Pick Up Slips to request blood from Transfusion Services

[RKB1988]

Looking for everyone's input on how the nursing units, ED, Surgery etc request the blood they are picking up.  What do they use for patient identifiers?  Trying to avoid the use of a patient sticker or label as these can be left over in the old chart pocket of drawer in a patient chart.  Potential for wrong patient to be requested by inadvertently using the wrong patient sticker.  Anyone have a pick up slip that the nurse can print out of epic with all the patient ID on it?

[David Saikin]

we require at a minimum the person picking up blood has the patient's MR#.  Ideally, they will also bring the crossmatch result and can verify the component being released.  Only requirement is patient MR# for p/u. 

[John C. Staley]

16 hours ago, David Saikin said:

we require at a minimum the person picking up blood has the patient's MR#.  Ideally, they will also bring the crossmatch result and can verify the component being released.  Only requirement is patient MR# for p/u. 

Sounds simple and easy!  I prefer simple and easy.  Helps prevent ingenious people from getting creative and trying to circumvent a complicated process.

[NancyC]

The nurse's "transfuse" order can be turned on to print when released. That is what our nurses bring to us out of Epic for blood pickup. The patient label is the downtime procedure for when the printer isn't working or for surgery patients because that workflow does not use transfuse orders.

[mcgouc]

Technically, physician ordered product and pick up person brought a copy of the order. In the real world, we knew nurses were entering transfusion orders. There was a handwritten paper order form for OR to avoid delays. 

[AuntiS]

We require any request for blood component or blood product pickup to have the following:

• Patient Name
• Patient MRN (i.e. hospital number)
• Type of product required
• Location (for phone requests to send via pneumatic tube system)

A sticker or other official paper is not required. The info can even be handwritten - but all is required and it has to be correct.

sandra

[Kelly Guenthner]

On 8/11/2021 at 1:53 PM, NancyC said:

The nurse's "transfuse" order can be turned on to print when released. That is what our nurses bring to us out of Epic for blood pickup. The patient label is the downtime procedure for when the printer isn't working or for surgery patients because that workflow does not use transfuse orders.

We do the same.  Ours is setup to print the transfuse order both to the blood bank and to the nursing printers.

[RKB1988]

Thank you all for your responses.  There is a big risk in the Surgery department when it comes to blood requests.  There is a significant amount of movement of patients and patient labels being left in rooms, paper charts etc. and request can me made on the wrong patient.  It sounds like those that have responded do not have any provisions for surgery except "downtime" process.  Any other ideas??

[Kathyang]

  There is a pick up slip that can be printed out of Epic. It is a blood requisition form. We also have a downtime form that nurses use when Epic is down. I am attaching the downtime form

Blood Product Pickup Form - revised 10.29.20.docx

[Ensis01]

On 8/18/2021 at 9:13 AM, RKB1988 said:

Thank you all for your responses.  There is a big risk in the Surgery department when it comes to blood requests.  There is a significant amount of movement of patients and patient labels being left in rooms, paper charts etc. and request can me made on the wrong patient.  It sounds like those that have responded do not have any provisions for surgery except "downtime" process.  Any other ideas??

My two penneth for what it's worth; when the patient is in the OR the anesthesiologist determines blood product requirements (often by verbal order) so all an OR runner needs is name and MR#. It seems your, very valid, concern is avoiding WBIT from the outset due to the issues you outlined above. I suggest the solution is that the OR processes need to be cleaned up (literally). Therefore get QA involved. I am not a manager so others here will be way better at giving suggestions on how to proceed down that path and ensure changes are made, and just as importantly maintained. 

[carolyn swickard]

We require the RNs (or another aide) to bring a small pickup slip with the patient admission label on it.  This label includes the pt's full name, MR# and Acct# (financial #) and the BB ID band number when they are picking up RBCs.  We do not require a BB ID band # for plasma transfusions.  They also must bring a copy of the current "consent to transfuse" form - filled out correctly.  

Outpatient RNs bring a copy of the transfusion order and the consent form - with the Pt's BB ID band # if picking up RBCs.

O.R. is required to bring one of the small pickup slips with the Admissions label and and the BB ID band # if requesting RBCs.  They are not required to bring a copy of the consent form.

E.R  - in an emergency situation, uses an Emergency Release form (handwritten by us) based on information in the computer or that the E.R. fills in.  They do not have to bring a consent form until everything is caught up and the TS is completed and the pt is off Emergency Release protocols.

Because we still use and require a unique BB ID wristband for blood (RBC) transfusion - both the floors and the O.R. have to prove we are all working on the same patient.  Until we get some kind of system that fewer people (I won't say none!) can screw up - I prefer the use of an independent BB ID wristband where the Draw - to XM -  to Transfuse circle has the best chance of not being corrupted.  We also require a second specimen (independent draw) for all ABORH confirmations.  Doing the best we can to not make a mistake.

[jayinsat]

On 8/18/2021 at 8:13 AM, RKB1988 said:

Thank you all for your responses.  There is a big risk in the Surgery department when it comes to blood requests.  There is a significant amount of movement of patients and patient labels being left in rooms, paper charts etc. and request can me made on the wrong patient.  It sounds like those that have responded do not have any provisions for surgery except "downtime" process.  Any other ideas??

O.R. has forever been, and forever will be the weakest link in transfusion services. As was previously stated, there are a lot of moving parts and many of those vital parts have no computer access since they are contracted workers. For instance, the perfusionists and anesthesiologist have no computer access since they are only here for the case. All orders are verbal orders. They are the ones starting and ending the transfusions. There is no computer in the suite, everything is done at the desk by the circulating nurse. We have fought for decades to change that process but have had no success. Everything is manual in O.R.