Product Read back content- at Issue and Bedside---Question?

[Linda0623]

Question series for you all on Issuing and Bedside Readback information, particularly for patients with antibodies:

 

• When issuing to a runner, does the tech issuing blood do a readback of patient and product demographics, blood type, DIN, etc. when they pick up blood?
• For Patients with antibodies, ( if you issue to runners vs. through pneumatic tube) do you include patient antibodies on the crossmatch tag/label, and if yes, is it part of a readback between the tech issuing and the runner?
• If you do not perform a readback at issue with the runner or you use the pneumatic tube, is the antibody status, or antigen negative blood requirement verified at the bedside by the transfusionist during the readback prior to the start of transfusion?

 

Our dept of healthcare quality is asking if nursing should be verifying antibodies/antigens at issue/bedside, but we in Blood Bank think that this is outside of nursing/clinician practice and would be difficult to educate and set up training for this skill. Nursing admin has asked me to see what the Blood Banking community is doing as current practice, so I appreciate any practices shared

 

Thanks

Linda

[AMcCord]

We put the information on the unit tag and on the EMR report. The information is included and verified during the blood bank checkout process, but our checkouts are done with either an LPN or an RN (except for traumas, which might be another tech on the lab end), so that part of our process doesn't match yours. The antibody/antigen information is not included in the list of things that nursing checks at bedside. We've never considered requiring it because, like you, we can't imagine how we would train them for that - most of them wouldn't 'get it'.

[tbostock]

Yes, we do readback with anyone who comes to pick up blood products.  No, we do not include antibody/antigen results in that process.  I agree with AMcCord, most wouldn't understand it, and the learning curve would be huge.

[MAGNUM]

Ditto here. We verify with the RN or LVN here in the blood bank and then they likewise check with another nurse at the bedside. The antibody/antigen history is not readback or verified.

[David Saikin]

Nursing brings us a component request form - provides the "why's" of the transfusion.  We ask the MR#.  When we pull the unit we compare:  pt name, mr#, birthdate, blood type; unit type and exp date.  We do not go over ag status - our units get tagged with the ag typing and these are also on the EMR.  If an astute nurse asks we are happy to discuss the ab/ag, blood groups system - as in depth as they want to hear (and they usually are pretty interested once we get started).  Most of the time it is a quick pick up.

[mollyredone]

We send most of our units by tube system. We do highlight the antibody on the unit tag and also highlight that the unit is antigen negative on the tag. When a unit is checked out in blood bank with a nurse many of them read "no antibodies identified" or the antibody listed and do look at the unit for the sticker. I don't think it is that difficult for them. They understand that if there is an antibody the unit needs to be negative for that antigen (without explaining the underlying theory of course)We don't do many bedside audits, so I don't know if they skip that on verification or not. But all our tags do state PATIENT ANTIBODIES: None identified, so many of them read that out loud.

 

Edited to clarify:  Our tags do state "PATIENT ANTIBODIES: None identified" if that is the case.

Edited October 10, 2014 by mollyredone

[Linda0623]

Thanks to all for responding so far! This will be very helpful to present to nursing.

Best,

Linda

[Sandy L]

We review Special Transfusion Requirements and unit attributes at dispense with the person picking up the blood.  This is an AABB requirement (5.23#4, 29^th edition).  It is also a requirement for RN to check that “Special Transfusion Requirements are met” at the bedside (5.28.3#4).  There is no requirement to review Antibodies/Antigens at dispense or at bedside check if you are following AABB Standards.   The Blood Bank LIS system verifies Transfusion Requirements vs unit attributes and patient antibodies vs unit antigens at time of dispense but the antibodies are not part of the verbal check.

[R1R2]

My answers are below

• When issuing to a runner, does the tech issuing blood do a readback of patient and product demographics, blood type, DIN, etc. when they pick up blood?
• NO
• For Patients with antibodies, ( if you issue to runners vs. through pneumatic tube) do you include patient antibodies on the crossmatch tag/label, and if yes, is it part of a readback between the tech issuing and the runner?
• Results of antign testing are included on the label.   We do no read back
• If you do not perform a readback at issue with the runner or you use the pneumatic tube, is the antibody status, or antigen negative blood requirement verified at the bedside by the transfusionist during the readback prior to the start of transfusion?
• No

[tcoyle]

Question series for you all on Issuing and Bedside Readback information, particularly for patients with antibodies:

 

• • When issuing to a runner, does the tech issuing blood do a readback of patient and product demographics, blood type, DIN, etc. when they pick up blood?  We read everything that is on the compatibility label as well as the unit number and product with any special needs (e.g. irradiated) and compare that to what is in the computer.
  • For Patients with antibodies, ( if you issue to runners vs. through pneumatic tube) do you include patient antibodies on the crossmatch tag/label, and if yes, is it part of a readback between the tech issuing and the runner?   Somewhat.  We verify that the unit is antigen negative with our antigen tag on the back of the unit.  Yes, we would include that with whoever may be picking the product up.
  • If you do not perform a readback at issue with the runner or you use the pneumatic tube, is the antibody status, or antigen negative blood requirement verified at the bedside by the transfusionist during the readback prior to the start of transfusion?  We always do a read back, even if it is going in the pneumatic tube the techs will perform a readback.  Nursing is expected to do their identification checks prior to transfusion.  We also have a blood verification program that most of our nursing areas use to verify that the product belongs to the patient and that it was issued in the blood bank computer.  If that program is unavailable, then they do the two person verification method.
• ~

Happy Friday!   See my answers above.