Patient identification

[DeeMc]

How are name changes handled in your facility?

Does your policy indicate that the compatibility label always match the identifiers on your specimen?

Does a name change always require a redraw?

Does your system process name changes automatically?

If you use an additional Blood Bank band, do you require a redraw so the Blood Bank band identifiers match the patient identification band after the name change?

Is your policy the same with Trauma?

[David Saikin]

When names change, for whatever reason, as long as the MR# and birthdate remain the same we will not abuse the patient with another venipuncture.   The name change is documented in the Medical Record.  We also use BloodLoc codes with a separate armband so our confidence level for patient specimen/transfusion is pretty high.

[pbaker]

If the name, DOB or MRN changes while the patient has a current BB specimen, someone from the BB must go and witness the armband being changed.  We take the current specimen with us for comparison and correct the label to match the armband.

If they change the armband without the blood bank involvement, we start over with a new specimen.

We strongly encourage them to wait until the specimen expires, but that doesn't always happen.

[Carrie Easley]

All of our patients admitted with an alias (Trauma, Jane/John Doe) are drawn with a blood bank band (Typenex).  The billing/stay number is used as the second identifier on the band since this will not change for the duration of the admission.  When the patient's identity is updated, the demographic changes print in Blood Bank.  When the nurse replaces the patient's hospital band with their real identity, the Typenex remains until the T&S outdates.  All packed cells have the BBID printed on the compatibility label and transfusion record.  When sending for the units, the nurse must include BBID on request.  If the band is accidentally removed, we do require a redraw.  We have an alert message built in Softbank to remind techs that the Typenex is in use. 

[pinktoptube]

How are name changes handled in your facility? Handled by registration and lab is notified via demographic print out.

Does your policy indicate that the compatibility label always match the identifiers on your specimen? Yes

Does a name change always require a redraw? Yes, it is the first or last name.

Does your system process name changes automatically? Yes

If you use an additional Blood Bank band, do you require a redraw so the Blood Bank band identifiers match the patient identification band after the name change? N/A

Is your policy the same with Trauma? Yes

[ltechlin]

How are name changes handled in your facility? Handled by registration and lab is notified via computer system.

Does your policy indicate that the compatibility label always match the identifiers on your specimen? Specimen, patient armbands (hospital and blood bank) and Transfusion Record  Form attached to blood product must match

Does a name change always require a redraw? No, we allow an Armband Change Form to be completed by the person changing the blood bank armband.  From this we update the specimen and Transfusion Record Form on the unit. Of course, we are checking the information sent from the registration department's computer system to ensure that the information is correct.

Does your system process name changes automatically? Not in the blood bank.  General Lab, yes, it is automatic.

If you use an additional Blood Bank band, do you require a redraw so the Blood Bank band identifiers match the patient identification band after the name change? No, we use the Armband Change Form to maintain an audit trail.  We only redraw the patient if the Blood Bank armband has been removed without utilizing the Armband Change Form.

Is your policy the same with Trauma? Yes, with the exception that hospital policy states that name changes are not done until the patient is admitted to a floor, discharged or transferred to another facility.  This way we shouldn't be having to deal with a name change until after the patient is stable and the urgent need for blood has passed. 

[BBfuntimes]

Would you be willing to share your Armband Change Form used for autid trail?

[KatarinaN]

On 4.5.2016 at 4:50 PM, DeeMc said:

How are name changes handled in your facility? - Via computer systems automatically. When ward makes a new order for the new name, it is then changed. We don't change it manually. Every info goes attached to social security number and if name change goes with same number there is no need for action.

Does your policy indicate that the compatibility label always match the identifiers on your specimen? - Yes

Does a name change always require a redraw? - No

Does your system process name changes automatically? - Mainly yes

Is your policy the same with Trauma? - Unidentified trauma patient will have temporary social security number and temporary name. When patient is identified later we unite the trauma information and blood bank history with the real patient history. 

 

[Mabel Adams]

We require a redraw.  For patients with trauma names, first, we ask that they not make the name change while we are transfusing furiously. We require the redraw as soon as possible after that but keep giving the units we had until we get the new specimen.  The reason we redraw them is because otherwise, 2 days later, you have them hanging blood on a patient whose BB armband doesn't have the same ID on it as the unit.  This gives them the idea that it is okay if the names don't always match when they are hanging blood which I think sets us up for errors in some other situation where, because of an error, the names don't match.

[Eagle Eye]

1 hour ago, Mabel Adams said:

We require a redraw.  For patients with trauma names, first, we ask that they not make the name change while we are transfusing furiously. We require the redraw as soon as possible after that but keep giving the units we had until we get the new specimen.  The reason we redraw them is because otherwise, 2 days later, you have them hanging blood on a patient whose BB armband doesn't have the same ID on it as the unit.  This gives them the idea that it is okay if the names don't always match when they are hanging blood which I think sets us up for errors in some other situation where, because of an error, the names don't match.

Almost same as Mabel: the only difference, our admitting calls us first and if the patient is critical and getting transfusion we do not allow them to change the name. we require new specimen after name change and we do not issue blood with new name crossmatched to specimen with old name...

[ltechlin]

On 6/9/2016 at 1:21 PM, BBfuntimes said:

Would you be willing to share your Armband Change Form used for autid trail?

I'm answering this from home, so I don't have a copy of the form, but it basically is as follows:

 

I _____________________ take responsibility for identifying the patient and changing the blood bank armband from ________________ to __________________. 

 

There is also a place for date and a patient sticker (name, MR # and DOB).

 

We use this form for name changes (Doe to actual name) or if a band needs to be removed (to place an IV).  Our hospital policy dictates that a John Doe isn't changed to his actual name in any computer system until he is admitted to an inpatient bed.  This prevents us from dealing with a name change during a MTP in ER or OR.  It was a battle that crops back up every 5 years or so, but nursing is good at following this.  Policy also dictates that nursing calls us as soon as they learn the patients' true identity so that we can do a history search, but we don't have as much success with that.

When we get an Armband Change Form, we update the armband (and name/DOB if needed) in our computer, on the specimen and reprint tags on any crossmatched products.

If we haven't had a chance to go change the BB armband, but nursing has updated the Doe name, we hand write in the true identity name on the transfusion tag, next to the Doe.  This rarely happens.

Merges of MR #s for a patient (a newly issued Doe MR# with a historic true identity MR#) doesn't happen until the patient is discharged.  This way we always have two identifiers, the MR# and Blood Bank armband number that is consistent.