eliminating blood bank bands

[snydercl]

We are considering eliminating the blood bank band here is our hospital.  We use meditech, TAR and are going to mobilab by this fall.  I am wondering what other hospitals have done for implementation and policy changes.  Areas of concern are:

 

Nursing cutting off the patient band......do you require them to notify the blood bank?  Do you restrict who reprints the admission band, while also having some supervisory process over that?

 

Trauma's and emergencies.........do you still use the blood bank band in these instances for identification?

 

What do you do about outpatient surgery patients? 

 

Any information, opinions, what worked and what hasn't is much appreciated.

[BankerGirl]

We are also Meditech, Tar and Mobilab users and you will absolutely LOVE Mobilab!  We have not used blood bank bands since I started here 25 years ago, so we have had much experience with nursing cutting off the band.  If we discover this, the patients BB specimen must be redrawn.  Nursing doesn't notify us, but the phlebotomists do because without the patient armband, Mobilab doesn't work.  We also require the phlebotomists to ask the patients their name and date of birth prior to drawing ANY specimens, so we know if the armband it incorrect.  If the patient is unable to respond, then they must get the patient's nurse to identify the patient.

 

We have a set of prenumbered Trauma packets with armbands and stickers all ready to go for anyone who comes in without identification.  We require the trauma information to remain until any immediate bleeding emergency is passed, and then we redraw samples after they update or merge the admission record.  We do have a stock of blood bank bands for use in emergencies when the armband gets removed or if a large number of emergency patients come in at once.

 

As far as surgeries, we require the patient to leave the armband in place if they are drawn prior to admission and the preadmission nurses punch a hole in the visit number barcode so that visit ID is not used for nursing, but we can still use it for our purposes.  We use the MR number as our armband rather than the visit number.

[AMcCord]

We've been using separate bands for a looooong time. We switched from Typenex bands to FinalCheck barcoded bands last September. If the patient doesn't have a band on, there is no lock code for the nurse to open the bag to get the blood out. If the wrong patient was drawn there isn't a matching lock code for the nurse to open the bag to get the blood out. This system is used with every patient who needs or might need blood products, traumas and surgicals included. We also draw all inpatients with handhelds used to ID the patient - the hospital ID band is scanned, labels are printed at bedside to label the tubes at bedside. (We still ask the patient to state and spell their name and state their BD, if they can - nurse ID if they can't.)

 

For all patients, including trauma patients, one of the 'code' stickers off of the bracelet goes on the patient specimen directly from the patient's arm. The barcode can be read by the Echo for trauma patients we haven't received an order for yet. The 'code' for the lock does not appear on any paperwork outside the lab - not on the unit, not on the chart, not on the back of the nurse's hand if I catch them doing that - with one exception. Surgery is allowed to take 2 'code' stickers off of the patient's band only IN surgery and place them directly on the anesthesia worksheets so that they can give blood products to patients whose arms are tucked under or draped. Once out of surgery, only the code on the band can be used.  

 

Hospital armband placement is usually done by registration clerks, sometimes ward clerks and nurses. We've observed the "identification" process used by some staff members for this task. This is part of why we use our own bands. Though I am hoping that our patient safety focus has improved that process and will continue to improve it.

 

Nurses do not cut our bands off. We have developed a culture of respect for those bands and we only lose a handful over the course of a year. When it happens, its almost always done by a new employee. When I call about it, I'm almost always told that the staff member in question has already heard about it, in detail, from someone on the floor and will never, never do it again.   Self-policing is working great, though it took time and effort and lots of occurrence reports over the years to get to that point. If a band must be moved because of an IV infiltration or restart or whatever, the bands we use now have small bands that can be used to reattach the original band. The floor must call the lab to request a tech to move/replace the band. Our pledge is that we will respond quickly to any request to move the band and that I want to hear about it if our staff is slow to respond w/o offering a valid reason. Doesn't need done very often.

 

We have a very strong focus on patient safety here from the CEO on down, so these kinds of things are regarded as very important.

Edited March 24, 2015 by AMcCord

[David Saikin]

My policy is pretty similar to AmcCord's except we use the BloodLoc system.  Has worked well for us too.