surgery blood bank refrigerator

[LIMPER55]

I would like to put a surgery blood bank refrigerator back in use.

Would you please give me some criteria for our SOP?

how is blood dispensed? who has keys?

I can handle the validation and alarms---I would like some bullet points for training people in the actual use.

Thanks!!

[David Saikin]

I assume you will dispense from the BB; blood to OR - stored in that ref - returned to BB if not used. Once the blood is out of your hands your control is non-existent. How will you verify that the blood was NOT taken from the ref, stored in the OR room and then returned to the ref? Define the process for return of unused units to the BB - you don't want it to return days later, esp if it is going to be needed post-op. Be prepared . . . an inspector may want to see it. . . only blood should be stored in it, though you can bet other "stuff" will find its way into it. Good Luck!

[John C. Staley]

I'm curious, why on earth do you want to do this??? :slap:

[LIMPER55]

I'm curious, why on earth do you want to do this??? :slap:

John--We are a trauma center ---and I am really tired of the coolers not being transport--but considered storage.

The other trauma center still has their refrigerator ---I remember the old days and the problems-but I have to think that was easier than telling the inspector that a cooler is really transport.

[BB001]

Have you looked at the secure remote blood storage refrigerator options offered by Mediware?

[John C. Staley]

About 4 years ago I saw an Italian blood storage system that was computerized. I don't remember the name, sorry, but was quite impressed with it. It was set up like a vending machine. The nurse provided either an entered or barcoded number which ID'd the patient and then the machine would open a door for the next unit available for the patient. I thought then it would be perfect for just the situation you are looking at. I see if I can find my notes somewhere and get you a name.

Saddly our administration could not see the light. They were blinded by the price, which, I thought was reasonable considering what you were getting. :shakefist:shakefist

[BB001]

John, the system you are referring to is the system Mediware is selling in the States as BloodSafe. You can get more information on the Mediware website.

[adiescast]

You could also install a magnetic lock on the refrigerator door that can only be opened by pressing a button in blood bank. It works well for us. They come get it in blood bank and take it to the refrigerator. They call us, identify themselves and the blood they are placing in the refrigerato, and we open the lock and document the time they placed it. When they want to use it, they call us, identify themselves and the patient, we push the button, and they read us the unit number(s) they are taking. They know their ability to have a refrigerator depends on following the system and that we do not do coolers if they lose their refrigerator privileges.

[LIMPER55]

I like this idea--

This sounds like our parking lot access that our security uses.

do you have a company that installs this?

[tbostock]

Just a heads up if you are accredited by the Joint Commission. Every JC inspector that I have ever dealt with has been adamantly opposed to blood refrigerators anywhere else but the Blood Bank. In many hospitals they had them removed during inspections.

[adiescast]

I like this idea--

This sounds like our parking lot access that our security uses.

do you have a company that installs this?

No, my plant ops guys found the locks and the release buttons. They installed them and it works great! The release buttons even have a light that indicates when the door is open.

[adiescast]

Just a heads up if you are accredited by the Joint Commission. Every JC inspector that I have ever dealt with has been adamantly opposed to blood refrigerators anywhere else but the Blood Bank. In many hospitals they had them removed during inspections.

FDA doesn't like refrigerators outside the blood bank either. They say you are not in control of the blood. When they saw our system, the FDA inspectors were impressed and felt that we did retain control. JC has never commented on our system in the several inspections we have had since its installation.

[LIMPER55]

I am forwarding this information to our Biomed dept. Thanks so much!

[tricore]

The system Mediware is promoting interfaces with HCLL. One of our hospitals purchased it from: http://www.neoterictech.com/BloodTrack.html

[BBK710]

Just a heads up if you are accredited by the Joint Commission. Every JC inspector that I have ever dealt with has been adamantly opposed to blood refrigerators anywhere else but the Blood Bank. In many hospitals they had them removed during inspections.

Our AABB assessor also "recommended" that we stop using blood refrigerators outside of the Blood Bank several years ago.

[awinkelmann]

Since Mediware was brought up, I will confirm that we do offer secured, remote storage, refrigerators that can be integrated with the HCLL transfusion system or operated on a stand-alone basis. The security of the blood enables these units to be utilized outside the blood bank; a number of options are available which I’d be happy to discuss more offline. These range from a large ‘vending machine’, to a nine drawer, to mini fridges – all of which are computer controlled. We can even add an electronic lock to an existing refrigerator so that access is limited to only those people with the proper credentials (ID badge and PIN entry if needed).

