Storing units in surgery refrigerator

[LIMPER55]

10 years ago we removed our surgery refrigerator--per Jacho regulations.

Now

The powers that be at our small hospital want to put the refrigerator back in use.

How many regulations can you help me with?

I need to present a fact filled argument against this.

please help

[SMW]

Why do they want to put it back into use? Your response will need to address their concerns about why they feel they need it put back into use.

[PammyDQ]

What regulation did JCAHO cite to not allow refrigerator in OR? I've worked at several hospitals with Blood Bank refrigerators and they were all compliant. Were they not monitored?

[Mabel Adams]

JC came out with a statement some years back that disapproved of remote blood refrigerators. I think it was part of the first patient safety goals or something on blood transfusion sentinal events. I have a copy somewhere. I'd suggest you put in a Hemosafe or the like to completely capture the process both safely and with proper documentation. If you put in a blood fridge they should have to sign the blood into it and out of it and document it all for full traceability. There are no regs against it, just the need for documenting every person that did anything with the unit and what time they did it. Many places with blood fridges don't do this part well. They have to be just as dedicated to proper patient ID when getting units out of the fridge as we are when they come to BB for them. They also have to bring units back to BB when the case is over. Maybe you can make the process onerous enough they will see the wisdom of not having a blood fridge.

[David Saikin]

My experience with BB ref in the OR is mixed . . . I have seen docs just taking any unit in there and just giving it (lucky on many occasions). Someone has to maintain them - temp checks/alarms/charts - - - bet it will be the lab. They have those BB vending machines - would work great but you need a BBIS. I like Mabel's ideas. Also think of the logistics - how will the blood get there and back again . . . will it somehow follow the pt . . .

[pbaker]

I know of one hospital in the St. Louis area (not mine) that has portable refrigerators controlled by the blood bank. they are loaded by BBK and "driven" down to the OR. there is only 1 patient per fridge.

Not sure of all the details, but it sounds like a better system than just 1 OR refrigerator.

[John C. Staley]

I know of one hospital in the St. Louis area (not mine) that has portable refrigerators controlled by the blood bank. they are loaded by BBK and "driven" down to the OR. there is only 1 patient per fridge.

Not sure of all the details, but it sounds like a better system than just 1 OR refrigerator.

Sounds like some very expensive coolers. Some of the logistics might be interesting such as: do they have battery power while in transit or do you just hurry real fast to get them plugged back in? do they have all the bells and whistles such as alarms and temp recorders or are they really little more than expensive coolers? Sounds like they could be a good idea but as the old saying goes, "The Devil is in the details".

:raincloud

[SMILLER]

I guess the on-going problems with the-powers-that-be that we have is that TPTB tend to agree to demands made by OR docs or whomever before they listen to the rest of us that have to take care of the patients.

Can you pull up all of the data that led to the OR fridge removal from 10 years ago and summarize it for them?

Also you will have to offer them something else to help placate whatever OR and administration people have been spending time on trying to get the OR fridge back. Why do they think they need a fridge? Do they not like the TAT in getting coolers into and out of BB? Do they need to get their orders into BB sooner? Try to think of something you can change that will show them that you are willing to enhance the current process.