How do you issue?

[StephanieM]

How do you all issue blood to the nurses?

Do you call every time you complete a crossmatch or do your nurses take the responsiblity to look in the computer to see if the units are ready?

Do you have pneumatic tube stations? Is that the primary method of transporting units?

Do you make the nurses or an approved courier come to blood bank to pick up units?

How do you track the blood administrations? Faxed paper with patient ID, form with the courier for window pick ups? Blood administration orders in the computer?

I'm trying to see if what we do could be improved or not.

Thank you all in advance for your replies

[David Saikin]

We only call emergent crossmatches; Nursing responsibility to see when others are complete.

Professional staff member p/u, though in emergencies we will release to any staff member presenting proper pt id info.

We track 100% of administration - not onerous 'cuz we're small and it is on line

[PAWHITTECAR]

We also only call emergent crossmatches. We have a pheumatic tube system but do not release blood through it. We require a RN of MD to pick up blood products but like David would release them to anyone with proper ID in an emergency. We require either a copy of the written order saying to transfuse or the computer order "nurse to transfuse" Curently no tracking but I am in the process of puting a tracking system in place to monitor all transfusions as we are a small facility also.

[Eagle Eye]

see my answer in bold letters.

How do you all issue blood to the nurses?

Do you call every time you complete a crossmatch or do your nurses take the responsiblity to look in the computer to see if the units are ready?

Only call when there is a delay in preparing blood according to policy. eg. for STAT, if antibody screen positive we notify as soon as screen comes out that the blood will not be available in 60 mins.

Do you have pneumatic tube stations? Is that the primary method of transporting units?

No.

Do you make the nurses or an approved courier come to blood bank to pick up units?

nurses, LPN, nursing assistant, resident etc. (defined in nursing policy)

How do you track the blood administrations? Faxed paper with patient ID, form with the courier for window pick ups? Blood administration orders in the computer?

receive transfusion tag back from the floor.

I'm trying to see if what we do could be improved or not.

Thank you all in advance for your replies

[SMILLER]

How do you all issue blood to the nurses?

Do you call every time you complete a crossmatch or do your nurses take the responsiblity to look in the computer to see if the units are ready?

     

      We have to call, our BB system is not interfaced with the hospital system.

Do you have pneumatic tube stations? Is that the primary method of transporting units?

We have a tube system but have never validated it for transporting blood.

Do you make the nurses or an approved courier come to blood bank to pick up units?

Approved, including nurses, transporters, etc.

How do you track the blood administrations? Faxed paper with patient ID, form with the courier for window pick ups? Blood administration orders in the computer?

 

      Products picked up at BB window with paper requisition checked against unit tag     and computer at time of issue. Run reports off of the BB system to get utilization data.

I'm trying to see if what we do could be improved or not.

Thank you all in advance for your replies

Scott

Edited June 8, 2015 by SMILLER

[CM2]

Do you call every time you complete a crossmatch or do your nurses take the responsiblity to look in the computer to see if the units are ready?

Do you have pneumatic tube stations? Is that the primary method of transporting units?

Do you make the nurses or an approved courier come to blood bank to pick up units?

How do you track the blood administrations? Faxed paper with patient ID, form with the courier for window pick ups? Blood administration orders in the computer?

Orders are placed and resulted in the computer, slips print at nursing station when we result ready. We will call OR's if we get TS while they are in the room, esp if we've issued emergency release already. Very few other calls.

No pneumatic tube. We didnt want to validate its a safe way to transport blood for one. And its hard enough to be sure the units are hung in a timely fashion when they are picked up by hand. Our old super was afraid we'd have a real problem with things ending up sitting in the delivery station. Its also hard enough to unjam/clean the system when a urine cup comes open, 250ml blood would be a nightmare.

Nurse, CCT or unit clerk are all ok. Must be employee (no volunteers) with badge and we request they have been given at least an inservice on what they are looking at. In the old days we did have one unit that would send the housekeeping staff on short staffed days...

