Blood Loc

[Mary]

Does anyone have a contact address or phone number for the manufacturer of the Blood Loc system? I couldn't locate it on the web.

Thanks

[bmarotto]

Try this:

http://www.bloodloc.com/

[Kathy3171]

The company that makes the Bloodloc is Novatek Medical. Their phone in 1-800-3585023. We have been using their product for several years and find that it works very well. There was a little resistance at first because of the extra time but it has been demonstrated to them that it has prevented transfusion errors on more than one occasion. No more complaints....

[John C. Staley]

I'm curious, is the use of the blood loc universal in your facility or are some areas such as ER and OR exempt from using it?

[Mabel Adams]

I have a feeling a lot of ORs would quietly exempt themselves with a pair of scissors!

[Kathy3171]

The only time we do not use the bloodloc system is when we are giving O negative, uncrossmatched blood for emergencies. It is used at all other times. We require that the loc and the bag be returned to the Blood Bank. If they are not returned or are returned torn or cut, it is reported to the hospital risk department. They follow up with the offending department and occasionally, the Medical Director of the Blood Bank has a few kind words with the head of the department.

[John C. Staley]

Kathy, sounds like you've got a pretty good system in place. How often do you get a bag back that has been handled inappropriately?

My concern is that we seem to spend a lot of time and effort policing other areas because they can't seem to figure out that following simple processes actually works and is safe.

[rcurrie]

What I like about the system is that in an emergency, when you don't have time to properly identify the patient, all you have to do is cut the bottom of the bag out.

No wait- that's what the nurses liked about it.

Whenever you have separate systems for "routine" transfusions and emergent transfusions, you are setting yourself up for failure. The last 4 mistransfusions I investigated were all "emergent" transfusions in which the recipient got blood crossmatched for someone else. The nurses all said they didn't have time to check the patient ID ("Hey- I have had Bed 4 for a patient ever since she got here- I know who she is." However, when she hollered "Go get some blood for Bed 4," the unit clerk grabbed the wrong patient stickers. There was no need to do a bedside ID because, after all, Bed 4 is Bed 4. Of course, the transfusion ticket had a real name on it rather than a bed number. Imagine that.).

I checked out the link to the website for Bloodloc and noticed a link to "Wrongful death lawsuits." Almost all of the links were to newspaper articles rather than the actual lawsuit transcripts or written judgments. Almost all concerned "tainted" blood, and no type of transfusion barrier would have prevented those errors. If the links to those cases are intended to present justification for using their system, they certainly fail in that regard.

I am not a fan of barriers to transfusion. If they work for you, then fine. But when CAP considers making barriers to transfusion mandatory, I have to protest. I will do that with the hospital checkbook. No more CAP.

BC

[Mary]

Good thoughts. I think we need to take a stand on these new requirements.

[Kathy3171]

In the five years that we have had the Bloodloc system, the bag has only been torn open twice. Once when we first started and once when the surgery department read the code incorrectly. We have not had any mistransfusions and the barrier system works for us. It's an extra level of safety that the nurses are willing to take in order to be assured the patient is getting the correct blood. They probably have a system where someone is opeing the bag as they walk it from the tube, so there are always ways around it. I just hope they walk into the right room and do the correct bedside checks.

[csjuarez]

Does the use of the Bloodloc system eliminate the need for the second nurse to verify patient/unit identity? Another question: When do you put the Bloodloc codes on the patient ID band? On admission; when the first Blood Bank sample is drawn; at some other time? What about when there is a massive transfusion such as trauma or a bad surgery case?

We're looking into this system, but it initially sounds like quite a bit of extra work for all concerned. Alternately we may need to institute a second sample protocol. Ideally we would get a barcode patient armband system, but since that's a hospital project it will take longer to convince, budget, and implement.

[Mabel Adams]

How does surgery handle these when the wristband with the blood loc code is often under the sterile drapes? Do they have a formal policy to record the wristband number when the patient comes into the room and for the duration of the case they refer to what they copied down?

[Kathy3171]

The bloodloc code is put onto the patient's inpatient ID band at the first draw for blood bank. For massive transfusions, we will issue several units in several bags with one lock (the bags can be piggybacked so more than one fits onto a loc). Surgery has a procedure for recording the bloodloc before the patient is under sterile drapes. We've just had our third torn bag. This was by a contracted dialysis tech that was unfamiliar with our system. Again, this has been referred to our Risk department for follow-up.

