Blood Distribution Staff Qualifications

[schorj]

I am the manager of a blood bank in a large city hospital which has a level one trauma center,a children's hospital, and performs open heart transplants and adult and pediatric bone marrow transplants.

Our blood bank is moving across the street, with the rest of the lab, from the main hospital. We are planning on keeping a blood distribution site in the current hospital close to the OR and ED. Blood will either be tubed or walked in coolers from the blood bank to the distribution site. Nurses or other hospital staff will pick up the blood from this distribution site.

The question is, "What should be the qualifications of the staff person who will be at the distribution site?" Should that person be a blood bank med tech who is familiar with all the aspects and special needs of our patients who need any different types of blood components or a "non-med tech" who can be trained in the actual process of distributing blood but has no formal training or experience?

[David Saikin]

Depends on your comfort level with non-technical staff in such a position . . . why not just get those blood vending machines that Mediware has . . .

[L106]

If I remember correctly, those blood vending machines are pretty pricey. (Although, a large institution like schorj has described sounds like the perfect place for the blood vending machines.)

Back to your question: Yes, it depends on your comfort leven with non-technical staff in such a position. However, other factors can be involved. Do you use a computer system in the distribution site? If so, does it have lots on bells and whistles and controls to avoid a serious distribution error (and has it been validated for these activities?) If these are in place, it is more likely that non-technical staff would be able to function in this area. Of course, anyone assigned to the area must be adequately trained, and their competency documented.

You commented that the distribution center was close to the ED and OR. Personally, I would want at least one technical person overseeing the center or at least available to handle the "heavy" situations such as issuing uncrossmatched blood, consulting with the docs about proper component therapy during massive transfusion situations, etc.

Donna

[Mabel Adams]

There is another blood vending machine--hemosafe I think. They are pricey but you don't have to keep paying salary year after year, no benefits to pay and they don't need vacation coverage. Seems like the return on investment in this setting might be pretty easy to calculate.

[Eoin]

We use Neoteric BloodTrack with Virtual Kiosk attached to remote issue fridge. Needs training and competency signoff for all staff on operating. The benefit is instant tracking of who is doing what. Expensive - but cut down a lot on non-conformances around issuing.

Cheers

Eoin

Edited March 23, 2011 by Eoin
Spelling

[adiescast]

I don't know if you have FDA walk in or not, schorj. We got cited on our last FDA inspection for not documenting cGMP training for our nursing staff who pick up blood from remote refrigerators. You may want to add that to your list of considerations.

[Bill]

Why can't you tube to directly OR, ED, and all nursing stations? That would save at least 4 FTE's not having a distribution station and/or eliminate a refrigerator or vending machine.

[rravkin@aol.com]

I think that in the abscence of an automated distributor a Blood Bank tech is your better choice given that you have a special needs population at your facility and the issue piont is the last chance for the Blood Bank to catch any errors prior to issue.

[Likewine99]

rravkin makes a good point, a technical person is probably a better choice in this situation. Based on the size of your facility and the complexity of your patient mix, I think someone with technical expertise would be the better choice.

You might want to talk to your Risk Management/Patient Safety department. They are usually pretty savvy re: rules, state and federal regs, appropriate documentation, etc. You don't want to put your facility and ultimately the patient at risk.

[Brenda K Hutson]

1. I echo Bill's question; could not a lot of this be sent via the pneumatic tube? For those locations that would want a cooler, here is what we did at 1 Hospital I worked at with 25 OR rooms. We labeled a cooler for each room (i.e. OR1 thru OR 25). The OR actually kept the coolers in their respective rooms. At that time, we used the cellsafe coolers with the freeze bottles. The OR also kept those in their refrigerators and freezers. Initially they would come down as they needed a cooler, but can you see the nightmare with that many OR rooms (not only for the Transfusion Service, but for transporters)? We would call the OR room as soon as we tubed it so someone would know to retrieve it (as the tube stations were not located in each OR room).

2. For those places that would just want the blood urgently to transfuse right away (i.e. ER), you could tube it.

3. That leaves uncrossmatched blood. I have to say, I am not familiar with "blood vending machines." Guess I missed that one. If you always give O NEG for uncrossmatched, I don't think you would have to have a licensed Tech at the distribution center. However, given the many possible scenarios of your Institution(transplants, etc that may have special requirements such as CMV- IRR; or Sickle Cell patients in crisis who need phenotyped blood; etc.), that would require some expertise. But you could still tube those uncrossmatched units with the special requirements. I guess that would leave type specific uncrossmatched blood. That should not be going in a cooler anyway (my opinon). It would be faster to tube the blood than to have someone walk to the distribution center; would it not?

4. In reality, a lot of Hospitals issue the blood to transporters who have only been trained to read back the information on the unit Form, back to the Technologist. They then carry it to the floor and hand it off to someone. Nursing should then be performing their checks. So not sure this would be much different.

But all of that being said, the move certainly seems to be in the direction of taking "more" precautions to protect the patients. That at a time when Hospitals are looking for ways to cut costs. Hmmm...not always so easy to reconcile those two, is it?

Brenda Hutson, CLS(ASCP)SBB