Blood Bank ID Bands

[jasonviau]

Does your facility have a policy requiring a separate ID band for patients who may require transfusion (Typenex, etc.)?

If you do, and you draw a Pre-Op Type and Screen, do you require the patient to wear the band from the time the sample is drawn until they return for surgery?

Please include the name/location of your facility in your response. Thank you for your help.

[Bill]

There was a thread not too long ago on this same question--you might want to search past threads for info

[Likewine99]

Yes we used a separate ID band and yes we require the pre test pt to wear the armband.

SSM DePaul Health Center, St. Louis, MO

[mmckee]

Does your facility have a policy requiring a separate ID band for patients who may require transfusion (Typenex, etc.)?

If you do, and you draw a Pre-Op Type and Screen, do you require the patient to wear the band from the time the sample is drawn until they return for surgery?

Please include the name/location of your facility in your response. Thank you for your help.

Yes, we use a separate blood bank ID bracelet. We also use a waiver form for pre-testing up to a week before surgery. Part of that form is patient consent to wear bracelet until discharged after their surgery and a statement that if they remove bracelet they will have to be redrawn and will be charged for second workup.

[LaraT23]

Yes we require separate BBK ID bands, and for our preop patients, we give them a choice. The risk of additional testing and billing issues are explained should they decide not to wear the band, and just bring it with them. This is all outlined in a letter we give them that they sign and we keep a copy of.

[John C. Staley]

No, no, no, NO and most definetly NO!! I fought long and hard against a blood bank specific armband. It complicates a process that can be simple and efficient. It is often a fall back when training and education will be "too difficult".

Ok, I'll get down of my soap box now.

[clmergen]

I am with John on this one. Having just changed jobs from a place without bands to a place with bands, I find the bands annoying. I think the problems they can cause outweigh the sense of security that they give. A strong hospital policy/procedure on armbanding patients (and re-armbanding) is a better way to go.

[Liz]

We never used wrist bands specific for transfusion but it has always been on my mind and it is interesting to hear your opinions.

[Liz]

There was a thread not too long ago on this same question--you might want to search past threads for info

Thank you, I found the thread!!

[Lbiggs]

We do not currently use specific arm banding for blood product testing, but are looking at the process. Can someone explain to me how to find that related thread. Thanks. LB

[tbostock]

We got rid of our bands last year.  Best thing we ever did.

[aafrin]

We do not have special blood bank arm bands, only the hospital ones. The patient cannot be drawn/ transfused unless they are wearing one. We were toying with the idea of having a specific blood bank arm band but gave up the idea due to increase in costs as well as cumbersomeness of two arm bands on one patient. We have to review this again in July for policy purpose and your inputs will be of great help.

[goodchild]

We got rid of arm bands in either 2008/2009 and I'm thankful. We've picked up on a number of WBIT since that time using Retypes.

[Lbiggs]

What is WBIT?

[goodchild]

wrong blood in tube

[Lbiggs]

What is your policy on retypes because that is the other process we are looking at as well?

[Dansket]

For those who do not use a secondary ID band system, but do confirm ABO type of patients with no historical blood type. How do you insure that the specimen collected for the ABO confirmation is done with a second venipuncture?

 

I've had experiences with phlebotomists and anesthesiologists who draw two containers with one venipucture and 'sandbag' the second container if ABO confirmation is required!

Edited April 29, 2013 by Dansket

[Dansket]

I am with John on this one. Having just changed jobs from a place without bands to a place with bands, I find the bands annoying. I think the problems they can cause outweigh the sense of security that they give. A strong hospital policy/procedure on armbanding patients (and re-armbanding) is a better way to go.

I can appreciate John's and cimergen's stance on this issue.  But there is a distinct advantage to a secondary blood band system and that it is designed to prevent WBIT; doing a blood type on a specimen collected from a different venipuncture is designed to detect WBIT.  So choose wisely..or do both!

[OxyApos]

We have a separate system using Typenex.  Until humans are error proof ( innocent or otherwise ) this gives us an added layer of security.  No transfusion events yet, but even with this system we have at least once a year a phleb that has been found to not check the hospital armband and just go my room number resulting in WBIT.  Hopefully someday we will get an electronic system that will let us get rid of the 2nd system but for now, it works.

[Sko681]

Im late but... we just instituted a separate arm band for BB after a very unfortunate incident.  (well more than one incident but one that was the straw that broke the camels back)   I agree, that if everyone played nice with policy and prodedure we wouldnt need them.  However, we were proven wrong more than once.    As for pre-op patients they go home wearing them.

[Lbiggs]

Sko681, can you embellish anything about the incident that would help me in a discussion with the lab manager and lab assistant lead? Also, what size is your facility? Thanks for any information that might help.

