A no armband system for transfusions?

[jerriemc]

Be careful with this practice. We used to do this but discontinued it when a blood bank armband was found on the chart of a patient who was Jehevoh's witness. The nurse looked closer and discovered it was for another patient. After that we started making the outpatients wear their armbands home. We try to stress to them that is for their own safety. We also let them see the actual armband numbers on their blood specimens. Most of them appreciate the safety measures once they are explained to them

[Gnapplec]

I agree again with jerriemc above, just explain the importance of these safety measures and most people are gladly going to wear their wristband. Don't just tell someone they have to wear one "because I say so...". Giving a little background information goes a long way.

[mrmic]

How did patients survive prior to Typenex??? It would be interesting to hear about real transfusion errors due to the lack of or because of additional armbands. Both numbers small no doubt. The cases I have observed really didn't matter whether there were more ID armbands or not. ie. the nurse gave the blood to the patient because they were expecting the blood to be for the patient (wrong patient); next ie, the room was darker than normal and the patient's looked alike, I didn't know they switched beds; Even the classic about what does the SOP say?, at the sentinel meeting the nurse said that's SOP not practice.....AAAAAHHHHHH!

Accountabilty of who IDs and bands the patient and then who identifies the patient at the time of transfusion is needed. The "its nobody's fault, it is a process error" is overated.

I agree with KISS....

[tricore]

Mabel, I totally agree and yet I may be over-ruled by those above me. Cerner says they have NEVER had a patient ID mixup EVER and my bosses appear to agree with them. It is hard for me to believe there is a system that can not be bypassed by some overworked employee trying to meet impossible turn a round times. I guess time will tell how it works here. Does anyone who have CERNER with Scanned ID for labels (print at bedside) had a problem of any type?

I assume by "Cerner" you mean your admitting department or HIS. I don't believe ".they have NEVER had a patient ID mixup EVER". The computer system won't mix them up but people sure do. I have seen many patients admitted with other people's medical record numbers in several different systems, including Cerner.

[tbostock]

Yes, you can get "tricked" into thinking a bar code scanning bedside administration is foolproof. Until humans come along. And unfortunately, compromise the safety of the system by trying to speed up the process. Here's my favorite: nurses that photocopy the patient's barcoded wristband to keep at the desk so they can do all of their scanning there and don't have to waste time at the bedside.

So until staff really understands the purpose of transfusion safety, and are held accountable by management to follow all safety rules, we will forever struggle with this. Sorry, sounding a little pessimistic today.

[Sandy L]

I assume by "Cerner" you mean your admitting department or HIS. I don't believe ".they have NEVER had a patient ID mixup EVER". The computer system won't mix them up but people sure do. I have seen many patients admitted with other people's medical record numbers in several different systems, including Cerner.

I think "Cerner" is referring to Cerner's Bridge application for scanning the patient armband and generating specimen labels at the bedside.

[dgibaud]

We use Cerner to generate the armband, and we use Sunquest collection manager to scan the armband and print requisition labels at bedside. Our major problems are not hospital armband vs blood bank band, they are lab draw vs nurse draw. The lab does a pretty terrific job of patient identity through numerous hours of training. The nurses.....not so much.

[Mabel Adams]

A system only works if everyone believes in its value, is adequately trained and uses it properly. That's a big "if." That's more important than having a BB armband or not.