Labels on Coolers

[beths]

I was just wondering what information should be included on the outside of transport coolers? The last QC of that cooler, patient information, unit number? I can't seem to find anything in the AABB manual that specifies exactly what needs to stay attached to the cooler.

[Brenda K Hutson]

We put name of Hospital (we have some Outpatient Transfusion locations), Cooler # (track with a log kept in dept.) and a Biohazard Label. At one place I worked at that had 25 OR Rooms, we numbered coolers for each room (i.e. OR1, OR2).

For our Outpatient transfusions, we also tape a document to the top that has the patient's name (1 of these locations could have several different patients being transfused on any given day; just to add what little extra protection it might have).

Brenda Hutson, CLS(ASCP)SBB

I was just wondering what information should be included on the outside of transport coolers? The last QC of that cooler, patient information, unit number? I can't seem to find anything in the AABB manual that specifies exactly what needs to stay attached to the cooler.

[scodina]

In addition to the above, we add instructions:

Only blood products may be stored in the cooler.

Do not put platelet products in the cooler.

Return the cooler to blood bank immediately when blood is transfused or no longer needed.

etc....

I think the only things you are required to put on the cooler are a unique identifier and a biohazard sticker.

[Brenda K Hutson]

There are platelet coolant packs (like the Donor Center uses to bring platelets to Hospitals). You would need to validate your coolers for that though.

Brenda

In addition to the above, we add instructions:

Only blood products may be stored in the cooler.

Do not put platelet products in the cooler.

Return the cooler to blood bank immediately when blood is transfused or no longer needed.

etc....

I think the only things you are required to put on the cooler are a unique identifier and a biohazard sticker.

[rravkin@aol.com]

We put name of Hospital (we have some Outpatient Transfusion locations), Cooler # (track with a log kept in dept.) and a Biohazard Label. At one place I worked at that had 25 OR Rooms, we numbered coolers for each room (i.e. OR1, OR2).

For our Outpatient transfusions, we also tape a document to the top that has the patient's name (1 of these locations could have several different patients being transfused on any given day; just to add what little extra protection it might have).

Brenda Hutson, CLS(ASCP)SBB

Brenda,

When one tapes a patient name to the outside of an "outpatient cooler" is there not a concern for HIPPA violation or patient discression?

[beths]

In addition to the above, we add instructions:

Only blood products may be stored in the cooler.

Do not put platelet products in the cooler.

Return the cooler to blood bank immediately when blood is transfused or no longer needed.

etc....

I think the only things you are required to put on the cooler are a unique identifier and a biohazard sticker.

When you say "unique identifier" what do you mean. Unique for the patient, or unique for the cooler? And, what size is the tag you put on the cooler. Is it a clear sleeve that is attached to the cooler? Thanks for any information everyone.

[adiescast]

[ATTACH]491[/ATTACH]

Thisis our label that we use for our massive transfusion protocol. The cooler itself is permanently marked with a cooler identification number and "Return to Blood Bank."

MBRP Cooler labels.xls

[Brenda K Hutson]

You know, I thought about that as I was typing my response. It is a practice that was in place when I started here 3 years ago. There is a specific courier that takes these coolers and they go straight to the Oncology Infusion Center. We Issue blood to couriers inside of the Hospital; who then carry the unit, with attached paperwork (and patient info) to the Nursing unit.

But to be perfectly honest, I do not know the answer to that. Where is the line drawn?

If anyone else has input about this, I am interested in hearing it. Sometimes I feel like there are some gray areas with regard to this (or at least they are gray to me)!

Thanks,

Brenda Hutson

Brenda,

When one tapes a patient name to the outside of an "outpatient cooler" is there not a concern for HIPPA violation or patient discression?

[clmergen]

We limited the name on the cooler to the last name only. That by itself should not be unique enough to be a HIPAA violation.

[adiescast]

Usually a name is not considered to be a HIPAA violation by itself. Doctor's offices are still permitted to call out patient names in waiting rooms.

[Dr. Pepper]

The name on the cooler issue was brought up to our hospital's HIPPA officer. She felt the issue was more of visibility to the public eye. Our coolers are transported from lab to OR via a back staircase rather than a main corridor or elevator. She was OK with that. Shades of gray for sure....

[bkrobinson]

We only put "Return to Blood Bank", a biohazard label, name of type of blood component to be inside the cooler and the annual validation label. We do not put any patient info on the coolers since that info is on the crossmatch tags on the units and we do send different patients to one site but the courier's pick up one patient's cooler at a time.

