Directed/Designated Donations

[mobea]

Hi

Working in a pedi hospital with a blood donor center, we get a fair amount of directed donors. As you can imagine, it is complex and sometimes emotional.....

Is there anyone out there in a hospital based donor center collecting directed donors for their patients? If so, I have a couple of questions for you!

- Do you charge the family and/or donors for this service? If you do, do you charge for the program or by unit collected?

- Do you require doctor's order for the number of units he/she wants collected?

- If no doctor's order is required, do you allow an unlimited number of directed donations for a patient? (for example, 20 donors for a tonsillectomy?)

- Do you crossover unused units into general inventory?

Any and all input is appreciated!! (I should add that eliminating the directed program is NOT an option {sigh})

[jtmtascp]

I supervise a hospital based blood bank in Louisiana. We accept directed units. We do not charge for this service because most of the units end up in our general inventory. Also, by ABO/Rh typing the donors as they present you can convert even those incompatible donors to replacement donors (blood goes to inventory; 15$ credit goes to patient's take home portion of bill).

A doctor's order is not required because directed donors are still volunteer donors; however, you might want to check your transfusion SOP to see if a doctor's order is needed for the transfusion of directed units. Some doctors prefer not to transfuse directed units.

[GGEHRKE]

We are a hospital based donor program and we collect Directed/Designated units. Although we do not have many directed donations annually we do offer that option to our patients. Most often, we will see directed donations for our NICU patients or if an autologous patient can't donate.

To answer some of your questions:

We do not charge the family or donors for collections since we have the ability to cross the units over to general inventory. The patient is charged the fees for transfusion.

We have a special form that the doctor must fill out which indicated the number of units desired, diagnosis and when the transfusion is needed. On the reverse of the form is a section for the patient or designee to sign. It basically outlines what happenes to directed units. (i.e if not compatable with the patient will be released to general inventory) Once this form is signed it is used for as many directed donations the patient/family send. It is only good for the length of the current admission.

The donation bags are tagged with a yellow tag. At the bottom of the tag is a tear off section which goes to the patient. They are to give these tags to the floor nurse who will attach them to the patients medical record. This way the floor is aware there may directed units for the patient.

[ShowDogDad]

We do quite a few directed donors for our ortho population. We do not charge. The recipient just gets charged for the blood during surgery if they recieve it. We do not charge not only because we may give out the RBC's to the general inventory, but also because every directed donation's FFP and PLT's go into the general inventory.

We do require a doctor's order for directed donation. HOWEVER... If the Dr. orders 1 unit of blood, we will take as many directed donors as the patient sends in. This is rationalized because many donors don't know their blood types. So, if the blood is incompatible, it is automatically put into the general population.

[stu]

Hi:

We work in a very similar fashion to Grace at New York Methodist:

No fee. Doctor's request for blood with the number of units requested.

If no Doctor's request then we treat them as regular units but call them replacement or honorary donations.

[Ann Viernes]

-Do you charge the family and/or donors for this service? If you do, do you charge for the program or by unit collected? No, we used to, it got too cumbersome, most insurances won't pay, too much time wasted in explanations. We do charge the same fees as any other patient is billed for what ever product is transfused. We also irradiate all directeds and charge irradiation.

- Do you require doctor's order for the number of units he/she wants collected? We accept a physician order but it is not required. Basically we need some indication from the recipient or guardian that the service is requested and the names of potential donors. The Illinois Blood law simply states that we have to allow patients to choose their own donors, and that the recipient is aware of those people who are donating for them.

- If no doctor's order is required, do you allow an unlimited number of directed donations for a patient? (for example, 20 donors for a tonsillectomy?) Basically, yes, by appointment only. If it get unruly we emphasize that only ABO identical units will be tagged for the patient.

- Do you crossover unused units into general inventory? Yes. Our procedure states that units will be released to inventory 7 days past the date of intended need.

[Deb]

We are a Hospital based donor center and yes, we do collect Directed units as outlined below. Note, we have seen this service continue to drop steadily over the past several years.

We do NOT charge for the program...The patient is billed for the transfusion and extra processing (i.e., irradiation,etc.) if any.

We do require a physician's order along with the number of units, type of component, AND the names of the donors the patient has acknowledged and approved as Directed Donors for them.

We do cross over the unit if the patient does not need it.

We have not seen excessive numbers of donors come in for simple procedures. (I don't think we have ever collected a directed unit for a tonsillectomy!)

We try to keep communication timely between collection and compatibility and number of expected units so the patient could request more donors if needed, but this rarely ever happens.