Blood Availability

[MaryH]

When blood components are available for use, normally the nursing unit is notified.  How do you document this phone call so the information can be found later?  Writing on the transfusion slip is good but if the unit is not transfused, then the notation is lost. Trying to determine a method that is not too painful to use.

[AMcCord]

We document calls in the LIS, same as calls about criticals and other information that gets called in the rest of the lab. That way it's always retrievable.

[R1R2]

We document calls in the LIS, same as calls about criticals and other information that gets called in the rest of the lab. That way it's always retrievable.

ditto

[tricore]

We also document in LIS.It also goes back to the HIS if it is entered as a chart comment.

[tbostock]

Ditto

[tbostock]

P.S.  We also document in our LIS any communication to the nurse or physician about delays, for example, why it will take hours to get compatible units because of alloantibodies, etc.  We've been burned a couple times ("nobody told us"), so now we have a name, date, and time of that communication in our system.

[AMcCord]

P.S.  We also document in our LIS any communication to the nurse or physician about delays, for example, why it will take hours to get compatible units because of alloantibodies, etc.  We've been burned a couple times ("nobody told us"), so now we have a name, date, and time of that communication in our system.

 

Ditto

[pbaker]

Since we do electronic crossmatches, we make it the RN responsibility to see if the test results are done in the LIS.  If the type and screen is done, the blood is ready.  We only call if there is going to be any kind of delay (i.e.Aby) and document on the transfusion order.

[Brenda K Hutson]

I feel like I am always the rebel on this site(Ha Ha)....

First of all, if this information is in the interface of your Hospital computer system, you do not "have" to call them. But that would be a battle you would have to fight with them. At my last place, the system they accessed to give them all of the other Lab resuls (i.e. CBC, Chemistry, etc.); also told them Unit#, Type of Product, Status (i.e. Issued, Ready, etc.). Fortunately I received the support of Nursing Management who agreed that just as they looked up other results, they could also look this up (after all.....what is the purpose of an interface?). The alternatives are either the Blood Bank spending a lot ot time calling (and possibly documenting such calls as you describe); or, Nursing calling every 5 minutes to ask if the blood was ready (which is what was happening.....and when we would ask them why they didn't check the computer, they said it was "easier for them to call"). No doubt it is "easier for them," but it was disruptive for us. So Nursing Management enforced that the Nurses had to look in the computer to see when blood was ready. We DID call STATS or actively bleeding patients; ER patients; etc. I think that is the "right" thing to do.

Now I am at a Hospital that has the same Hospital computer system. However, my predecessor set it up such that we call everytime we have blood ready; and we have a Log that staff must complete (place for patient Name and MR#; Date/Time Called; What RN we spoke to; and our initials). That is "treating it" like a critical result; but to me, blood availability (with perhaps the exceptions listed above) is not a critical result. So that is now a battle I will need to try and reverse (just currently won the battle to stop having transfusion orders printing out in our dept.; another thing set up by my predecessor....but which Nursing then used to put the owness on us to check for transfusion orders.....so they tried to come after us recently when a Nurse transfused without an Order in the computer). That is also not our responsibility. Did tweak some of the Blood Bank forms they use (i.e. pick-up slip and Transfusion Tag) to add a space where the Nurse has to sign that she verified an Order to transfuse.....that was my assistance to them while giving the responsibility back to them. So I have to wait awhile to address the next battle.

Sorry for the long response!

Brenda Hutson, CLS(ASCP)SBB

[mollyredone]

We do call when there are delays in getting units, but we have "unit ready" slips that are the second part of the unit tag that we tube to the floor.  They bring this down (after verifying that the blood bank band number on the patient matches the one on the unit ready slip) or tube it down when they want a unit.  It works out well for us.

[Brenda K Hutson]

 

That is an interesting idea....one I had not heard of before.

Brenda

We do call when there are delays in getting units, but we have "unit ready" slips that are the second part of the unit tag that we tube to the floor.  They bring this down (after verifying that the blood bank band number on the patient matches the one on the unit ready slip) or tube it down when they want a unit.  It works out well for us.

 

[EDibble]

Unfortunately, our LIS does not have the ability for the nurses to see when the blood is ready. We have a documentation list, and record day, time, who we spoke to, etc. Granted, we are a relatively small hospital, so only have to make 6-10 calls per day.

[SMILLER]

Right now, our BB system is not interfaced for reporting to the hospital system, so we call every time blood is ready.    Generally nursing does not nag us with calls before the product is ready because they know we will call them.  (Granted, we often get a call back later on apparently non-critical orders from the floor asking "Is our blood ready yet?" -- "yeah, I called an hour ago...")   We do not bother with logs.

 

This year we will become fully interfaced with the hospital system, but I think we will still be calling when product is ready to ensure that the more urgent situation patients are taken care of. 

 

In the other direction, we are constantly reminding ordering locations that they both have to put in an order on the HIS AND call the BB to make sure we actually see the order. 

 

Scott

[bxcall1]

Since the EMR shows unit status (ready) in real time we don't call unless we know the patient is in dire need.

[Even0404]

We depend on the nurses checking the computer system for routine blood orders only.  We still call Stat blood orders and all other blood products ordered. This at least halves the number of phone calls we used to make. We do not log these calls because it is in the computer that blood is ready, even though once in a while it would be useful to remember who you talked to.

 

Unless there is a obvious pop up on the patient chart with something for the nurse or care provider to press to acknowledge that stat blood is ready, I don't see a call becoming unnecessary for stat orders.  

 

Our interfaces were just set up recently to allow this to work and before this we called with every order. There was some resistance and "why didn't you call mes" this from the floors but it seems to be OK now.

 

We are also working on the floors being able to see if there is a current sample and expiration of the current sample, so they know when to draw a new type and screen. This is a work in progress though because of varying circumstances of each patient.