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Storing Saline Cubes


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We have a new safety committee in our laboratory, and they are saying that we need to remove our saline from the 10L cube cardboard boxes and store the 10L bags in another plastic box that we relabel.  

They are using the "no shipping boxes" as the basis for this decision.  We've never heard of anyone in blood bank doing this.  Our arguement is that we are not a patient care area, so the cardboard shouldn't be a problem. 

The committee is saying since phlebotomists come in and out of the lab, it counts as patient care......they do not come and hang out in the blood bank storerooom.  

Having a hard time convincing the committee that we are not going to be taking saline out of the box.....HELP! :)

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Posted (edited)

Yeah, joint commission actually checks for that. It's because cardboard boxes or shipping containers can carry dirt and other contaminants and introduce them to new environments.  Is there a room where you can store the saline boxes where the plebs don't go in and out of? Maybe put a sign outside your blood bank storeroom, "No phlebotomist allowed".  We have used saline in cardboard boxes for many years, but phlebotomists usually have no business to go in our blood bank storeroom. 

The safety committee's job is to be familiar with joint commission and OSHA standards and regulations,  and patient and employee safety is their first priority. There is probably a "technicality" somewhere you can find that might help you, good luck. 

Edited by SbbPerson
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Wow. Never heard this one. I agree with SbbPerson that it's a JC thing due to the dirt that could be on the box, but if you are keeping the boxes in an area where you are not doing testing (aka the storeroom) I don't see how they can enforce this. We keep our saline in the boxes as well, and they are just on a wire rack in the room next door. No one has batted an eye at this, between CAP, JC and the FDA. Can you make a case that when the saline bag is out of the cardboard it is less safe? Like, once the level of the saline gets too low in the bag, its too difficult to get the saline out, and therefore it's wasteful? Try to find a way to make them see the bad sides of having it out of the box. Good luck! 

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It's because cardboard boxes or shipping containers can carry dirt and other contaminants and introduce them to new environments. 

Also, nasty vermin such as roaches love cardboard.

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Interesting discussion. Yes, cardboard can carry dirt and/or insects, but to imply that the presence of such on supplies like saline cubes creates a risk to patients and staff is an extreme stretch. We don't live in a  vacuum and most of us spend time outdoors with the dirt and bugs every day (potentially bringing them inside with us). A wipe with a damp paper towel should be sufficient to clean an obviously soiled outer container.

If you talk to the manufacturer of the saline, I'm sure they would argue that the outer box is not merely a convenient shipping container, but also an integral part of the product itself, designed to support the flexible primary container and get the best performance from the product. After all, they've designed in a nice little tear-out section that creates a perfect hole for the spigot/tap.

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50 minutes ago, John C. Staley said:

I'm going to be blunt.  This is ridiculous!!  You have the potential of causing far more problems by removing the cubes from their protective container.  

:coffeecup:

Agreed!

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Request new safety committee to audit the trail the saline boxes take from the manufacturer to the blood bank to ascertain where this "dirt" is coming from. Or to put it another way show the manufacturer for this product is required to maintain a level of cleanliness to prevent roaches etc., the couriers the same. As mentioned above this is ridiculous   

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We had an over zealous infection control team (made up of 100% nurses) come to our lab last year making the same demand. We told them, in essence, we will not comply because the risk of injury from handling those containers were greater than the risk they were trying to alleviate. Furthermore, the risk of accidently confusing saline with formalin, whose containers look exactly alike, was to high when removing from the cardboard containers. In addition to that, we told them the man hours required to keep up with that would require additional FTE's, which would not be approved. 

They conceded and we continued on, business as usual. TJC does not really inspect labs that are CAP, AABB, or CLIA certified. Those organizations understand the logistics of the cubes and do not have a problem with it. Most infection control officers are nurses and think from the nursing perspective only.

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I think you should invite members of that committee to remove a bag from its cube, try to label it sufficiently (substance, lot #, expiration, etc.), attach that label in such a way that it will stay attached when the bag 'collapses' as it's emptied, hoist the bag up to the level of a cell washer without the aid of the box (especially this part), and suggest ways to keep the collapsed bag at an angle that will ensure all the contents are used. 

I'm willing to bet they'll come around.  :D

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We've never been cited by CAP, the FDA or TJC. TJC does come into Blood Bank because we handle the frozen/refrigerated tissue grafts and never a word said. Our saline in use is quite visible to anyone who walks into the department. That request is overboard and made by people that have never worked in the lab.

Agree with the comments about safely handling the plastic blob, utilizing the reagent w/o waste, proper labeling w/ lot, etc.  and the fact that it would look just like formalin and some of the reagents hemo uses.

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We got the same song and dance from our infection department some years ago. Our manager told them the instruments would not work correctly if the saline/reagents were not in the manufacturer's container, the interior plastic bag would droop and possibly break without the cardboard support to contain it. The solution/compromise was to make a notebook of "acceptable" cardboard containers, e.g. saline/reagent cubes. If an inspector questioned, we would show them the book with pictures of what had to be in cardboard to maintain lot numbers or integrity of the reagent.  

I agree, the rule is to reduce incoming exterior dirt and insect infestation for patient areas but the lab is not a patient care area. Some committees make a mountain out of a molehill and go too far.

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