Computer ordered units should be finalized as complete by the nurse on their end, which takes care of the majority of billing. Softbank has usage reporting for our end. Paperwork wise, we retain the printed orders we use to issue from as well as the pickup slips and the returned completed transfusion hangtags. And of course copies of any emergency release/downtime/OR manual orders.

-c

Edited December 13, 2012 by CM2
text wall

[Justina]

A trained staff member (RN, multi-tech, etc...) can pick up blood products if they come to our BB window with a blood authorization form. Basically this form tells us the patient info and location,that there is consent, and which product they are picking up. After we dispense the unit in LIS, we review all crossmatch info with the courier and they then sign for it.

It is not our policy to call, the RNs have access to product availability in LIS (but we do call sometimes or they call us).

We do have a tube system in the lab but we do not use it for blood product transportation (only used for sample transport).

We track administrations daily (matching authorization forms to transfusion records, all are reviewed for compliance).

[Mabel Adams]

We call if order is "to give" to say blood is ready although I would like for nurses to learn to tell blood is ready from the HIS. Maybe with the new EMR.

We have a pneum tube but don't use for blood--it would need to be reconfigured and often gets overloaded so things are too slow. I have used them elsewhere and maybe we will here sometime.

Trained volunteers plus employees can pick up blood.

We run a program in the BBIS that converts any unit that was issued over 24 hrs ago (plus some other rules) to "transfused". Nursing will soon be starting a process to audit transfusion record completion (paper) because they do not always do it perfectly and inspectors don't like this.

[DeeMc]

Nursing is responsible for monitoring the EMR to know when products are ready. We do make a phone call if we know it is an urgent transfusion. The RN calls when ready to begin transfusion, an issue process is completed over the phone and the product is sent via pneumatic tube using a secure send feature requiring the "transporter" to be at the tube station when the product arrives. In pneumatic tube system downtime, trained clinical personnel (Nurses, PCAs) come to the Blood Bank to pick up products. We require all units not transfused to be returned to us. Those that are not returned are automatically updated to transfused in our computer system.

[Dr. Pepper]

How do you all issue blood to the nurses?

Do you call every time you complete a crossmatch or do your nurses take the responsiblity to look in the computer to see if the units are ready?

We have an order category "Call When Ready" and that's what we. We log date, time and who we talked to. Volume is one the small side and it's not too much of a pain.

Do you have pneumatic tube stations? Is that the primary method of transporting units?

We use the tube. The AABB publishes a nice little validation guide. Our tube system has a maximum ride time of 90 seconds and stays indoors, minimizing 2 potential problem areas. We double bag the units but have never had one break (I would think the tube beats them up far less than centrifugation and squeezing in a plasma extractor during processing). We call the floor after we send it to avoid the unit sitting in their tube station. When the floor wants a unit, they send a slip with a patient label, component desired and where to send it. We send it along with a form that the person getting it on the other end fills out and returns. The only issue we've really ever had is a tech entering the wrong destination code when launching the tube. Doesn't happen that often (check twice), maintenance keeps a dynamic log so we can usually figure out where one went. We maybe lose one (long enough for it to get too warm for return) every 2 years?

Do you make the nurses or an approved courier come to blood bank to pick up units?

How do you track the blood administrations? Faxed paper with patient ID, form with the courier for window pick ups? Blood administration orders in the computer?

A weakness for us - we assume it gets transfused. Will be moving to electronic documentation of the transfusion.

I'm trying to see if what we do could be improved or not.

Thank you all in advance for your replies

Good luck Stepanie

Edited December 14, 2012 by Dr. Pepper

[BBCLS]

How do you all issue blood to the nurses?

Do you call every time you complete a crossmatch or do your nurses take the responsiblity to look in the computer to see if the units are ready?

Do you have pneumatic tube stations? Is that the primary method of transporting units?

Do you make the nurses or an approved courier come to blood bank to pick up units?

How do you track the blood administrations? Faxed paper with patient ID, form with the courier for window pick ups? Blood administration orders in the computer?

I'm trying to see if what we do could be improved or not.