[Brenda K Hutson]

Right; but when coolers are taken places and "dropped off" by couriers, you could potentially end up with several coolers in a general outpatient location area (i.e. an outpatient Oncology Center we send coolers to). It is just 1 more alert that hopefully catches the eye of the transfusionist. Is it necessary? Who knows. What is necessary in any given Institution may vary based on SOPs; protocols; workflow; staff experience (both within the Lab and outside); etc. etc. Everyone has their own comfort level; and that can certainly vary from Institution to Institution (I know it has for me). But with this issue at my current Institution, it is not due to a lack of comfort, but rather was the protocol when I arrived and I have not felt the need to change it.

Brenda

We only put "Return to Blood Bank", a biohazard label, name of type of blood component to be inside the cooler and the annual validation label. We do not put any patient info on the coolers since that info is on the crossmatch tags on the units and we do send different patients to one site but the courier's pick up one patient's cooler at a time.

[EDibble]

Is that per AABB or CAP, or something else? The unique identifer and biohazard sticker I mean.

[tlorme]

WE issue coolers all the time to our cardiac and trauma OR's. The coolers contain only a sticker identifying them as belonging to the Blood Bank, and a biohazard sticker. The coolers are all numbered so we can keep track of which coolers went to which OR's at what time. Inside the cooler is a 'tracking sheet' that contains the patient info, location the cooler was issued to, and the unit numbers for the products inside the cooler. When the cooler reaches it's destination, the receiving RN must verify the tags on the units and document a visual inspection as well as date & time the unit(s) is taken from the cooler on the tracking sheet, which comes back to the BB with the cooler. This tracking sheet is a requirement of our state DOH.

[KBBB]

We will begin sending units to two other hospitals soon. Our plan is to tag the cooler with the patient last name only to comply with HIPPA. Also, blood for transfusion is not considered a Biohazard. I think I found that info in the Technical Manual somewhere.

[EDibble]

@KBBB - that was my take on it also. The units are not labelled as biohazard, why would the cooler be?

:juggle::juggle::juggle::juggle:

[JOANBALONE]

Maybe so someone doesn't borrow it on the weekend for a picnic.

[EDibble]

You know, I should have thought of that , but really, a better label would be "Human Blood Products Only" or some such thing. Something similar to a refrigerator being labeled "store no food or drink in this refrigerator"

[kirkaw]

I would like to re-visit this issue. We have been told that we cannot affix anything to the outside of the cooler that cannot be cleaned, so no tape or paper. I would like to know what, if any, information is required on the outside of a blood transport cooler and the citation of that requirement, whether it be AABB (which Standard), Joint Commission, CAP or FDA.

Thanks,

Amelia

[bmarotto]

Very interesting discussion.  Most coolers are used to transport blood to the Operating Room with some going to the ED or other critical care area during a massive tranfusion.  For the OR, the coolers are dropped off at an inner core desk then brought into the room when needed.  We have a slip that goes into a clear plastic sleeve attached to the cooler handle.  On it we have the patient name, medical record number, cooler number, OR room if going to the OR, and number and type of products in the cooler (red cells/plasma).  The OR staff, ED staff, or messengers transport the blood.  We have not been cited for a HIPAA violation for having the full patient name and med rec number. 

 

My thoughts on this: 

1.  If we ommitted the patient ID and only had an OR room we would be no better than when floors call and ask about the blood for the patient in "Room xx".  

2.  Many coolers are sent to the OR each day.  We do not want the OR to be opening coolers and pulling units to check patient ID in a common drop off area.  It is too easy to mix things up if they are trying to verify several coolers/units at the same time. 

3.  It is not uncommon for there to be two patients with the same last name in the OR, especially since we do living related donor liver and kidney tranplants. 

 

If we ever get cited, then of course we will change our practice.  For now, I am sticking with what I think is safer for the patient.  

Edited August 29, 2013 by bmarotto

[KKidd]

We have a tag that is attached to the cooler. When blood is placed in the cooler we insert a paper into tha tag with patient name/MR and return time. During transsport to the OR, the tag can be flipped over with the blank side showing. That way no one can see the patient information. Our coolers are numbered and also have the information for the max storage time and a biohazard sticker. For our ED cooler we also have information that the cooler is not to leave the facility: the blood bank will package blood in a box for transfer to another facility.