Blood inventory

[EMB4879]

I know this has been here before, but where exactly in the technical manual it states how to calculate your rbc inventory (16th edition). Our supplier is trying to cut down on how much we keep in inventory. No problem with that, we dont want to waste.

Overall we transfusion around 8000 units/yr and are a Level I trauma center. We dont want to skim down to low and are afraid this will happen. We are understaffed, and will be teaching students in july/aug on top of it. any help/references/ideas:confused:.

Oh yeah, did I mention we are a teaching hospital on top of it. I know more products are ordered "on hold" then needed, and our xm to transfusion ration is high (2:1).

[clmergen]

I don't think it's as simple as a formula, although my last supplier did have some sort of algorithm based on previous years needs. But it also depends on how close you are to your supplier. I was at a Level 1 trauma center and we kept a pretty low inventory because our supplier was across the street.

[BLipkin]

The 14th Edition of the AABB Technical Manual has a "Determining Inventory Levels" section starting on page 80. There is no comparable section in the more recent (16th Ed.) Technical Manual.

[KKidd]

What is your outdate rate? For me, that would be a better indication of your inventory management even more than the CT ratio.

:whisper::whisper::whisper::whisper:

[EMB4879]

Our outdate is low, only about 1-2 %. They want it down to zero which would be great. Our argument is if we do decrease stock, or rotate stock, now the units that are set up on a patient, will have to be recrossmatched (increasing tech time, cost, etc.) plus if these are antigen typed units, then we really have to start from scratch and who knows if we will find antigen negative units out of the few we have.

The supplier is not far, and we know we could have units in approximately 20 minutes if needed....it is just 20 minutes is unitl that box is in the door and not into inventory and patient ready. With just 1 tech working nights/weekends/holidays (and we all know this is when the worst patients come in), we are VERY resistent. :mad:

[pbaker]

We transfuse about 5000 RBC/year. Our blood supplier did a usage audit for the last 3 years and determined what we used by type. From that they calculated the best mix for out shelves. We have cut our inventory in half. We rotate our shorter dated stock once per week. If the unit is set up on a patient we do not take it down. If the unit is a special need unit, we do not send it back until later or request a replacement prior to sending it back.

Although the staff was VERY resistant at first, they have come to see how helpful this really is and that it really does work.

P.S. We are not a trauma center.

[rravkin@aol.com]

EMB4879,

Is the 1% to 2% wastage strickly Packed Cells?

[tcoyle]

Are you using an electronic XM protocol? If you are or can, you can remove those units for the just in case...we don't allow holds anymore since we are using EXM and we tell the docs they can have blood in five minutes when requested. (This is for EXM eligible recipients only, of course)

[EMB4879]

Yes the 1-2% is just red cells, including autos.

[EMB4879]

EXM...we want to get this going but are having issues with our new lab director even though our medical directoris ok with it. In addition, we are waiting for LIS upgrades which keep pushing back the dates...then is pushing back our dates sicne we done want to validate, then revalidate with the upgrades.

[SMILLER]

I would agree that your outdate rate is the best way to monitor whether your inventory is appropriate. I am not sure any formula is going to be as useful as what you yourself see happening in your blood bank.

We only have about 100-130 units of pRBC at a time here, but we are a smaller Trauma II hospital. If we have outdated units, they are ususally short-dated units on consignment so that when they expire, we return them to our supplier for credit.

We are fortunate to have a blood supplier within about 15 minutes from our hospital so that we do not have to keep more than one 5-pack of platelets on hand.

[GilTphoto]

1-2% is too high. At 8000 units/year, that's 80-160 units/year.

Your inventory levels must be too high.

We transfuse about 2700 RBC's/year and we are not a trauma center

Our inventory levels are:

15-20 O pos

15-20 A pos

2-4 B pos

4-6 A neg

4-6 O neg

We never stock B neg, AB pos, or AB neg

Our outdate rate is 0-2 units/year

and we almost never return any blood

what we order, we use!

[KKidd]

1-2% is too high. At 8000 units/year, that's 80-160 units/year.

Your inventory levels must be too high.

We transfuse about 2700 RBC's/year and we are not a trauma center

Our inventory levels are:

15-20 O pos

15-20 A pos

2-4 B pos

4-6 A neg

4-6 O neg

We never stock B neg, AB pos, or AB neg

Our outdate rate is 0-2 units/year

and we almost never return any blood

what we order, we use!

Our stock is slightly more and the only thing that we tend to outdate is AB pos. At one time we stopped stocking them, but our supplier talked us into stocking 2 and they would give us credit for the expired units. We seldom outdate any other type and don't return any units. Our outdate rate is 0.1% (approx.)

:boogie::boogie::boogie:(It's Friday!!!!!!!!!!!!!!)

[macarton]

Our supplier is wanting to increase our supply to cover the NW corner of Alabama in an emergency. Right now we keep 100 O pos, 30 O neg, 80 Apos, 24 Anegs and B pos, 8 AB pos, neg and B neg. We are a 400 bed facility and the blood for our other hospital comes to us and we supply and rotate them out as needed. All retypes are done by us when units logged in. Right before the tornadoes hit south of us, there were some TVA transmission towers knocked down in the early morning that cut off electricity to Huntsville and Decatur areas. Lifesouth called and sent us a large shipment. When the tornadoes hit that afternoon, we were glad to have the extra as we still had to place an order the next day.

[adiescast]

We also have a 1-2% rbc wastage rate (this is all forms of wastage, but outdate is probably most of it). We are the end users in our system, however, and usually receive shorter dated blood because the blood center knows we will use most of it. We are a level one trauma center, >800 beds, open heart surgeries, NICU, massive transfusion protocol, etc. We have a blood conservation program started that we hope will reduce our usage.

[Malcolm Needs ☆]

We have a blood conservation program started that we hope will reduce our usage.

I don't know if it would help, but there is a lovely book entitled, "A Manual for Blood Conservation" (or, as I once wrote it, "A Manual for Blood Conversation"), edited by Dafydd Thomas, John Thompson and Biddy Ridler, 1st edition, 2005, tfm publishing, which retailed at about $48 US (£25, $67 CAN, 42 euros), which I found really useful.

:idea::idea: