other orders. No justification is ever given. Rita

Do you require a copy of the written order and/or consent form to be presented by the transporter to pick up blood? We currently require only the patient's full name and medical record number to be presented in written form. Most transporters use an ID label from the patient's chart. We've recently had several orders placed in the computer system for blood products for patients who had not consented to receive them. We also have had orders for the incorrect blood product, such as liters of plasma for a therapeutic exchange that was written on the chart by the physician to be performed with Albumin from the Pharmacy. Irradiation orders have been overlooked. Another hospital in our city requires a copy of the physician's written orders to be presented to pick up blood. I've heard of others requiring a copy of the consent form. I'd like to address this at our next Transfusion Committee meeting and it would be good to have an idea of what other facilities are doing. Asking Nursing Service to change a procedure can be challenging, especially if it requires additional steps. I'd appreciate any comments. Rita Berry MT (ASCP) SBB Transfusion Service Supervisor Baptist St. Anthony's Health System 1600 Wallace Blvd. Amarillo, TX 79106 (806)212-4337 rita.berry@bsahs.org