Thank you all in advance for your replies

We only call emergent crossmatch. We have pneumatic tubes, primary method. When we send blood in the tube a " Delivery Receipt Form" goes with it. Orders in computer.

[LCoronado]

Our nurses could look up blood availability, but usually choose not to ("they are too busy!"). As a courtesy, we call the floor when blood is ready, but the message often does not reach the appropriate parties and we repeatedly get more calls asking if there is blood available. Worse yet, they often just place another order instead of calling or looking. We then have to call them and cancel orders which are not needed. Very frustrating.

We do not issue blood in the pneumatic tube. Only trained personnel pick up the blood (Unit Secretaries, ED techs, nurses, CNA's, transporters) using a Blood Issue Request Form containing patient identifiers, special needs, the RN signature and the name of the ordering physician.

We "dispense" in the computer system, which changes the status of units to "transfused" once per day. A report is generated from the computer and all blood administration documentation is electronic. The Blood Bank can then review this doumentation on line. Currently it is pretty dismal, but since we are cited for this at every State inspection, we (the BB + Nurse Managers + Staff Educators) have to come up with a new plan of action at least every two years. This frustration tops that of the problems with ordering, so we have chosen to concentrate on this battle at present.

[tbostock]

How do you all issue blood to the nurses?

Do you call every time you complete a crossmatch or do your nurses take the responsiblity to look in the computer to see if the units are ready?

Do you have pneumatic tube stations? Is that the primary method of transporting units?

Do you make the nurses or an approved courier come to blood bank to pick up units?

How do you track the blood administrations? Faxed paper with patient ID, form with the courier for window pick ups? Blood administration orders in the computer?

I'm trying to see if what we do could be improved or not.

Thank you all in advance for your replies

Yes, as a courtesy, we call the floor to tell them the blood is ready and we document the name of who we told.

Yes, the pneumatic tube system is our primary method of issuing units. The nurse sends us a request form. We issue the units, 2 BB techs read everything back and forth and both sign the request, and it goes up with the unit. If we don't get the request back in 10 minutes, we start calling them to return it.

If blood is picked up in person, it can be any hospital employee (no volunteers, no students).

The blood admin orders are in the EMR, which print for us in the BB. But the blood admin is still on paper for us, as our EMR does not have an FDA approved system for that.

[LynK]

We call all XMs to the nurses. Unfortunately, our nurses are not trained to look in the computer for available products, although we are trying to change this practice to reduce interruptions in blood bank. We issue products to RNs, LPNs, MDs, unit secretaries, as long as they are an employee of the hospital. No volunteers are allowed to pick up products. I track all transfusions through the computer. We have a pneumatic tube system, but it's not for blood bank products.

[pbaker]

We only call if there is going to be a delay in receiving blood such as an antibody or a special need unit that must come from the blood center. We do electronic crossmatch on demand so we have trained (if they listened) the RNs to know that if the type and screen results are in the computer, the blood is ready. They place an order for "request for delivery" in our computer system when they are ready to hang the unit. Blood bank orders, crossmatches and issues the unit at that time. There is a second check of labeling by the blood bank staff and the blood is transported by pneumatic tube. A phone call is made to let the floor know that blood is on the way. The blood is sent by badge secure so we can track who sent it and who removed it from the tube station. Nursing policy states that only an RN or LPN may remove it from the tube station. If it does not get released on the floor in 5 minutes, it will automatically return to the blood bank. Blood administration is tracked/audited by nursing.

[Dr. Pepper]

Blood administration is tracked/audited by nursing.

Boy, would I love that!

[tkakin]

How do you all issue blood to the nurses?

Do you call every time you complete a crossmatch or do your nurses take the responsiblity to look in the computer to see if the units are ready?

We are in the same boat as LCorondo's response to this

Do you have pneumatic tube stations? Yes Is that the primary method of transporting units? Yes

Do you make the nurses or an approved courier come to blood bank to pick up units? Approved courier, does not have to be a nurse. Definately have to have a "request slip" with patient ID.

