What would you do? Outpatient transfusion

[LaraT23]

Here is a scenario,

We have an outpatient ambulatory surgical center. We give regular outpatient transfusions pretty much every day to cancer patients, and those with different chronic anemias. We have a hospital courier who takes coolers with blood, all crossmatched and tagged and issued across the parking lot essentially to the infusion area.

Our assitant admin. says that this is not acceptable and now wants the infusion nurses to pick up the early ones ( at 7:45 or so) and blood bank staff to take any later ones over there ourselves. Now, we are not a huge facility, so we have one person in blood bank most days and then sometimes someone else in another dept. who can cover for lunch or meetings.

My question is, do any of you send blood to outside facilities for transfusion and who takes it? Does anyone know of any standard ( he cites JCAHO) that dictate that only a licensed person can transport blood or blood product?

[David Saikin]

I am not aware of any reg like that . . . we had pt transport p/u blood routinely for years. They did have pt info for the p/u. Components should not be handed out to an area just because you know the patient is going to be there. It should be a formalized process.

[L106]

We have exactly the same situation as Lara described. Our Out Patient Transfusion Center was moved out of the hospital into a building about a half block away (rather than across the parking lot.) Personnel from the Out Pt Center (Nursing Assistants, LPNs, or rarely, RNs) come and pick up the blood products from the Lab. I do think it's up to management/administration to make the call on who they want to designate as the "gopher." (I think the logical solution would be to have a courier or non-professional person do the chore, but administration would not add such a position to the budget.)

Of course you need to be in compliance if there are state regulations governing this issue, but I am not aware of any JCAHO standard that dictates that only a licensed person can transport blood or blood products (and I doubt that this information is correct.) Our blood supplier is 100 miles away, and blood is delivered to us by a volunteer driver, who obviously is not a medically licensed person. As far as that goes, in most states, Blood Bank personnel have passed registry exams, but we are not "licensed" by any agency. So unless your state has a specific regulation on this subject, I suspect he JCAHO argument is poo-poo.

[shelleyk482]

My understanding has always been that this is a facility specific preference . In most of the facilities I have worked in (all but one in Texas), there have always been couriers (non-professional) that transport blood to an off-site facility. In my opinion, it is a significant waste of money & time to have a high-dollar nurse or tech, who should be doing something else, transporting the product. Of course, there needs to be an appropriate transport container and training of the transport concerning the importance of promptly delivering the product where it needs to be.

I would be interested in seeing what JCAHO standard the adminstrator is refering to.

[LaraT23]

The main issue raised by the administrator was that we have different processes for issuing blood on the floors and for surgery. We require that nurses bring a transfusion record with the patient name, date of birth, medical record number and blood bank bracelet number. For those outlying areas, we just pack up the units that are ordered for those patients, one per cooler and labeled on the outside of the issue sheet wrapped around the unit. The infusion nurses fax over the transfusion sheets as soon as they have finished so that I can get that info into the computer. They don't come and pickup with a transfusion sheet. I also don't ask that surgery does that either. So, different processes make administration nervous.

[shelleyk482]

That makes sense. In the other facilities where I have worked we had non-professional couriers pick up products for both inpatient and outpatient. We required a "Blood Product Requisition" form that had the patient name, medical record number, wristband number and the product type & number required. This form was required for all transfusions; inpatient & outpatient. The couriers were also required to do the full dispense procedure regardless of where the product was being dispensed to.

[adiescast]

We allow any hospital employee or volunteer who has been trained in blood transport internally to do the transport within the hospital. We use couriers or cabs to take blood in coolers to outpatient tranfusion centers. They have no special training that I am aware of, but they do know that they have to take the cooler straight to the destination. We have not had much problem with delays and those are handled by contacting the supervisor of the individual courier or the cab company (who want to keep our business). When I was in Texas, we used a family run courier business to transport blood in coolers. They were not specially trained, but they were extremely reliable.