Paperless system

[spavlis]

Has anyone else wondered when the Blood Banking industry will become paperless for temperature quality control. Our hospital has just invested in an electronic temperature monitoring system. The system documents everything from alarms, to daily checks, to corrective actions. My question is ... Do you we still need to take the daily internal temperatures and the digital readouts everyday, if we have this automatic temperature monitioring system? According to the AABB, CLIA, and FDA we are only required to monitor the temperatures and document the corrective actions for out of range temperatures. It says nothing about correlating the internal temperature to the digital temperature to the automatic monitoring system. Though this is the norm for most places.

Is anyone truely paperless for daily temperature readings? If so, how often do you perform the temperature correlations? I was told that maybe once a month might be good.

Any help would be appreciated.

stephanie

[Franklyn]

The AABB, etc. no longer require daily "physical" checks of refrigerators and freezers as long as the temperature is documented q4 hours and there is a tested/validated alarms system. At my own facility we have done away with the daily log.

However, we still generate a daily report of the previous days alarm events to verify, daily, that all alarm events were responded to appropriately and documented as required. So, we basically traded one piece of paper for another. We could view the report on the screen, of course, but as it is a shared responsibility the report just pops out on a printer in the lab every morning and the tech in charge is responsible for reviewing and and following up on any missing information. We have been doing it that way for years... We bought our first centralized alarm system around about 1993.

Using a collection of databases and computer applications we have eliminated a BUNCH of paper, but I am not hopeful for a completely paperless system in the near future. Sometimes, paper logs are just the easiest way to solve a problem (and sometimes create a new one )

[spavlis]

Franklyn

At your hospital do you perform any temperature correlation to verify that the automated temperature monitoring system is operating correctly? ( Ie. an comparison of the automated temperature to the internal temperature to the digital read out)?? If so, how often??

thanks

stephanie

[Franklyn]

We perform a twice yearly alarm test that validates the calibration of each remote probe and that the unit is alarming correctly. The AABB requires such testing on a "periodic" basis, which we determined to complete twice per year.

We used to do it quarterly, but I managed to change that.

We use an NIST traceable electronic thermometer and document that the centralized alarm system and the local refrigerator display (if present) all read within +/- 1 degree C. Then we test that the alarms activate at the correct high/low temperatures as defined by our SOP. This used to require the old "fire and ice" testing but with our new system we have avoided that on anything monitored centrally.

It takes one staff member less than a shift to calibrate and test all 30+ refrigerators, freezers and storage chambers.

[Lcsmrz]

The biggest difficulty I've had is deciding which of the 3-5 thermometers (Graph, Alarm, automated system, LIG, upper, lower) in a temp-controlled cabinet is the "real" one. All are NIST-traceable or calibrated, yet can be 1-2 C off with respect to the others, even if in the same solution.

Fortuantely, some one decided that the cheapo LIG NIST-certificate one was the standard by which all other temperature-sensing devices will be compared. So, as long as the same thermometer remains in the cabinet, the other thermometers are calibrated to it. Heaven forbid if we have to chagne it!

I've convinced the powers-that-be that getting a "real" set of NIST thermometers (limited range, 0.1 C resolution) is the only way to go in the future ...

[Franklyn]

Variations in temperature within a refrigerator, or even a vessel, are common, predictable and preventable. Within my own facility every thermometer in the vessel (e.g. Digital display temp, Nist Traceable probe and alarm system) fall within a maximum 1 degree spread, everytime, period. Thermodynamics address variations in temperature within a vessel - two easy techniques are to rubber band all the probes together so that they are all reading from approximately the same location (do not let them touch the sides of the containment vessel) and simple agitation homogenizes the contents of the vessel.

Variations between top and bottom temperatures are a function of airflow, how full the refrigerator is, shelves vs. drawers and thermal mass. All issues that should be addressed by a validation of the storage device.

I, personally, am a BIG fan of buying a fluke meter and having it calibrated once per year. You can buy multiple probes, they are durable, relatively cheap and provide resolution to 0.1 or 0.01 degrees or more based on what you buy.

[Bill Phillips]

The long and short of it is that if you go with a computer-based, paperless system, the sensors need to be recalibrated and the entire system revalidated at least once yearly in order to meet AABB and FDA guidelines. Doing this is the only way to ensure that system readings are accurate. If this is done, no daily logs or manual checks are needed, although we print out reports as a backup.

Hope this helps.

Bill

[e2di]

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