Specimen expiration

[NewBBSup]

I'm sure this has been asked before but I cannot find a feed about it.  What does everyone use as their expiration for a sample when the patient has NOT been pregnant or transfused?  We currently use 10 days but my pathologist is considering changing it to a 3 day expiration of all blood bank tubes regardless of whether they've had an exposure or not.  I'm thinking of the ramifications of this with not being able to do our pre-surgical specimens a week in advance and it would really change our workflow.  Advice please.

[R1R2]

14 days for presurgical only, 3 days for inpatients regardless of transfusion history.     Why does your path want to change? 

[StevenB]

Fight to keep your 10 days at a minimum!  There is no scientific basis to move the expiration to the 3 day standard for the untransfused, non-pregnant patient.

Personally, even 10-14 days is too short!

Edited June 8, 2016 by StevenB

[goodchild]

We do 7 days presurgical patients. In-patients: 3 days, day of collection is day 0 (i.e. 96 hours).

[pbaker]

For consistency, we do 3 days for everyone.

[NewBBSup]

Thanks all.  She wants to change b/c she's afraid a patient may be confused when answering the question if they've been transfused or not.  She thinks we may not get a reliable answer and wants to keep it 3 days across the board for everyone.

[Dan87]

6 days for presurgical with signed documentation of no transfusion or pregnancy hx within last 3 months.....3 days for inpatients..... First day being 0.

[KatarinaN]

Every patient 5 days regardless of situation and that five days is for minutes. If the sample is drawn 8th of June 2016 10:52 p.m. it expires 13th of June 10:52 p.m. We don't ask any questions and make no exceptions. (Well... never say never in immunohaematology )

[SMILLER]

Similar to Danny, above, except we accept pre-op specimens 10 days out from day of surgery.

Scott

[mollyredone]

I've responded to this before.  We live in a small town and don't have people coming to have surgery here from 100 miles away, so we use 84 hours as our expiration time for everyone.  If you live in a large city, I can see how that would be a problem for pre-ops.  However, if a pre-op patient is in the hospital and on the fourth day they need blood, I can extend the expiration time if the pre-op questions on transfusion and pregnancy have been answered in the negative.  It doesn't happen often.

[jalomahe]

30 days for pre-surgical patients. They must have answered NO to pregnancy and/or transfusion. We aliquot off the plasma and freeze it for use when the patient arrives for surgery.

3 days for all other patients with day of draw being day zero and expiration occurs at 23:59 on day 3.

[Brenda K Hutson]

  Have seen 3 days across the board (as your Physician has requested), up to 30 days.  There are pros and cons to different outdates.

A Pro for 3 days is consistency....we know that anytime you can keep Policies consistent, there is less room for error due to exceptions.  That also leaves you with a fresher specimen (though if you use electronic crossmatch, not so much an issue).

If you use separate Blood Bank Armbands and your Policy is that those armbands MUST be placed on the patient at the time the blood is drawn (even if it is a Pre-Op Outpatient), you may have angry Physicians, Nurses and Patients who feel you are not being considerate of the patient           (making them walk around for days with an armband on.....plus can have problems if it gets wet in shower).  But perhaps those armband issues are N/A for you.

By limiting it to 3 days, it makes it difficult for patients who live far away and/or that have transportation problems with limitations.  Those patients may end up getting drawn on day of surgery, thus resulting in increased stress for Blood Bank and delay of surgery.

Those are just some of the considerations.....

Brenda Hutson, MT(ASCP)SBB

[goodchild]

Welcome back @Brenda Hutson, haven't "seen" you in a while.

[jojo808]

Although the 30 days would be great for anyone, we cannot guarantee or that our patient's have not been transfused or not pregnant to we are conservative and stick to the 3 days.

The pros and cons were mentioned above and the consistency is what we bank on and again it was mentioned there is less room for error if you keep consistent. If you keep to 10 days or longer make sure the pre-transfusion consent/checklist has a signature verifying that the patient has not been recently transfused and is not pregnant!

For our surgical patients: They have an ABO/RH, antibody screen drawn with their pre-op labs (anywhere from 1 week to 1 month prior to surgery) to detect any abnormal lab results that may postpone the surgery. Then they get "banded" and crossmatched on the day of surgery with no surprises.

[macarton]

We use 3 days in house, as we have a lot of transfers from other hospitals.  Surgery patients we have a form that pre-admission testing asks the patient about transfusion history and pregnancies. If everything okay, we extend surgeries specimens up to 7 days.   Problem is that they will answer No to have you been told there is a problem finding blood, even though we have it documented that the patient was sent a card to carry with them and a letter explaining the antibody.

[Brenda K Hutson]

On ‎6‎/‎10‎/‎2016 at 3:46 PM, goodchild said:

Welcome back @Brenda Hutson, haven't "seen" you in a while.

Thank You....that is very kind of you.. ......combination of some health issues and WAY too many projects going on at work (getting ready to

purchase, train on and implement the Erytra).

Brenda Hutson

[tricore]

 (getting ready to purchase, train on and implement the Erytra).

Are you going to interface with your blood bank system?

What are you using as a back up when the Erytra is not available?

[Brenda K Hutson]

5 hours ago, tricore said:

 (getting ready to purchase, train on and implement the Erytra).

Are you going to interface with your blood bank system?

What are you using as a back up when the Erytra is not available?

Yes, we will interface with our current Sunquest.  Until the Erytra is validated and ready to go, we will keep one of our ProVue's going.  As a back-up once we are only using the Erytra,  we have also purchased the Manual Station as well as DG Reader (which we will also interface).

Brenda

[Liz0316]

We use 3 days for inpatients, regardless of status and 21 days for pre surgical with a signed form stating no preg/ trx in 3 months.

[goodchild]

For all institutions which have instituted greater than 7 days pre-admission testing, how do you have it set up for the pre-in account and the day of surgery account so that the results and whatnot are both there?

Our registration department insists that billing/account compliance prevents them from registering pre-in accounts >7 days out from the day of surgery.