Patient re-type

[KRIS]

Good day, 

I am new tech assign in Blood bank, i would like to ask how do you deal with patient without history , are you doing the retype with the same sample or will you just do the re-type if there is request for blood transfusion. Someone told me that its a CLIA or CAP requirement.  Please ,kindly shed some light about this matter.

 

I will appreciate all your responses. Thank you.

[Kathyang]

       This is a CAP and AABB requirement. We get a new tube on any inpatient, OR patient, or ED patient whether they are getting blood or not. That way if they do need blood, we already have the second type. The tube should be drawn by a second person at a different time.

[tkakin]

We also get a new draw if no patient history on all banded patients.  BUT Is it necessary to do a second ABO on a patient that is an O?  

[DebbieL]

We also do a second type on all patients without a history in the computer. We try to use a stored Hemo specimen collected at a different time to save the patient another stick. If there are no previous specimens, we order an "ABO Recheck" in the computer. Only the Lab can place this order to keep nursing from ordering this by mistake which they used to do.

We used to only do the rechecks on any type but O. We got a new Lab Director who didn't like that practice so we moved to retyping all new patients. 

 

[Baby Banker]

18 hours ago, tkakin said:

We also get a new draw if no patient history on all banded patients.  BUT Is it necessary to do a second ABO on a patient that is an O?  

It is best from an operational standpoint to do the same thing every time.  If you always do a second type on patients without a history, you won't forget to do one.

[Malcolm Needs ★]

19 hours ago, tkakin said:

"BUT Is it necessary to do a second ABO on a patient that is an O?"

It certainly is if your patient is not a true group O, but is of the rare Oh type.  It might just save you killing them!

[AMcCord]

CAP allows you to retype the same specimen if you use electronic patient ID when the specimen is collected or issue product with a barrier method (FinalCheck or BloodLoc). Whatever you do, it should be clearly spelled out in an SOP.

[NMA27]

3 hours ago, Malcolm Needs said:

It certainly is if your patient is not a true group O, but is of the rare Oh type.  It might just save you killing them!

Wouldn't a second type on an Oh patient be just as likely as the first to simply appear (erroneously) as group O, if using standard ABO typing methods? Am I missing something? 

[Malcolm Needs ★]

Hopefully, an antibody screen would be performed, and so the anti-H would be detected.

[slsmith]

1. retyping with the same sample but different Tech is a CAP requirement, no matter what the order is.

2. then a 2nd sample drawn by a different person or a different time is required for anyone possibly getting a transfusion. I don't know if this is a CAP requirement yet although I know it on their check list. But I do believe it is a AABB requirement

[AMcCord]

If the same sample is used for both types, CAP does not require a different tech to perform the second type. CAP doesn't require a second sample drawn by a different person for transfusions. You can meet the requirement for mitigating misidentification risk by utilizing an electronic ID verification system at the bedside when specimens are collected and by using a mechanical barrier system for patient ID/unit ID when transfused. Verifying the ABO group with a second sample is another option.