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ABO Confirmation, 2nd Draw


Barb Thompson
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Ok, so my facility is in the middle of a massive computer downtime. No electronic records can be accessed, not even the patient backup/history file. ABO confirmations are still required, I imagine, but in this type of situation, would we just require a second specimen on everyone? (I think I already know the answer). Has anyone else been in this situation and how did you handle it?

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I copy my histories to a file on the desktop of all of the PC's in the blood bank on Wednesday of the week. They are also copied to a flash drive. It may take a little time to look up the history of a patient, but it saves the patient a stick.

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Even though computerized you should have a backup system that allows you to identify previously encountered patients.  How will you know if there is a patient w special needs (irradiated, CMV=, etal).  Some places have a dedicated laptop which updates w patient info; I use paper records.  I'd worry more about the special needs than if I need another specimen.  (if you used a barrier protection ID you wouldn't need a 2nd specimen).

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  • 2 weeks later...

Sorry no help here as we have a backup system that we can check  patient history(backed up weekly). There is more to check for other than historic type such as antibody history, or special needs. And for history that may not be backed up yet there is a Patient Activity Report that prints daily that is reviewed for accuracy of result input, among other things. We use that for current information, not much help for special needs or previous antibodies but still something

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  • 2 weeks later...

We perform electronic back up once per day.

We also back up a simplify patient data in the last 24 days in an excel sheet once per shift daily. 

That is kind of scary if you do not have any type of access especially if the patient has a non-reactive antibody.  But yeah, before every downtime, we would perform all our back up so that it is current as much as possible and can be access offline from 1-2 designated PC.  The excel version is accessible from every PC.

 

 

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On 10/1/2020 at 4:51 PM, Barb Thompson said:

The data is backed up, but we are not allowed to use flash drives and can’t access any computers!

The paper filing cabinets took up too much space, so everything went electronic.  Nothing is accessible. Not the LIS, not the pc’s, nothing!

I would cite you if inspecting you.  This is unacceptable.  You need access to critical patient information whether downtime is scheduled or unscheduled.

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Having a readily available back-up for the ABO and any antibodies, ABO discrepancies and special needs (such as irradiated) is required. Ours was done to a  PC in the transfusion service in the background at 0400 every morning.  It was a hassle to get IT to make that program for us, but I kept giving them documentation that the info is required to be available when the computer goes down.  Had we not had the back-up, we would have had to keep making cards to check during downtime. 

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Per CAP (not sure if you are accred by them) second type is only required for computer crossmatch and since the computer is down, there should be no computer crossmatches going on.  Other than that, 1 type on file is perfectly acceptable to issue any type blood.  However, many labs use the second type to check for WBIT.   Anyway, you need to follow your lab policy.   I personally, would feel uncomfortable giving non group O type specific with just one type on file during massive computer downtime.  

 

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It was a ransomeware attack. All the data was electronically backed up daily. Just imagine backing up on a flash drive (for those of you who do) then having no computer to plug it into! We thought we had all bases covered, then this happens. Do you back up your backup? And the backed up backup? To go back to paper files would require a whole room to hold everything. 
be warned! If it happened to us, it can happen to you!

we had no access to any pc’s or LIS or HIS.

this was a nightmare, but also a learning experience.

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On 10/1/2020 at 9:26 AM, David Saikin said:

Even though computerized you should have a backup system that allows you to identify previously encountered patients.  How will you know if there is a patient w special needs (irradiated, CMV=, etal).  Some places have a dedicated laptop which updates w patient info; I use paper records.

Similar to the laptop, we have an isolated computer seemingly "off-network" that has scheduled backups of patient information. Within our workflow, we're required to check it multiple times a day by seeing if a new patient record entered the system after testing is completed.

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On 10/23/2020 at 3:14 PM, Barb Thompson said:

It was a ransomeware attack. All the data was electronically backed up daily. Just imagine backing up on a flash drive (for those of you who do) then having no computer to plug it into! We thought we had all bases covered, then this happens. Do you back up your backup? And the backed up backup? To go back to paper files would require a whole room to hold everything. 
be warned! If it happened to us, it can happen to you!

we had no access to any pc’s or LIS or HIS.

this was a nightmare, but also a learning experience.

Experienced this. We backup the backup on an encrypted flash drive. If it happens again we would have IT give us a laptop (not connected to internet or network) to use just to pull the files.

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