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How old does the patient have to be before you toss a clin sig card?


Karrieb61

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Another poll, thanks for putting up with me and my polls: we still have paper card records on patients with some kind of clinical history that may affect transfusion since AABB requires us to keep these records "indefinitely". I can't find anything that tells me how indefinite indefinite is in terms of the patient's age. We are clearing out old cards and have some from people who are 114 according to their birthdate.

I assume you are determining your own cut-off birthdate, if so, what is it? I am toying with tossing cards on patient who would be in excess of 102 years of age. What do you think/do? Needless to say, if we have any old cards with missing dates of births or no medical record numbers, I instruct people to toss those anyway but these have only been found on cards where the patients still are =/- 100 years of age. Thanks.

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I have used Social Security Death Index to determine if people are deceased and then keep the paper records for 10 years after that (that's what CAP indicated should be done) We only keep paper records for antibody patients. I also check the obituaries daily because otherwise our antibody shelves would get overloaded.

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So you don't pick an age like 102 or something? I have no idea how I would access SS numbers at work as we have a very firewalled computer system and accessing the outside world is difficult. For the most part, I am looking at records of patients who haven't been in our Blood Bank in maybe 20 years and would be well over 100 if still alive. I also don't imagine our Medical Records dept would be happy to help me locate SS #s from records of theirs that are probably archived.

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Social Security numbers are usually found in our patient demographic section, along with address, phone, religion, etc. If they are not in the system, I sometimes will access the SS death index http://search.ancestry.com/search/db.aspx?dbid=3693&cj=1&netid=cj&o_xid=0000584978&o_lid=0000584978&o_sch=Affiliate+External

and I look for the patient to have died in our county in Oregon. It probably wouldn't be as easy to do in a large metropolitan area, but people tend to not move around as much in our area. But I never delete based on someone with the same name who has died in Florida, for example.

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We get a list of patients that have expired within a hospital visit and pull those antibody folders. We also check the obits all the time .... we want to know where our multiple antibody patients are - all the time! Other than that, these antibody folders just hang out in the file....

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We do pull the cards when we receive notification that the patient died while in the hospital but that's it. I am talking about very, very old cards on very, very old former patients. If I had the time and access to SS info I would do that but I don't so I still don't know what to do other than stash these really ancient cards into a shoe box.

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We do pull the cards when we receive notification that the patient died while in the hospital but that's it. I am talking about very, very old cards on very, very old former patients. If I had the time and access to SS info I would do that but I don't so I still don't know what to do other than stash these really ancient cards into a shoe box.

If there are not too many cards can you enter the patient/antibody into your current LIS?  

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The death records we look at are what comes through the HIS interface for patient discharge. We also save the obits in the local paper - which covers a pretty big area (we are in a rural area). I also check the obits for the local mortuaries - they have them on line. I will sometimes access the social security index to confirm that I have the correct patient when there are 2 or more with the same first and last name - depends on the current setting of our firewall whether or not I can do that. Everybody else just stays in the file.

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In the 28th edition of the AABB standards 5.13.5 says "ABO Group and Rh type, difficulty in blood typing, clinically significant antibodies, significant adverse events to transfusion, and special transfusion requirements,"Minimum retention time is 10 years.  That being said we do keep ours for longer though depending on how old the records are you might want to consider pitching them.

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R1R2- you mean some people actually have LIS records of their patients???? We have absolutely minimal data going back only about 6-7 years. I would never bother to update whatever new LIS we might get someday to enter people who are 110 years old per our old workcards.

Sko681, I thought we had to keep these records of problem patients indefinitely? I'll have to go dig out the Standards book. Thanks all.

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In the 28th edition of the AABB standards 5.13.5 says "ABO Group and Rh type, difficulty in blood typing, clinically significant antibodies, significant adverse events to transfusion, and special transfusion requirements,"Minimum retention time is 10 years.  That being said we do keep ours for longer though depending on how old the records are you might want to consider pitching them.

 

See 5.14.5 in the 29th edition of Standards.  It was inadvertently changed to 10 years in the 28th edition, corrected to Indefinite in the 29th edition (effective April 1, 2014).

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Social Security numbers are usually found in our patient demographic section, along with address, phone, religion, etc. If they are not in the system, I sometimes will access the SS death index http://search.ancestry.com/search/db.aspx?dbid=3693&cj=1&netid=cj&o_xid=0000584978&o_lid=0000584978&o_sch=Affiliate+External

and I look for the patient to have died in our county in Oregon. It probably wouldn't be as easy to do in a large metropolitan area, but people tend to not move around as much in our area. But I never delete based on someone with the same name who has died in Florida, for example.

 

How do you search this file now?  I used to use the death index and search by SS#, but you can't do that anymore and you can't get far on Ancestry.com without joining it - something I am not going to pay for!  The lists that are generated now are too generic, they don't even give you the whole birthdate, and if you don't know the date of death (because, after all, that is what you are looking for!) you get too many candidates.  If you have a workable trick, I would love to know about it.   Thanks.

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As a quick follow-up, we are extra quiet today and  I am taking cards of patients who if still alive are at least 100 years old and I am putting them in a separate card file calling them "Pts approx. 100 years old, problem patients, mostly dead"  Haha,, only kidding about the mostly dead but I am holding those cards of problem patients who are about 100 years or older off to the side permanently. Really, does any accrediting group really expect you to maintain a "current" file on someone who would be 110 years old now? I am being sassy and bold and taking them out of the current hard copy file.

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Where is my lovely crammed Roladesk file? No we have these on PIMS (Patient Information Management Systems) now under clinical alerts, with details of last known status for antibodies and/or special requirements. In addition, we have a hard copy Alert Notice, which sits first page in the Patient Notes (No EHR here), so blind Freddy couldn't miss it (except they occasionally do).

 

In the Lab, we have a Database for these which will be kept in perpetuity [requirement is 30 years (Regulatory Requirement)]. - Might make a historical (or is that hysterical) paper one day - probably when antigen stripped blood is in vogue and antibodies are a vague thing of the past.

Cheers

Eoin :P

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