Suggestions for Typenex armband process??

[nicki0281]

We currently use the Typenex pre-printed barcoded armbands. You place a patient label with all pertinent information on the armband and then attach to the patient. You draw a sample and then place a sticker from the armband onto the tube that also has a patient label with all pertinent information.

Does anyone have any suggestions as to how I can ensure that the correct patient label is being put on the armband and the tube? The best I can come up with is having a second staff member identify the patient and initial the tube/armband as verification. Any other great ideas??

[L106]

I understand what you have explained and what you are asking. (We use a Typenex-type band, too.)

A critical point to stress to your staff is that the patient's name and ID # that they write on the Typenex label must be copied from the patient's regular hospital wristband. (ie: Do not copy the patient name and ID # from some computer label, etc.)

You could have a second staff member identify the patient and inital the armband (as you described above), if you choose to do that. However, the point has been made in several other posts that having a second person "check" something often doesn't cut down on errors. (Sometimes it is actually more laxed because each individual is counting on the other individual to catch any errors.) Also, sometimes making a process longer or more complicated doesn't necessarily make the process "safer'.

Donna

[clmergen]

Training and competency assessments are your best bet. Really make sure your phlebotomists know why we are so strict. I am switching to a band that uses the patient label in order to cut down on the handwriting errors and I intend to strongly train in positive patient identification. Other than that, make sure you hire good phlebotomists and fire those that aren't capable of positive patient identification 100% of the time.

[carolyn swickard]

As I understand it, Typenex has two different bands now with barcodes - one is handlabeled and one uses the pt ID labels generated by computers (usually Admissions). Both have their problems - spelling and number errors on the handlabeled one and wrong pts on the printed labeled ones and no way to detect it. I prefer to use the handlabeled one, despite the redraws and we always require the presentation of the Blood bank ID wristband number before we will release RBC units. If they can't find the BB ID wristband on the pt's wrist - they can't give us the number and we can't give them blood. Nursing has even found ways around that - putting the wristband number on the chart and making copies, but hopefully errors caused by that practice will be caught by the 2 nurse reidentification of the pt at the bedside (not the nursing station!!), especially with Joint now looking for pt participation in the identification process (where possible). I don't know how the make this process error proof, but I prefer at least making them write the name and numbers instead of slapping a label on - especially if those labels may not be present at the bedside when the specimen is drawn - the problem I fear the most.

[DANDERS]

Can anyone tell me how you're utilizing the barcode itself. How are you reading them in the blood bank and then at the patient's bedside?

[clmergen]

We will be barcoding the wristband number into the LIS at prompts. Another way to cut down on human error. If we ever get to a better EMR, hopefully the RNs will have to barcode the wristband number also.

I do intend to get some of the handwritten ones to use for our outpatient draws that won't have readily available patient labels. But for my inpatients, I want less writing. I want the nurses to be able to read what is on the patient's wrist and not hav eto "guess" what the name or number might be.

[carolyn swickard]

We can read the barcode into the LIS computer system at the place for band numbers (Meditech) and will eventually move to the Meditech bedside barcode verification for transfusion, but I have not seen that system and don't really know how it works. It has been discussed on this site in prior threads.