[AMcCord]

We have a separate system using Typenex.  Until humans are error proof ( innocent or otherwise ) this gives us an added layer of security.  No transfusion events yet, but even with this system we have at least once a year a phleb that has been found to not check the hospital armband and just go my room number resulting in WBIT.  Hopefully someday we will get an electronic system that will let us get rid of the 2nd system but for now, it works.

 

The electronic system will not catch all ID errors. Scenario:  Patient gets an armband slapped on with the wrong name (because the person doing it did not properly ID the patient). The armband should have gone on the wrist of the patient next door. The armband error is discovered later on and a new correct armband is placed. But... before the error is discovered, the patient is drawn for a crossmatch and other tests using the wrong name (your phleb/nurse didn't follow the rules for IDing patients when they collected the specimen). When the armband is changed, no one notifies the lab (all those nice tests drawn on the wrong patient have been run and reported). The patient next door, the one whose name was on the armband the other guy mistakenly got banded with, is supposed to be transfused. Lucky us, we already have units tagged with his name (unfortunately, the specimen was drawn on the guy next door before someone discovered he was wearing the wrong armband).....we transfuse those units. Disaster strikes - his blood type is not the same as the guy next door who was drawn for a crossmatch while wearing the transfusion recipeint's armband. It's called the swiss cheese effect - there's a paper written describing it. All the errors we can make are the holes in the cheese. Usually the hole only goes so far into the cheese before you run into a solid wall of more cheese. But sometimes, if the cheese is sliced just right, the hole goes all the way through. There's nothing between your patient and disaster but air.

 

I'm not saying that the electronic system isn't going to be a good thing. What I am saying is that if we are complacent and make the assumption that it's the end all and be all and will prevent all errors, we are sadly mistaken. The most critical step is still going to be properly IDing the patient every single time we are near him and not relying on an electronic gadget that reads a bar code (though that will be great for errors caused by mixing order slips from different patients together). The whole thing falls in a heap if the patient was not properly ID'd in the first place We won't know for an absolute fact that he was correctly ID'd, that corners weren't cut or work-arounds used by someone who thinks the whole system is dumb. We must follow a robust policy of carefully IDing him every contact and using that electronic gadget as ONE of the tools in are tool belt.

 

Wheww! don't know what came over me...I'll get off the soap box now. Admission errors and associated patient ID errors are one of my nightmares.

 

 

[aafrin]

AMcCord, you are absolutely right, a buffoon who gaffe's on patient ID procedure because of no time, lengthy procedure, too much work or who's a smart---s thinking the system is dumb - is a potential for disaster. They shortcircuit the procedure and get away with it a couple of times and then become bold & smug, until their luck runs out and puts patient, blood bank & themselves in grave danger. Computers, electronic gadgets like bar code readers etc. are just helpers/tools with no mind or intelligence which is why they say GIGO about them - user intelligence is what counts....

 

The scenario you depicted has happened once here, but luckily for us & the patient, the second sample requirement saved us all.

 

Sorry, if I got onto your soapbox......getting off now.

[Dansket]

To AMcCord and ALLOURBEST NLR,

 

Regarding the incident AMcCORD described, was your facility using a secondary blood bank ID band or did Nursing remove the hospital ID band from one patient and re-attach that same band to a different patient?

 

Blood Bank ID bands like TYPENEX are designed so they cannot be reattached.  At the time of specimen collection, both the blood sample container and the patient are identifed with a unique number-letter code.  This code is transferred to the compability label attached to the blood container.  Nursing must match code on patient's blood band with code on form.  In the incident you describe, the Nurse would arrive at the bedside and discover that there was no blood band on the patient.

 

Properly designed electronic systems mimic the TYPENEX system..

 

Dan

[Mabel Adams]

We have one of those great electronic barcode armband systems.  Except the OP transfusion patients and pre-op patients don't wear hospital armbands so they can't be scanned.  And line draws in ICU are collected by the nurse so the phlebs swing by, print the labels for them and leave them for the nurses. (They usually draw BB specimens with the phleb present, but not always.)  And in OB the nurses collect specimens when they set the IVs and they haven't been trained on the scanner system so it is bypassed again.  Until every patient is ID'd using the barcode wristband scanner which prints the test labels, I don't think it is being used to it optimum and I can't count on it.  

 

I am trying to choose a new BB banding system for our 4 hospitals. Two have used a band that is left on for the entire visit with new specimens getting the same number and the other 2 have used the old Typenex bands that are one specimen per one band number.  Still trying to decide which approach is best.  Both have advantages and disadvantages.  I would like to trust the hospital band system enough to give up the separate band but not yet.