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Greetings,

Does anyone send blood to inpatient units via a pneumatic tube system. If so, do you have a document that accompanies the unit that nursing fills out, verifying that the unit was inpsected upon receipt and found to be OK?

What regulatory agencies would govern such a practice? I cannot find a suitable reference in the AABB standards. Would this fall under all standards/CFR references for blood transport?

Thanks!

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The only documentation we required when the nurse took the blood out of the tube system was what time that happened.  Our expectation was the blood would be removed from the tube within 15 minutes of when we sent it.  Audits found that most of the blood was at the patient's side and the transfusion started within 15 minutes of the time we had sent it.  Thorough validation determined that the transport was safe and efficient for the blood products. Besides, I doubt the nurse would know if anything was wrong with the blood short of it leaking all over her foot.  :coffeecup:

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I'm also curious if there are any standards or documentation requirements for this. We would really like to simplify our pneumatic tube requested blood documentation.

 

I agree with John and no, I don't know of any standards or documentation requirements for this. 

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CAP has a standard that has something along the lines of "you know what time it left & what time they received it:"  We have them tube down a request for blood slip.  When we send up the unit, our unit tag has space for a stamp that we place & they fill out documenting when they removed the unit from the tube.  They tube the filled out slip back down to us.  We require time and employee number in addition to the normal part the tech fills out with when the blood left the lab.  We only do this for the OR, Recovery Room and CVICU after a fresh heart arrives from OR.  Our tube station is not in the BB or I would allow it for everyone that has their own tube station.

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This is our request form, which is used for pneumatic tube transport. They send it to us as a request, two techs check everything and send it up with the form, and we set a timer for 10 minutes. If we don't get the form with the bottom line filled in by that time, we start nagging them.

Request Form for Blood Products May 2012 rev.doc

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Our Translogic system has a process called "secure send" where we use a code to send the pneumatic tube and the nurse must use that code to retrieve the tube when it arrives.  If retrieval is not within 3 minutes, it is returned to the Laboratory.  In addition our tube system has a tracking program to show where & when a tube is sent and then received.

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We also have a request slip, which I've attached.  It is a 2-ply copy that the nurses complete when they are ready for products to be sent.  They complete the top section and send it to the Transfusion Service (TS).  Then we issue the blood and complete the middle section, sending the top copy with the product and keeping the carbon-copy in the TS for reconciliation.  Once the nursing unit receives the product, they complete the bottom section and return it to the TS.  This way we can keep track of the outgoing units and ensure that the nurse has received the product.  If we have the carbon-copy with no returned slip, we can call the floor and find out if they received the product.

 

It works really well for us.  We also used the AABB publication of the pneum. tube validation guidelines that were referenced in another reply.  We used a data-logger to get a near-constant temperature reading during our validation studies.  The inspectors really liked it, though it might have been more than was necessary - you would want to at least do the temp. before and after delivery during validation.  The nurses LOVE the pneum. tube delivery!

 

Request Receipt for Blood Products BLADM FS6.pdf

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We use the badge secure option to send blood.  BB staff must scan their badge to send the product and nursing staff has to scan their badge for it to drop into the tube station.  That way I can track who sent it and who removed it from the tube system.  If it isn't removed in 5 minutes, it automatically returns to the blood bank.

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  • 1 month later...

 

AABB has a guideline for pneumatic tube systems. Not too expensive.  $25 non-member/ $20 member

 

053045 Guidelines for Pneumatic Tube Delivery Systems: Validation and Use to Transport Blood Components
ISBN #1563951924

 

I am currently working on pneumatic tube validation and have the guidelines from AABB.  I have a question about something in their sample validation procedure.  It states in Phase II that "Computer sign-out of the product (or other means of documenting receipt) by the ward will be audited.  There should be evidence of receipt and product inspection for all products issued (traceability and trackability)."   How is everyone documenting that receipt?  We are thinking of having a sticker on our unit ready slip returned to us with initials and time of receipt.  How long would those have to be kept?

 

I was also thinking we could document it in the computer in blood bank as a unit comment, such as "received from tube system by NUR.XXX at 0800 in acceptable condition"

 

TIA, Molly

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  • 3 years later...

We also use secure send on our tube system.  It returns to us if not picked up in 10 minutes.  We also have a form that accompanies the unit that nursing fills out and returns to us after a clerical check.  I hadn't thought about revalidation.

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We have been using the tube system now for 3 years.  We did an extensive tube system validation, then we did an audit for each location to which we send blood.  If another area wants blood tubed, we would perform an audit before allowing it.  Right now we tube to ICU, PCU, surgical floor and medical floor using secure send.  With secure send, the tube will not drop down until the secure send code is put in and it alarms continuously.  We have never had blood come back to us.  I have had to call maintenance only a couple of times in three years to locate our tube, which was empty.  We use a "special" tube, which is only different in color from the others, and it states on it to return to blood bank.  We save our "unit ready" slip until the tube comes back so we know who to call if it doesn't.

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If you're using a TAR system then you could probably add some required custom queries about when it was gotten out of the tube system and by who.

Or maybe have a dummy order than nursing puts in after getting out of the tube that files with their name and date and time.

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  • 2 weeks later...

Does anyone require documentation of the handoff to the nurse if someone else transports blood by foot?  If we don't have to document that handoff, then why would we have to document it being acceptable when the nurse gets it out of the tube?  They currently document that the unit was acceptable when they hang it.  My goal would be that there wouldn't be much time elapsed between us tubing it and them hanging it.  Maybe I am missing something.

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I agree, Mabel.  A handoff is a handoff.  We document inspection upon release in the BB.  We validated the system, all stations, then started using it.  We do not use secure send - it slows the whole system down and led to many complaints. 

We use Epic for med record, and it auto prints in the BB when they nurse is ready to transfuse.  We put a sticker on that print out to document who in the BB is sending, date/time.  RN documents receipt with initials/date/time and sends it back.  If we don't get it within 10 minutes, we call and track it.

I've attached our downtime request slip.  This is simple - patient name/MRN and the product requested.  Same documentation of send/receipt.  Works for either a person picking up or sending through the p-tube. 

I'm a big believer in the KISS principle - Keep It Simple, Stupid! 

Blood Request slip.pdf

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We used the AABB publication as a guideline. When validating we sent a tech to the floor to time how it took & the unit's temperature.  We required a request/order and the floor had to sign an area that said unit appeared acceptable and information checked, time it, and return when they received the blood. We called when we tubed it & followed up if the form was not returned in a few minutes. We kept the completed form with our transfuse orders.  We only tubed to two locations.  That said, the blood bank has no control over the blood once it leaves.   One day we issued a unit, got a request for another patient, waited until we got the completed form for first unit back, and issued, called & tubed the unit for the next patient. A few minutes later, the first nurse called wanting to know where her blood was.  She had delayed getting her unit & the second nurse had grabbed it & completed the form. Two people had signed the bedside check area, but the first unit was hanging on the second patient.  Thankfully, it was group O & the patient had no antibodies. 

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