Preadmit Specimens

[glewis]

Is anyone willing to share their procedure for preadmit specimens?  We are planning on extending our retention from 8 to 28 days for crossmatches.  At the present time we use Blood Bank armbands and serologically test.  We have a request from a new provider to extend for 28 days and found that it is not as easy as it sounds!  Some hospitals repeat the ABORH and the preadmit questions prior to surgery.  All help with this topic would be greatly appreciated.

[Cliff]

23 hours ago, glewis said:

Is anyone willing to share their procedure for preadmit specimens?  We are planning on extending our retention from 8 to 28 days for crossmatches.  At the present time we use Blood Bank armbands and serologically test.  We have a request from a new provider to extend for 28 days and found that it is not as easy as it sounds!  Some hospitals repeat the ABORH and the preadmit questions prior to surgery.  All help with this topic would be greatly appreciated.

If the patient has not been pregnant or transfused in the prior three months, many facilities extend to 28 days.

You do need to perform the type and screen within three days of collection.  https://www.ecfr.gov/current/title-21/chapter-I/subchapter-F/part-606/subpart-H/section-606.151

[Bet'naSBB]

sent you a pm!

[DebbieL]

We have an Extended T/S form used in Pretesting. The nurse will ask the patient if they have been transfused or pregnant in the last 3 month. Nurse signs the form and answers Yes or No.  The form along with T/S specimen is sent to BB. We do the testing that day and indicate on the form if the patient has a BB history. If not, we will need an ABO Recheck specimen collected the morning of surgery. We put a round sticker on top of the specimen so we don't discard accidently. We place a comment in the computer that the patient has an Extended T/S for our info on the day of surgery.

Two days before scheduled surgery, we fax the forms to Surgery Holding. Holding wants these early so they can make up the charts the afternoon before surgery when it is not so hectic.

Day of surgery-Nurse asks the transfusion and pregnancy questions again, signs the form and collects the ABO Recheck specimen if needed and faxes the signed form to us. We also send a list to Surgery Holding of all the patients we know needs an ABO Recheck collected while IV is being placed so we can be sure they get the message before the patient is rolled away

The BB will find the preadmit specimen in storage & test the ABO Recheck, if needed. We have a special BB order we place in the computer to answer some of the questions about the pretesting. The XM now gets 3 days and the preadmit specimen has the sticker pulled off the top and is placed in storage with all of today's specimens. In this process, we remove the comment from the computer.

We will extend up to a month, so 30/31 days so we don't have to count on our fingers. LOL. If the patient comes in for surgery past the 30/31 days, we request a new  order and specimen. 

If the patient turns out to have an antibody, we will ID and write the info on the form and hang the form up for all BB to see.  We will scan for Ag- neg units prior to surgery. We write a BIG note on the form that we want a FULL pink top collected on the day of surgery and redo the T/S and crossmatch the units. We don't redo the AB panel as long as the screen appears as expected, plus the patient hasn't been transfused.

It takes 3 departments completing their tasks but it works like a charm after the initial learning curve.  We do not use BB armbands so I'm not sure how that would work. I don't see people wearing an armband for a month or requiring a patient to bring the armband with them on the day of surgery. Maybe some of this info can help you.