How do you track the blood administrations? Faxed paper with patient ID, form with the courier for window pick ups? Blood administration orders in the computer?

Request slip, and the computer

I'm trying to see if what we do could be improved or not.

Thank you all in advance for your replies

For one facility we enter transfusion data in the computer, for the other facility it is automatically transfused after a period of time from issue.

[kate murphy]

We call most orders. We use electronic XM, so unless there is an antibody, no units show in the EMR that they are ready.

P-tube is the primary method of getting units to the floors. The nurse sends a "Blood Products Requested" slip with pt info and what product they'd like and the destination tube station. The BB has red canisters that are used only for blood transport. Nursing must send back the Request slip to verify receipt. We call to track them if the slip isn't returned in 15 minutes. The same Request slip is also used for manual pickups, as we will not tube rare units. Nursing, residents, transport personnel are approved to pick up units. We used the AABB booklet to validate the p-tube.

EMR has separate "nurse to transfuse" orders. The BB audits some every week. Nursing responsibility for ensuring that consent is obtained.

We assume every product that is issued is transfused. Again, audits of a small percentage every week show (mostly) proper documentation.

Good luck!!

[Kim D]

We are currently having nursing staff come pick up blood products. They now want 1 nurse off the unit/floor  picking up products on 2 differnent patients at the same time.  What are thoughts on allowing this practice?

[marvy1]

RN responsibility to look in computer to see if blood product is available

If avail they enter "order" to release product which creates printout (in duplicate) in Transfusion Dept

We issue products based on this printout and send 1 cc of product release paperwork with product. We make a phone call to # appearing of paperwork letting RN staff know product was sent

RN staff is responsible to return this product release paperwork to Transfusion which lets us know product was picked up at tube station. IVIG and neonate syringes not sent by tube

[SMILLER]

How do you all issue blood to the nurses?

Do you call every time you complete a crossmatch or do your nurses take the responsiblity to look in the computer to see if the units are ready?

Do you have pneumatic tube stations? Is that the primary method of transporting units?

Do you make the nurses or an approved courier come to blood bank to pick up units?

How do you track the blood administrations? Faxed paper with patient ID, form with the courier for window pick ups? Blood administration orders in the computer?

I'm trying to see if what we do could be improved or not.

Thank you all in advance for your replies

 

Since BB reports do not interface back to the hospital system, we have to call when bllod is ready for pick-up.

 

We have a tube system, but do not use it for transporting blood products.  The products are picked up by a aide , unit secretary or nurse.  At the time of issue from the BB, we do a face-to-face read back between an order slip and the tagged unit.

 

Scott

[mollyredone]

We are currently having nursing staff come pick up blood products. They now want 1 nurse off the unit/floor  picking up products on 2 differnent patients at the same time.  What are thoughts on allowing this practice?

We don't allow that. They can pick up multiple units (in box with ice and Safe-T-Vues) or one PRBC and FFP, etc, but they have to be on the same patient.

 

When blood is ready at our hospital, we send "unit ready" slips through the tube system.  The nurses verify that they have checked the patient's blood band and initial it, then send it back through the tube system.  We send our blood (one unit at a time) in secure mode, which means it will not stop alarming or drop into the bottom until the proper code is entered.  Family birth, ER and OR still have to send someone to get their units, but we do tube the unit ready slips to them.

[tbostock]

We are currently having nursing staff come pick up blood products. They now want 1 nurse off the unit/floor  picking up products on 2 differnent patients at the same time.  What are thoughts on allowing this practice?

We don't allow this...ever. If the need was that urgent, I would hand deliver one myself to make sure there was no mixup.

[Auntie-D]

We are currently having nursing staff come pick up blood products. They now want 1 nurse off the unit/floor  picking up products on 2 differnent patients at the same time.  What are thoughts on allowing this practice?

 

We don't allow this - one patient, one blood product. After all - we don't open all out samples and batch label them for ease of time...

 

Dealing with more than one patient at a time is the best way for a mistake to happen.