Armband Expiration for Outpatient Transfusions

[MHiggins]

What is your hospital's policy on armband expiration for outpatient transfusion? Do you allow them to be drawn one day for testing and transfused the next, even though they are not inpatient? Does your hospital allow patient's to wear their armband from their inpatient stay home to be used for a routine outpatient transfusion the next day? What if they came in through the ER and received blood, would you allow them to have a routine transfusion the next day in outpatient on the specimen from the night before? The patients receiving outpatient transfusions here are typically oncology/chronic anemia patients that come fairly regularly. Any regulation references on this subject would be appreciated!

[mld123]

We use a Typenex bracelet that is placed on the patient at the time of the outpatient draw.  They are instructed to leave that on until they come back for transfusion.  The specimen is still only good for 3 days, but most times they come the next day for transfusion.  When they pick up the blood, they have to use the Typenex # off the bracelet for our issue card.  We would not allow someone to go home with an inpatient armband and then come back for transfusion as an outpatient.  The armbands are removed as part of the discharge process.

[AMcCord]

We also use a Blood Bank armband placed on all our patients at the time of draw. Our armbands have full patient identification on them: full name, MR#, birthdate plus date/time of collection and phleb initials. We use a label printed at bedside from a scan of the patient's hospital band with the handheld device for the patient info on the BB band if an inpatient. If an outpatient, the same info is hand written on the band and verified by the patient or another responsible party (like a spouse, adult child, nurse). Outpatients are instructed to leave that band on until transfused.

We have allowed patients drawn in the ER to receive blood the next day on the Infusion Center utilizing the blood collected in the ER - its a planned event, we know its going to happen that way. The hospital band may or may not be removed but the BB band must stay. When they are admitted to the Infusion Center, they receive a hospital band for the infusion visit. The patient information, except the billing #, on that band must match the information of the BB band and the BB band must be on the patient's arm. If there is a problem or the BB band has been removed, we start over with a new specimen.

Inpatients receive their blood before they are discharged or we start with a new BB band and specimen when they come in for an outpatient infusion visit. We might make a special exception if the patient has a complicated antibody issue and we are waiting for the reference lab to get us the right units or if its an Onc patient with ongoing platelet transfusions. That would be planned on a case by case basis.

If the patient really really doesn't want to wear the armband or is not going to leave it on (dementia, for example), we utilize our PAT process which uses a postcard size card with all their identifiers for patient ID. They are given the card when drawn, there is an armband sticker on the card, they bring the card back when they return for transfusion, we ID the patient and match the patient ID with the card and the armband (we hold the armband) once the patient is admitted and transfusion goes from there.

We require that the nurses performing the bedside 2nd check prior to the transfusion check both the hospital band and the BB band for identifiers. If there is a different hospital band and it doesn't match, the transfusion doesn't happen until we re-ID, redraw and retest the patient (They are audited for that and their annual training includes that.)