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"Pick-up" slip


Cliff

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Hi,

Disregarding the concern about an official order, Medicare issues, and the billing aspects, what are your thoughts on issuing products without a formal pick-up slip (or whatever your organization calls it) being presented?

For instance, if you had products crossmatched and received a phone request to issue the products through a pneumatic tube and were provided the patients full name and medical record number (and you verified this in your computer and documented the request), would you issue the requested products?

Thanks for your replies

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Our facility doesn't issue blood in the pneumatic tube, but we do make them bring "something" with the patient's name and medical record number on it when they come to pick up blood. We do not have any one official "pick-up" slip that must be used. We are in the process of implementing a Pre-Printed MD Order Form for BBK tests and products (and orders to transfuse) and we have been batting around the idea of making them bring that when they come to pick up blood. That way the BBK tech could actually check the MD orders for themselves as part of the issue process (to ensure they were transcribed by the unit coordinator correctly into the computer). The courier would take the order form back with them to be used for more units (if more than one unit was ordered) and the form is eventually scanned into the patient's electronic record. They are hoping to move to physician order entry within a couple of years. :)

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Our facility uses a preprinted pickup slip. It is about a 4' x 5" slip that is on a pad, so the RN's can just rip off one at a time as needed.

It has a place to print or stamp the patient's name and medical record number and to write the unique BB armband number.

There are boxes to check off the floor location, the product requested and any special attributes.

There is a place for the RN to date and sign that the pickup slip is correct.

We use the pneumatic tube system to issue blood and require a secure code a on the pickup slip.

The BB tech records the unit number issued on the pick up slip, so we can reconcile the units issued with the computer the following day.

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We get a call from the unit, and require they tell us their name, patient name (they need to spell last name), DOB, band #, transfusing physician, tube station #. We don't even accept written requests through the tube, and NO ONE comes to our lab. (too far?? we're on the sixth floor...) We write it on our log at the time of the call and issue in the computer (sometimes later).

At the hospital I used to work at, we did written requests through the tube.

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While we have a pneumatic tube system, we don't send blood through it.

A nurse has to physically come to the blood bank with a signed copy of the informed consent with the blood bank armband number written on it.

We then record the unit number, product type, date and time issued on the form, then do a clerical check with the nurse:

1. Name and billing # on form, match compat label

2. Patient ABO/Rh and unit ABO/Rh

3. unit # on compat label match unit label

4. exp date on compat label match unit label

5. BB armband # they wrote on form, matches the # we have on label

We then use this form to manually charge for the product at the end of the shift.

We would like to get away from using the consent, as we have to statistically analyze what percentage are signed by the doctor (poor - only 20-25%) and what doctors aren't signing. The committee always wants a plan to improve the signature rate, but nothing seems to work! Too much work for nothing!

I would like to use a form where they check off justification for transfusion, but our pathologist doesn't want to rock the boat.

I wouldn't feel comfortable with no pick-up slip at all.

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Hi Folks,

We don't use pneumatic tube. We are probably lucky in that issue fridges are near wards and theatre. The reason we don't use them is.

1. Non-validated method of transport. We have data loggers so shooting them about might be an idea to try.

2. What carriers are used? Is no-one concerned about cross-contamination if carriers are used for other infectious path material (even if in bio-hazard bags).

Regarding "pick-up slips". As soon as crossmatch is completed, a compatibility form is issued and that is required for collection. In emergency, there is a book to fill in and sign at issue fridge. Works OK. Large trauma centres are going to have a problem with this though I realise.

Regards Eoin.

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We use the pneumatic tube system and require that a phone call be made to the transfusion service with the patient name, location, pt #, and name of the person calling. We also require that a copy of thy physician's order for the actual transfusion be faxed to the lab prior to issuing the blood. The nursing staff must also put in a request through the computer system that prints in the lab. Seems kind of redundant, but that's the name of the name in transfusions.

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Cliff, that's exactly how we issue blood to the OR. It would be very difficult (to them impossible) for OR to follow our normal protocol. When they need blood they call, provide the patient's full name and MR number from the armband. We write that on the request form everyone else sends to us and then follow through our process.

So far so good and we've been doing this for over 6 years.

