Pre surgical testing

[pbaker]

I am looking for information on how other facilities handle pre-admission blood bank testing.

How far out from surgery date will you allow pre-testing? Must the patient leave the pre-test armband on? What testing do you perform day of surgery? How do you ensure the patient pregnancy/transfusion history from pre-testing to surgery day? Is there a specific location they must be tested through (i.e. admitting, OP lab, etc.)?

I am trying to revamp our program, so thanks for any information you can provide

[Deny Morlino]

We allow most surgeries to perform the pre-surgical ABO, Rh, and ABS up to 14 days prior to surgery. The exceptions are the usual pregnant patient and any patient transfused within the last 3 months.

We request that the patient leave the armband on after the specimen is drawn at the pre-surg point. If this is impossible (i.e. work related, etc.) the patient must be responsible for bringing the band with them the day of surgery for application of the band prior to surgery. If the band is not present, we start over.

If the surgery warrants a crossmatch per MSBOS we redraw the morning of surgery, honor the ABS provided the above conditions are met, and perform the crossmatch for the indicated number of units.

The pre-surg draws are coordinated through the preadmission testing department and routed through our outpatient draw area.

Part of the success of this process requires the surgical nurses following their checklists and verifying the blood bank ID band is present, and the lack of transfusion within the last 3 months. Any female of childbearing age (and some that are a stretch of that term) have a qualitative bHCG performed the morning of surgery.

Hope this helps.

[Likewine99]

14 days before surgery, PreTesting RN's have a "pink form" they fill out re: transfusion, pregnancy or surgery with last 3 months.

XM's done evening before and yes armband must be left on or everything repeated day of admission. If armband is removed we credit the first set of testing to keep the billing compliance people happy.

[AMcCord]

We go 7 days preop. The patient is given a card with their armband number on it and a blood bank form is filled out - pregnancy within 90 days? and transfused within 90 days? The patient signs that history form with the phleb signing as a witness. When the patient returns, we ask the patient to sign the ID card they took home with them, ID them with their hospital ID band, etc, and armband them with a blood bank ID band - the number matches the card they returned. IF the card does not come back with them, we start over. We attach the newly signed card to the previously signed history form (signatures checked to be sure they matched) and file for documentation.

[Eoin]

Hi Folks,

We have a big orthopaedic load and use pre-op clinics extensively. We use typenex system and will collect 30 days prior(given the caveats of not pregnant, no history of antibodies, not transfused within last three months). Plasma is aliquoted before testing and then stored at -30oC. We saw the typenex band as a high risk area, and now use the attached form which patient signs at time of collection and then patient must identify their signature to the admitting nurse on the ward (as well as the positive identity check on name & DOB). This TCI (for To Come In) Form and Typenex and Group, Screen & Hold result are held in BB lab until admission). Reglators were happy we had risk assessed the process, and closed what we saw as a high risk area. We had tried applying band, but compliance with keeping it on was poor and level of illegibility on admission was high. We have not identified any non-conforming events in the five years we have been operating this system.

Cheers

Eoin[ATTACH]437[/ATTACH]

BB101F.doc

[pbaker]

Would anyone be willing to share a copy of the "card" or "form" that you use for pre-testing?

[vam3401]

We allow pre-surgical specimens to be collected up to 30 days prior to the surgery. History of pregnancy and/or transfusion in the past 3 months is documented at that time. Units would be crossmatched day of surgery, if needed. We do not use a specific blood bank armband, so no armband requirments for us. On day of surgery, the transfusion history is asked by the RN and a pregnancy test is performed per surgery policy. If the transfusion or pregnancy history has changed since the specimen was collected, a new Type and Screen specimen would be collected.

[Eoin]

Would anyone be willing to share a copy of the "card" or "form" that you use for pre-testing?

Its attached - just after my name - work away.

Cheers

Eoin

[AMcCord]

Here's what we use for PAT patient documentation. The sticker that both forms ask for is the patient ID number that we use on their Blood Bank ID band. We get our ID #s in sets of 5 duplicates.

PAT Documentation.doc

PAT Card format.doc

[pbaker]

I couldn't find the attachment Eoin :-(

[adiescast]

It is in Eoin's 12/8 post immediately after and on the same line with his name at the end of the post. It is called "BB101F.doc"