Documentation/Testing for additional samples needed.

[RRay]

This process has been different every place I have worked.  How do you handle documentation and use of additional samples when needed to complete a workup?  

Do you ABO/Rh type the new sample?  T&S?  No additional testing?  Does your LIS support this documentation?

I'm not aware of any specific standard that says the sample you use to XM has a T&S performed on it.

[SbbPerson ★]

At my current place of work, there is a form/document we use to indicate that the specimens drawn are additional samples. These samples get their own unique specimen number and they are ordered as additional specimens.  There are only valid if the patient's type and screen is current (within 3 days).  My LIS support these documents because additional sample is an order with its own order code. Of course, all samples must have the patient's name, ID number, etc... to prove every sample are from the same patient. 

 

I use to work for a blood bank  that uses blood bank band numbers. I think most places in America uses blood bank band numbers. It is basically the same idea as above, except that they don't have "documents" to indicate the samples as additional samples. Instead, the additional specimens are labeled with the patient's blood bank band number and are only valid if the type and screen is current. 

I hope this helps. Thank you

Edited October 12, 2022 by SbbPerson
grammar

[RRay]

Thanks for your feedback!  I'm surveying the audience to see what can be pieced together as most efficient.  Currently, my LIS requires override when a specimen being used for XM has not had a T&S on it.  This LIS is going away next year tho.

I have only used blood bands at my current institution and am evaluating getting rid of them.  They cause a scary % of redraws (nurses cutting the wrong band, or rebanding when transferring between units, etc) and delay in patient care when patient ID isn't at question. And they're expensive.  

[SbbPerson ★]

20 minutes ago, RRay said:

Thanks for your feedback!  I'm surveying the audience to see what can be pieced together as most efficient.  Currently, my LIS requires override when a specimen being used for XM has not had a T&S on it.  This LIS is going away next year tho.

 

I think that is a pretty standard and good safeguard for a LIS to have. What are you trying to XM? RBCs? Does your LIS do electronic XM? I assume you need additional sample because you need to do an AHG XM? Was the patient's current type and screen positive? Does the patient have a history of antibodies and what are they? 

[SbbPerson ★]

29 minutes ago, RRay said:

I have only used blood bands at my current institution and am evaluating getting rid of them.  They cause a scary % of redraws (nurses cutting the wrong band, or rebanding when transferring between units, etc) and delay in patient care when patient ID isn't at question. And they're expensive.  

You are right, for all the reasons you have indicated.  I have always used blood bank bands until my current position. At first I was hesitant on not using them, but now I realize that nurses do get them wrong all the time. And this caused so much delay for patient care. Especially these days when a good chunk of nurses in hospitals are travelers, you need to train them each time.... Ugh, it's so time consuming. 

[RRay]

Anyone else care to share their protocol for documenting additional specimens needed for workup?

[Auntie-D]

I'm out of the lab now, but we wouldn't test them unless the current sample was going to expire in the next 24 hours and the Hb was low. We would record them on the system as a spare so we could use them if needed.

[RRay]

I think you misunderstood.  I'm asking about when you run out of sample when doing complex testing.  How do you document the additional samples to complete the workup.  Are you saying you wouldn't complete the workup unless Hb was low?

How were you able to record them as spare?

[Auntie-D]

Sorry I misunderstood. We would record them the same way as a rejected sample - there was a code for 'stored' that had been historically in there from when we used to do frozen G&S (shock horror) and it was repurposed.