Kellimq Posted October 13 Share Posted October 13 Hello From Down Under, My hospital has implemented the two blood group policy for giving group specific red cells. I have had a question from our head anaesthetist about evidence that this practice is safer? Does anyone have any links to evidence or where it is written in any other guidelines around the world? Thanks! Kelli Quantock - Mater Hospital Brisbane, Australia Link to comment Share on other sites More sharing options...
Ensis01 Posted October 13 Share Posted October 13 What is the two-Blood group policy? Link to comment Share on other sites More sharing options...
Malcolm Needs ★ Posted October 13 Share Posted October 13 Guidelines for pre‐transfusion compatibility procedures in blood transfusion laboratories - - 2013 - Transfusion Medicine - Wiley Online Library This is a link to the UK Guideline that talks about two samples being typed. All of the BSH Guidelines are evidence-based. Ensis01 and AMcCord 2 Link to comment Share on other sites More sharing options...
Ensis01 Posted October 14 Share Posted October 14 Ok, two-Blood group policy is same principle as US second check; GET THE ABO RIGHT!! Does Australia follow the UK standards? Link to comment Share on other sites More sharing options...
Malcolm Needs ★ Posted October 14 Share Posted October 14 No idea, I am afraid. Link to comment Share on other sites More sharing options...
Joanne P. Scannell Posted October 14 Share Posted October 14 I always 'balk' at this idea because as we all know, the probability of two patients having the same blood type is high. We have had a few instances over the past few years where a wrong patient was drawn (we use BB Bands so it's very obvious) and they were the same blood type but one had antibodies and the other didn't. And yes, there are those who have had to come up with 'defensive measures' to 'assure' that there is no 'cheating', e.g. RN draws 2 samples and holds one in case the BB asks for a second, a witness (do you really think that happens as intended?), different colored tubes for the second draw (assuming they don't draw the wrong patient twice). I could go on and on about this ... but that wasn't your question, was it? David Saikin, Malcolm Needs and John C. Staley 3 Link to comment Share on other sites More sharing options...
Arno Posted October 14 Share Posted October 14 Guidelines in Australia are pretty similar to the UK guidelines as far as I can see. https://anzsbt.org.au/wp-content/uploads/2018/06/GuidelinesforTransfusionandImmunohaematologyLaboratoryPractice_1ed_Nov20_.pdf They require as well a second ABO typing. Ensis01 and Malcolm Needs 2 Link to comment Share on other sites More sharing options...
John C. Staley Posted October 14 Share Posted October 14 As Joanne mentioned above, no system is fool proof and there are lots of creative, inventive fools to prove it. Keep your system as simple as possible which should minimize the need for creative people to find ways around it. Now to your question, does it actually help prevent problems? Probably a few but certainly not all! I've seen people become lax in their diligence when they assume they are protected by the system. They seem to assume that if they make a mistake someone down the line with catch it. This is something to be avoided if possible. The only way that I know of to prevent this type of mind set from developing is through education and convincing everyone involved in the process that their step is critical and by keeping it simple they will be more likely to perform their step as instructed. Malcolm Needs, Ensis01, AuntiS and 3 others 6 Link to comment Share on other sites More sharing options...
David Saikin Posted October 18 Share Posted October 18 On 10/14/2021 at 9:07 AM, John C. Staley said: As Joanne mentioned above, no system is fool proof and there are lots of creative, inventive fools to prove it. Keep your system as simple as possible which should minimize the need for creative people to find ways around it. Now to your question, does it actually help prevent problems? Probably a few but certainly not all! I've seen people become lax in their diligence when they assume they are protected by the system. They seem to assume that if they make a mistake someone down the line with catch it. This is something to be avoided if possible. The only way that I know of to prevent this type of mind set from developing is through education and convincing everyone involved in the process that their step is critical and by keeping it simple they will be more likely to perform their step as instructed. We used to have sign in our BB: The Buck Stops Here. Of course someone altered the posters to "The Buick stops here". My boss was pissed off about that. The concept being that if you have a system of multiple checks and balances you better make sure the first one works. I have seen this concept evidenced too many times in my career. People get complacent. Arno, John C. Staley, AMcCord and 2 others 5 Link to comment Share on other sites More sharing options...
cthherbal Posted October 25 Share Posted October 25 (edited) I did a swiss cheese diagram after the fatality in the US a few years ago to hit home what COULD happen. Attaching, feel free to tweak for your use. It speaks to just one of the reasons why we require the sample confirmatory sample, and probably the most important one, WBIT. Swiss cheese TX incompatible transfusions patient death1.pptx Edited October 25 by cthherbal Ensis01, jtrick, albaugh and 2 others 3 2 Link to comment Share on other sites More sharing options...
albaugh Posted October 26 Share Posted October 26 WBIT is where it all starts. But there are several other steps in the process where the brakes could/should be applied, as we all know. Thanks for this great visual representation! Link to comment Share on other sites More sharing options...
David Saikin Posted November 12 Share Posted November 12 We use blood locs. Barrier protection. Only need one specimen. Nursing has bought into this so it works well. AMcCord 1 Link to comment Share on other sites More sharing options...
AMcCord Posted November 15 Share Posted November 15 On 11/12/2021 at 12:02 PM, David Saikin said: We use blood locs. Barrier protection. Only need one specimen. Nursing has bought into this so it works well. Working well for us as well. We use FinalCheck. David Saikin 1 Link to comment Share on other sites More sharing options...
Johnv Posted November 17 Share Posted November 17 Does anyone charge for a 2nd blood type? We have it set as no charge but since it is an important safety step, recognized by Joint Commission and AABB, the question was should not this be a chargeable event? If you do charge for a second blood type, is there an insurance code or CPT that applies to a 2nd blood type test? thanks. John V Link to comment Share on other sites More sharing options...
Ensis01 Posted November 18 Share Posted November 18 Charge for ABO, not sure the codes Link to comment Share on other sites More sharing options...
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