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There is a Prepare order that transmits to the Blood Bank LIS and a matching Transfuse order that is used as part of BPAM. They open the transfuse order and scan in the patient information and then the blood product information. It also captures vitals and adverse reactions - we use a functionality of "Screen Shot" that displays cumulative transfusion records which are hyperlinked to the Transfuse Order (that's my best interpretation of BPAM without actually using the program). The nurses have to have training to use it and buy into it for it to work best but it's a permanent record that can be seen at multiple facilities that are part of a multi-facility healthcare system.

Epic has a module to document transfusion information called BPAM (Blood Product Administration Module) - it communicates with BB LIS and has fields for all of the appropriate documentation.

Just last month, we had a unit from our supplier labeled as O+ but retype showed that it was AB+. I personally don't mind re-typing units so that we can do an electronic crossmatch.

Well, (drumroll please) is my answer from CAP: COM.04250 is for comparing test results. I do suggest comparing the antibody screen and ID for the different methods used in your laboratory. Thank you, Amy Meier, MBA, MT(ASCP) Technical Manager, Laboratory Accreditation Program So I guess I will be figuring out how to have adequate sample for comparability studies across 3 methods with tube being the problem child

Just underwent AABB and CAP inspection - we were cited for CAP in not including antibody identification, DAT, and compatibility testing for all method platforms. We have been performing comparability testing for ABO/Rh and antibody screen for the last 13 years and multiple inspections without citation. Anyone else had this experience?

Is there any concern that the RBC is irradiated more than 24 hours prior to the transfusion? Irradiated units will have higher K+ levels which could be an issue, couldn't it?

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We dropped AABB for our satellites - these days I'm even questioning the need for the largest Blood Bank to stay with AABB. Combing through multiple standards and performing 2 self-inspections with minimal staff and trying to keep things running makes me wonder why we need both CAP and AABB- especially with the fees that are charged. AABB wouldn't answer either phone or email about getting a copy of the new standards so we had to purchase them.

I would use the Autoprint functionality with caution as having unsolicited labels print remotely easily leads to misidentification of patient samples.

We require a type and antibody screen on the neonate and transfuse according to any demonstrating antibody. Rh positive infants born to mothers who received antepartum RhIG usually have positive DAT with anti-D eluted from cord red cells. The majority of these infants don't require transfusion in my experience.

We use SoftBank and Epic BPAM as well and have encountered this issue a few times. We primarily handle MTP patients usage on 'dummy' patients to get uncrossmatched units to the patients more quickly. Because we have so many activations - we assign an expiration date to the dummy patient's MTP order number. Orders are renewed on Mondays for the dummy account to help with preventing the interface crash that happens when too many units are assigned to a single order.

I might be dating myself - years ago I worked for a transfusion service that manufactured packed red cells. CAP had required proficiency testing for the manufacturing process - if I remember, it was measuring the hematocrit. Just looked on the test menu and it seems that is no longer 'a thing'. So use the word 'competency' instead. Our trauma program uses a lot of blood and liquid plasma before we know the patient's blood type - I don't think I would choose Group O liquid plasma even though it is low-titer. As I write this, I realize that I'm looking at the problem with a distinct bias against more work for my team so please forgive. When we implemented whole blood, I was definitely averse to splitting the product to create components because of the work - both physical and intellectual - and I am still thinking that way. If it is feasible for you and you embrace the process, go forth!

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You will need to develop a validation and QC plan to ensure that the hematocrit on the RBC product meets pre-defined criteria and regulatory standards. You will need to have proficiency testing program as well. We transfuse LTOWB as well but consider the wastage as part of the provision of products meeting the Trauma programs needs - I do not want the headache of manufacturing regulation (I might have skipped over the FDA inspections as well- don't forget that....)

Our pathologists have authorized O POS for adult males and females 56 or older without requiring permission - we have this written into our MTP and Emergency Release policies. Younger females or pediatric patients would require a phone call. Since we average 25 MTP monthly, this is a tremendous help in conserving O NEG.

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