As others have mentioned, more information is available at our website: http://www.mediware.com/index.php/Remote-Storage/. I also have a couple of white papers on other customers I can share with you, including one on OHSU who recently reported that the system helped reduce their CT ratio from 3.1 to 1.2. If you are interested, feel free to reach me at aaron.winkelmann@mediware.com.

[Barbarakym]

Where I have worked in the past we used Safe T Vue's on any unit being dispensed to Surgery (for their refrigerator). We followed up on any blood not returned to the blood bank by end of day. If some blood came back after that day of surgery there were incident forms filed. However we could tell by the Safe T Vue if the blood was safe for re-issue. They turn red and do not revert to former temperature.

Where I am located now, they want coolers (presently have nothing). I have validated the coolers but was worried about this very issue and thus we are combing the cooler (with log tag to take temps) with safe t vues which must be acceptable for re-issue. Coolers can only be out of the BB for a specific period of time (now 4 hours, we may increase it to 6).

Kym

[DPruden]

I think Haemonetics makes a secure blood fridge too, but I can't remember what it is called.

[mminhas44]

Though it sounds primitive, but what we used to do at my previous institute was that a BB staff was assigned for daily visit to OT; along with temperature checks, he used to check for blood products. The bag number,patient ID and issue proforma copy of any unit without a patient in the OT was investigated and appropritaely discarded along with taking an explanation from the OT staff.

[BobG]

I have seen mention of smart refrigerators from Mediware, Haemonetics, Neoteric and Angelantoni (an Italian company). These are all essentially the same product.

The refrigerator (called "HemoSafe") was built an Italian company (Angelantoni) and the software that manages access (called BloodTrack) was developed by Neoteric. Neoteric was then acquired by Haemonetics. Mediware distributes this product rebranded as BloodSafe with integration to HCLL. The system is available in several sizes and can manage crossmatched and emergency release blood. The Haemonetics version is available with integration to other Blood Bank information systems.

It was featured on the news in Seattle not long ago. Here is a link to the news video:

http://www.king5.com/news/local/Overlake-Hospital-adopts-blood-vending-machine.html

[carolyn swickard]

You might also try the Minnesota Thermal Golden Hour OR coolers - they will maintain the 2-6C temp range very well for at least 8 hours and qualify easily as "storage".

[L106]

You might also try the Minnesota Thermal Golden Hour OR coolers - they will maintain the 2-6C temp range very well for at least 8 hours and qualify easily as "storage".

These are what we use when we deliver blood to our Out Pt area (which is in a different building a couple blocks away.) They are expense, but they work very well. However, the ones that we use can hold only 2 (maybe 3??) units of Packed Red Cells.

[carolyn swickard]

These are what we use when we deliver blood to our Out Pt area (which is in a different building a couple blocks away.) They are expense, but they work very well. However, the ones that we use can hold only 2 (maybe 3??) units of Packed Red Cells.

They also have a larger one - Credo Cube - OR container - everyone will complain about the weight, but I did just validate one with 8 units in it and it might hold up to 12 units. It will last a good 8 hours - a little less than the Golden hour units.

[L106]

Thanks for the info!!

[TIrwin]

We have the HemoSafe in our OR area as well as three BloodSafe controlled small refrigerators with kiosks and magentic locks distributed throughout our facility for massive transfusions. We are very happy with their performance.

A word about the "coolers as storage" idea: When we had our AABB assessment in 2009, the assessors threw that at us as well. I knew it sounded wrong, (not to mention the fact that our assessment was prior to the effective date of that standard) but at the audioconference for the changes, which unfortunately didn't take place until a few weeks later, Debbie Kessler made it very clear that blood sent to the OR in coolers is "transport", not "storage", as long as the time period doesn't exceed what the cooler is validated for. She said "the cooler is transporting blood out to the OR and back to the transfusion service with a pause in the OR". I made very detailed notes about this so that we could respond to the variance.

That said, I would still recommend the HemoSafe if your budget allows. You are able to maintain tighter control over your inventory and keep detailed logs about their disposition.