transferred patients with blood

[pbaker]

We have recently implemented electronic transfusion documentation and, with a few exceptions, done away with paper documentation.  In performing the documentation audits, I discovered a patient had electronic documentation for a unit that was never processed through our blood bank.  In digging further, it appears that the patient was transferred from another facility with a unit of blood hanging.

For those of you that have electronic documentation, how would you have handled this event?  I'm still researching to see what kind of documentation the unit actually came with.

[BankerGirl]

How did you find out about it in the first place? And how did they document the transfusion electronically if the unit was never in your system?  Is it in nursing notes or something similar to that?  If that is the case, I would think that as long as they followed your transfusion procedure then it should be fine.  That is the way we have handled it in the past.

[tbostock]

We can't transfer a patient with blood hanging unless an RN goes with them.  So that nurse would be responsible for filling in the data in the EMR after the fact.

[pbaker]

Unfortunately, nursing and blood bank systems don't "talk" to each other, so it is very possible to document something that never came through our blood bank.  I discovered it when performing documentation audits. 

We don't currently have a policy, so that is what we are trying to develop.  I guess it has never happened before or no one ever caught it.

[AMcCord]

We have policy that states that any blood that comes in with a patient must be delivered immediately to the Blood Bank and may not be infused based upon any testing performed by the transferring hospital - don't care what the patient's doctor says! If it's an emergency, the patient can have type O emergency release blood, which the Dr. will sign for. If the unit is hanging when the patient arrives, the infusion must be completed/documented according to our policies and procedures. The empty bag with attached tag must be returned to blood bank, which means that we are aware that the event has taken place. If there is a paper flow sheet of any kind that comes with the blood/patient, we are to receive a copy of that document with whatever documentation was completed prior to the patient's arrival here. Then I can check for documentation done after the patient hits our doors. It doesn't happen very often here, but I don't think we are missing them.

[Auntie-D]

There is good documentation on the UK regulatory site. I don't know whether this would be transferrable?

It contains transfer documentation as well as guidelines.

Standard transfer

https://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwivzvagtrHLAhWEORQKHTmNAtkQFggcMAA&url=http%3A%2F%2Fwww.transfusionguidelines.org%2Fdocument-library%2Fdocuments%2Frtc-ne_p_transfer_blood_components_between_hosps%2Fdownload-file%2Frtc-ne_P_transfer_blood_components_between_hosps.pdf&usg=AFQjCNHHenQ0oTqIsd0espcwE9GkXtVb2g&bvm=bv.116274245,d.bGs

Emergency transfer

http://www.transfusionguidelines.org.uk/document-library/documents/nbtc_tlm_transfer_of_blood/download-file/nbtc_tlm_transfer_of_blood.pdf

Edited March 8, 2016 by Auntie-D