Transfusions Performed Across Town

[Jane]

Our hospital administration has come to me wanting to transfuse outpatients at a facility the hospital owns across town (about 20min away). These would be patients that are only coming in to receive blood. Have any of you had experience with this that you could share?? I don't want to do it but if I am forced to, I want to make sure to minimize the pain.

[adiescast]

We do this and doctor's offices too. It is easier if the outpatient facility is part of your system, since you have somewhat better control over compliance. You have to make sure that the staff and couriers are appropriately trained to handle blood. We have a "shipping ticket" that provides a place to record the temperature of the blood on receipt and after 4 hours, in case any of the blood sits in the cooler that long. If they are going to do a lot of transfusions, you may want to consider a remote blood refrigerator, although that is extra maintenance work. One problem is getting the pretransfusion sample and having time to work it up without making the patient wait forever. We try to get a sample the day before the expected transfusion. What else can I tell you about?

[Melanie]

Jane, I worked at the ARC reference lab and they are the transfusion service for many dialysis centers and other rehab hospitals. The nurses call in the order and collect the sample. The red cross then sends a driver to pick up the sample and deliver it to the reference lab. The sample and all the paperwork must meet all requirements or sample is discarded and facility must recollect. We then perfrom T/S, and crossmatch. Another tech must verify all paperwork before units are tagged. Once tagged, all work is checked again and the products are shipped out by distribution to the center on the day and close to the time required. they are boxed up like all other units with the proper amount of ice for the box, etc. Once the box is opened at the site they are responsible for the units. Units can not be returned to ARC unless the box has not been opened and it is within the time limit. ARC found that if the centers had refrigerators it was too hard to keep track of QC. Many of the centers did not comply with requlations, so it was mandatory that they only order units to be transfused. If patient was a no-show or was sent to other hospital, they were to notify reference lab and send products back in unopened box or units would be rejected and discarded.

There is always more work than you think. Good luck!

[ChrisH]

Hi Jane, we are a multifacility system with a large OP transfusion service. This seems to be a big practice (OP transfusions) in the south. We made sure that each OP transfusion facility (nursing homes, Oncology centers, dialysis centers, ect) has an approved SOP that meets our requirements.

We supply a form for the receiver to sign and document the temperature (we supply the thermomters - our big expense). Some locations use AABB boxes or we use our own coolers.

We will not accept a product back into our inventory once it has left the hospital.

Some locations have courriers to pickup or we use hospital courriers.

The Oncology and Dialysis centers get us a sample the day before or so. The nursing homes usually want to transfuse the same day.

If you have any other questions let us know.

[Jane]

Thanks so much to all of you for your answers- anybody else have any experience in this area??