:haha:

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That is, and has been, our normal procedure for at least 10 years. The name of the requesting RN is recorded in the LIS, as well as date, time and, by default, the issueing tech because they're logged in. The transfusion tags do not print until issue so there is no way to send out units without computer entry.

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We do not (yet) release products via the tube. We require that something in writing with the patient's identifying information on it be presented to the blood bank. We retain it and attach it to the issue documentation records that are kept in blood bank.

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hi Everyone

I have worked three different places and they all required to have pickup slips. The pick up slips included

1) Patient's Full Name

2) Medical Record Number

3) Blood Bank Armband Number (unique Identifier)

4) Type of component Requested/ #of product needed

5) Date and time Unit(s) issued

6) Issuing tech's code and receiving Nurse's Code/Initials

7) Unit Number (Component Type)

I would be affraid to issue anything on the floor without anyof the information in the lab on a hard copy form to cover any mistakes.

I have seen many mistakes like patient has wrong armband number in the LIS then the physical arm band #. There is a possibility of mistake while patient have multiple component allocated to them and nurse orders one product and realises that, that is not what they wanted and lab sends different product for the same patient.

At my current job we don't have Pneumatic system so we don't tube components, but i have worked at a place where we use to send products through the tube system but we still received the Pick up slip signed by Either Nurse or physician with all the above listed information

Thanks

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We actually have the nurse release the blood product via LIS when he/she is ready to transfuse. The "Release" prints in BB. We issue the blood and sent it to the floor via pneumatic tube. The person receiving the unit will sign the release form and return the form to the BB via pneumatic tube. We save the forms for 3 months then discard them, because we have a computer timestamp of the release request.

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We also use a preprinted form that includes patient information, a spot to check that the RN verified the Dr.'s orders and that consent was signed and the RN's name. Here's my question--do you guys keep these forms and if so, for how long...and why? I usually keep them for about a month and then get rid of them.

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We have a pneumatic tube system, but no one bothered to check with a Lab person before selecting & installing it. The carriers are too small to hold a unit of blood, so we cannot send blood to the floors via the tube system. (Bet there are lots of you out there who aren't surprised by this type of lack of communication, huh?)

We don't use any form of "pick-up" slips. When the nursing unit wants a unit of blood delivered, they actually order a test code in the computer for "Issue PRC X 1". A label prints in Blood Bank & it contains all of the pertinent patient info, which we check against the crossmatch paperwork on the unit we intend to issue.

Until about 4 years ago, a Blood Bank tech would then deliver the blood to the patient's bedside (or Surgery or ECC.) However, now we page a circulating Pharmacy tech to come pick up the blood & deliver it to the floor, thanks to a multi-department Six Sigma project. (Our Pharmacy techs have turned out to be wonderful; very consciencous and careful.)

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  • 2 weeks later...

We have a "pick up slip" if the nurse comes in person to pick up the blood. It must have the two identifiers on it (name and medical record number).

We have a pneumatic tube request form that we use for units that we "tube".

We also require a transfusion order form faxed to the Blood Bank before we release the blood.

The only "verbal" orders we allow is for traumas, which we personally deliver to the ER.

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We require written name/MRN for all pickups and p-tubed units. (we validated p-tube for all products) Same slip is used throughout the house - even the OR. But we will accept any piece of paper with a written name/MRN on it.

I'm curious about those that use p-tube to deliver blood - how do you document receipt of the blood at the nursing unit? I think it's a CAP requirement.

And does anyone use "secure send"?

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Our pneumatic tube request form (it's a two part form) is sent to us through the tube. We sign out the blood, two Blood Bank techs check the product against the request and both initial the form. The whole form is sent up with the blood. The person taking it out of the pneumatic tube carrier takes the request form out, initials the receipt part, keeps the front copy for the chart, and sends us the back copy. If we do not receive the back copy back within 15 minutes of sending it up, we call the floor to make sure they received the blood, and ask them to send back our copy. This works pretty well for us, and fulfills all the regs.

We do not use secure send. If when we call the floor they say there is no carrier in the station, we can look on the pneumatic tube control PC and see where it ended up if someone accidentally sent it to the wrong station. I think this has only happened once.

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