Retention of "Pick-up" Slips

[Keystone]

We use "pick up" slips when issuing blood. These contain the patient's name and medical record number. These aren't orders, they are just a way that the transfusing area alerts the blood bank that they are ready to transfuse a previously ordered product. Does anyone use "pick-up" slips when issuing product to floors? If so, how long do you save them for? AABB Standards don't specify that these be saved or for what period of time.

Thanks

[lef5501]

We used to use pick-up slips at my last hospital. We kept them for one week, just in case we needed to check a number, etc.

[MJDrew]

We keep them for a month, then pitch them.

MJ

[John C. Staley]

We have something similar to issue blood via the pneumatic tube system. The floor sends down a request and we send back the blood. We keep the requests for 6 months because we were the first in the corporation to use the tube system to issue blood and keeping the requests that long made my medical director comfortable. It's been almost 5 years now and I think I could persuade her that 1 month would be plenty. I've never had to look back more than the previous month for information.

[bevydawn]

When someone comes to get a unit of blood or blood product, we require they bring us a "pink card" that has the patient's name and MR# (usually has the patient's sticker on it), vitals, and ordering physician's name on it, plus what product they want. We then either write the unit # on the "pink card" or put a sticker from the unit on it. We are supposed to dispense the unit in the computer at that time and then use the "pink card" to do the verbal check against the crossmatch tag with whoever has come to get the blood. We then save the card until the computer prints a batch transfusion report which happens twice a day at 06:30 and 18:30. Then we just use these cards to make sure everyone did in fact dispense the unit in the computer and they are then thrown away. However we then maintain the batch transfusion report for one month which has all the important info on it that the "pink card" had.

[Lcsmrz]

Pickup slips were used to notify the BB of the request to transfuse (name/product/etc) and to enter the receiving person into the computer. They were kept a month, then discarded.

The receipt slips signed and returned when issuing via tube system were for some reason kept for a longer period of time, maybe because that information was not entered into the computer.

[Karen Olsen]

We use slips of paper to pick up blood products. They contain the patient Id information, the TS Ident-a-Band number and the products they wish to pick up. We keep them for a month, but I have never had to look anything up on these slips.

[Annabelle]

We keep the pick- up slips for three months.

[JMunden]

AABB 24th STD, pg 75 item 3.

5.11.1 Requests for blood and components are kept a minimum of 5 years. We have been saving since August ;( If I interpreted incorrectly, let me know...I could use the storage space.

[Lcsmrz]

A nurse's request for XM'd units is different than a physician's request (order) for blood products. You should retain the issue information somewhere, but the extent is what's being discussed here.

Many places use a nursing form to notify the BB to send them a unit, and this information is generally captured in the BB computer at the time of issue. It's interesting to see how many different ways you can handle that piece of paper!

[Karen Olsen]

AABB standard 5.11.1 is referring to the original request for the crossmatch, and yes they must be retained for 5 years - sorry. We are discussing the simple form of patient identification that the floor brings/sends to the BB to pick up the actual product. Unless your facility has a more official purpose for this item, like reason for transfusion, required hematology lab results, issue record, etc., I don't really see any reason to keep this slip of paper any extended time period at all.

[rcurrie]

Pickup slips are not the same thing as the request. We use them. The person picking up the blood brings the slip with them, we verify the required data, then give the slip back to them to do with as they wish. We document everything we need to document in the computer anyway.

BC

[Mabel Adams]

For awhile CAP made it sound like they wanted us to keep it if we use a tube system to issue, but they reworded the standard so now it is covered by the nurse doing an ID check when hanging the unit. I haven't gone back to tossing mine again yet, but probably will.

[Sandy Jo]

We use the pick up slip (called Blood Order/Review Form) as a part of utilization review. It contains the indications for the transfusion and I review it initially (as supervisor) and if I detect any out of our justifiable conditions, it would go on to the pathologist for further review. As it stands I don't keep the "justified" slips more than tow months. I only keep the "unjustified" and the additional review/action taken with those cases. Even though I use if for different reasons (review) I am not aware of any need to keep the form longer once they have actually been reviewed and are deemed "acceptable." Do others agree?

[MEVANS]

Our facility also has nursing provide a slip with patient name and medical record number (generally the blood product numbers are included as well) and we store these for two weeks. I have only needed them when someone has not filed the information in the computer system (not to often). As stated earlier I believe the standard is referring to the physician's request for blood products. At our facility this is in the patient's medical record and entered in our computer system which meets the five year requirement.

[JMunden]

Thank you everyone; As consensus is request means "physician" request, I'll go back to keeping the nurse request for 1 week. AABB should clarify the standard with physician before request, having just been recently inspected-I tend to interpret the literal meaning/implication.

[John C. Staley]

We've been playing a semantics game around here. Doctors "order" blood. Nurses "request" blood. The Drs order the blood to be crossmatched and then, occasionally, transfused. The nurses request the blood be sent up so they can transfuse it. That's how we've defined things around here and it seems to be working.

[rcurrie]

If I were making a Constitutional challenge to the AABB Standard, I would argue that it is "void for vagueness." That is one of the easiest ways to overturn a law, and it is quite an effective defense. AABB should add a definition for Request that makes it clear that it is referring to the physician's order. Even better- they should change the wording to "order", as that is what much of the medical field uses.

BC

[Karen Olsen]

Just to complicate things even further. I think there are really three things involved. The original physician order in the chart, the nurse request taken from the Dr's order in the chart and sent to BB, and then finally what I believe started this whole discussion is the patient identification used to pick up the blood product to ensure positive patient identification. This last piece of the puzzle is what we keep for one month and then pitch- and as I have said above, we have never had the need to go back and look at one of them - ever.

[bselcer]

At my hospital, a large acute care teachng hospital in Montreal, Canada we chose to use the NCR (non carbon copy) of the medical prescription in order to obtain all blood or blood products from our Transfusion Service. This saves paper and avoids additional errors made by selecting an incorrect hospital card to stamp on a paper/label, etc. The (NCR) prescription is hand delivered/faxed to Transfusion Service. It is verified by the technologist, prepared and then issued to the Nurse/Nursing delegate. The transporter then returns to the clinical area with the product, the transfusion record and the NCR prescription. All 3 itmes are hand delivered directly to the transfuser. A verification of patient, product and medical order is done immediately at that time. Transfusion Service does not retain this NCR copy of the prescription.

Bonnie Selcer- Transfusion Safety Nurse,Jewish General Hopital

Montreal, Quebec

[rcurrie]

I like that policy, Bonnie, and it is something I recommended at my institution but I was shot down on that. Too much trouble, they say. Although I hope it never happens, if we do have an adverse event related to this issue, I will be the first to say "I told you so."

BC

[donellda]

We keep them for about 3 months then toss them. We attach them to the back copy of the transfusion record for review the next day and then we file them in a box. Occasionally we do have to back to them for trauma committee reviews.

[bbkdiane]

Our pick up slips have the product, patient demographic label, date, and like a check, the messenger endorses the back with signature and initials. We add the patient blood type and a sticker from the product. These slips are later paired up with the return slip from the transfusion. They are stapled together and kept on site for one year, then off site for a total of 10 years. This system has worked well for 33 years. Also, no tickee no bloodee.