Product Wastage in/from the OR

[Ellen Zeigler]

We're a large university center. The OR has 3 refrigerators that are monitored on the blood bank system. There is also a large cooler on wheels for liver transplants that has been validated. The blood bank and the OR are 3 floors apart. Overall our blood wastage is low for the size and complexity of the facility, however, it appears to be creeping up. A large number of the products wasted are a result of apheresis platelets or cryo being thrown into bags with red cells to return to the blood bank. We end up with cold cryo and platelets and warm RBCs. For room temp products (not expecting the product labeling to be sufficient) we put a green fluorescent 2" X 3/4" on each product that says DO NOT REFRIGERATE .

Any suggestions? Thanks

[Moncada]

We also put stickers on our CRYO and platelets (same exact color....flourescent green!). We still get an occasional unit back in a cooler. For all blood products wasted (especially avoidable wastage!), I send an e-mail to the nurse manager and their Director about the details. Sometimes I will include the actual cost to our facility. This was instituted some years ago by the Blood Utilization Committee. At first it was just sent to the Nurse Managers, but the Service Line Directors were added as well. For wastage in the OR, the head of the anesthesia department gets a notification because they are the responsible parties in the OR.

This has actually seemed to improve our wastage numbers. It is also a great forum for educating the nursing staff about the importance of following protocols and not requesting blood until all their ducks are in a row (informed consent, IV, premeds, pre-transfusion vitals, etc).

While I don't always get a response, sometimes I do get "the rest of the story" which helps the blood bank to understand about why some wastage is unavoidable. It has actually been a positive communication tool with good outcomes. It has even helped to disperse the "30 minute" myth that still seems to live on outside the walls of the transfusion service!

Good Luck!

[Brenda K Hutson]

Document all occurrences on your Facilitie's Deviation/Occurrence Report Form (whatever you call them); then Track and Trend the occurrences. If problems continue even after notifying the responsible parties, take it up a notch to your Facilitie's Compliance Officer (QA Director, Risk Management, etc.; again, whatever they are called at your Facility).

I have also found it helpful when presenting the data, to include the $$ impact. That is kind of a universal language; especially with today's economy and Health Care Costs and Restrictions.

Good Luck!

Brenda Hutson, CLS(ASCP)SBB

We're a large university center. The OR has 3 refrigerators that are monitored on the blood bank system. There is also a large cooler on wheels for liver transplants that has been validated. The blood bank and the OR are 3 floors apart. Overall our blood wastage is low for the size and complexity of the facility, however, it appears to be creeping up. A large number of the products wasted are a result of apheresis platelets or cryo being thrown into bags with red cells to return to the blood bank. We end up with cold cryo and platelets and warm RBCs. For room temp products (not expecting the product labeling to be sufficient) we put a green fluorescent 2" X 3/4" on each product that says DO NOT REFRIGERATE .

Any suggestions? Thanks

[goodchild]

Coincedentally I just had a conversation with the nurse manager from L&D about a wasted platelet from the L&D OR the night before. Putting the dollar amount in the follow up e-mail as well as the impact on our limited apheresis platelet inventory (we get one per day, with 2-3 days of shelf life) was requested by the nurse manager to highlight the issue for the OR staff.