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PPID in the OR


seraph44

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Hello Blood Bankers,

Have any of you encountered issues with PPID of patients in the OR in a sterile field? Some colleagues and I are trying to see if there is a way to properly verify the patient in during a surgical procedure when their armband is hidden due to a sterile field. Since a whiteboard, or room number is not an acceptable form of identification, what are other facilities doing in this case? Is there any literature with guidelines regarding this? 

Thanks,

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Hi Scott,

This is what they are stating here. Which tells me that they are not checking the blood before it gets hung. They say they use a white board but I'm almost certain they are not checking the blood with the white board and I don't think that's acceptable (I can't find literature on this at least). I'm concerned because several times they send a courier that is not involved with the case to pickup blood and if there are two patients receiving blood and the courier takes it to the wrong room, this can lead to some serious issues if they don't properly check the patients and the blood. 

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Periodically we audit bedside transfusions, to ensure the readback and other pre-transfusion procedures are followed there.  If you believe that your OR is not following your hospital's procedures, it seems like you would have to run an audit there to ensure that those associates are not cutting corners.  This si a department to department quality check so I would think you would have to set it up with the respective directors.

Scott

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We use a process where the BB armband is verified before the patient is draped and the BB band number plus patient ID sticker are placed on 2 identical cards.  One of these cards is used by a runner to come pick up blood products and the other stays in the OR to serve as a proxy for the BB band while it is under the drapes.  The cards are discarded at the end of the case and not used outside of OR. I am sure the process is not always followed perfectly but it is better than us having policies that OR finds impossible so they just totally ignore them and don't check blood at all.  We installed Epic not too long ago so blood is checked by the scanning process too.  Of course, in OR, the anesthesiologist can just click the "Uncrossmatched" button and hang anything without Epic raising any flag.  I assume they are doing manual ID checks in those cases (crosses fingers).

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Once the patient reaches the OR, his/her armbands are cut off and laid on the patient's forehead, chest. An armband sticker can be attached to the Informed Consent, which is in the OR with the patient. All armbands must be replaced before the patient is moved to PACU. We provide a reattachment band for the Typenex band. The others get taped together. If the band is not on the patient when he/she reaches PACU, redraw and retest. PACU does a great job policing that part. Based upon my observations of anesthesia in the ED checking patient ID prior to transfusion for traumas, it's obvious they take it very seriously and I would expect the same in the OR. We have discussed expectations for patient ID and they've always been very receptive. 

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