[supertech]

I am so glad to have found this website. It is such a relief to know that we are not the only ones struggling for a solution!! I am curious... did you look at barcoded armbands before deciding on the bloodloc system? We are starting extensive research to find the safest and most cost-effective system.

Ashlea Servi

Transfusion Services Coordinator

Truman Medical Center

Kansas City, MO

[Kathy3171]

I've always been interested in barcoded armbands, but waiting for administration to agree to the spending of the funds was taking too long. We are finally starting to barcode the patient armband and they are currently using it for bedside glucose ID but that's about all. They will need to research PDA's or some other method of RN bedside ID that works for multiple departments (Laboratory, Pharmacy, POC, etc.) before we will switch completely. Hopefully, I will be retired by then.....I'm about validated out!!

[armymt2002]

My boss has tasked me to write a policy and SOP to use this system. Would it be possible to look at someone else's policy/SOP to see how it is done? None of the military hospitals are using it yet. Thanks.

Kristine

[rcurrie]

One of the best places to start is the product insert. Many product inserts lay out the SOP for you.

BC

[armymt2002]

Thanks for the information. I do have the directions from the website but since this involves the nurses and doctors I was wondering how others are tracking the bag (i.e. do you put a patient label on the bag) so the wards can't try substitute uncut bag for one they cut open instead of using the lock. How does the wards get the armbands if the nurses draw the blood (which they do here) and not a phlebotomist drawing the blood. Who is responsible for training the nurses? Thanks.

[rcurrie]

It's been a long time since we tried this, but we were the ones that put the blood in the bag and locked it. It was already in a locked bag at issue. We had phlebotomists that collected the blood back then, but nursing collects about half our specimens now. We abandoned the system when the point was reached where the nurses cut the unit out of the locked bag over half the time. We required the bag to be returned to the blood bank after the unit was removed. The bag was either returned "cut" or we were told they forgot and discarded it, which really meant they cut the unit out.

BC

[Kathy3171]

Nurses perform the majority of the draws for our hospital so they are the ones responsible for labeling the armband with the bloodloc code. We have very strong administrative support that backs us up if the nurses don't comply with the entire process. Any occurrence reported to Risk due to bloodloc errors is referred to the Nurse Manager of the floor involved and appropriate disciplinary action is taken, usually reeducation for the first offense. One floor now requires 2 RNs to verify the bloodloc at the time of draw because of one nurse's failure to follow protocol. It seems cumbersome, but at the same time, the nurses do really like the added safety feature. Also, the contracted dialysis tech that tore the bag has been asked not to return to our facility.

As far as the SOP, I followed the manufacturer's guidelines, then added our own requirements such as, if it the specimen is missing any of the main identifiers (name, date of birth and Bloodloc code) the specimen will be redrawn, no exceptions. If they can't wait, then it will have to be issued uncrossmatched.

[delvigo]

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[Franklyn]

We started using the Bloodloc system several years ago as a corrective action for a cluster of errors. A multidisciplinary group that included nurses came up with the decision to use the system. Nobody was really happy about it as it adds a quarter million to the bottom line and required culture change and constant vigilance, but we have documented multiple events where the system prevented mistransfusion. One caveat - we had to redesign the stickers and process to fit our facility. We have more than 60,000 admissions per year and the "factory" sticker set contains about 12,000 unique combinations. We also discovered multiple error scenarios that we repeating and could only be correct by redesigning the labels. The AABB accepted my poster on the project a few years ago.

Here is a JPG of an example label from our customized set:

So, after nearly three years I can say it works but will require the same sort of effort as any other patient ID band system. It will require you to change culture in nursing to make bypassing the locks for ANY reason verbotten and, if you are really going to implement it, you lock EVERY product for every location, even the ED and surgery.

I could go on about our "custom rolled" variation on the Bloodloc for hours, but suffice to say we buy the locks and bags from Novatek and the stickers from Computype. Novatek was instrumental and extremely helpful in getting our home rolled system put together, as a vendor they have been responsive and dependable, but implementing the system in any configuration within a facility will require a fair amount of effort to make it work correctly.