Disinfecting Blood Bank Coolers

[Dan87 18]

Do you disinfect your coolers after they are received from OR/floor? Or OR/floor disinfects them prior to returning them? Or do you even bother to disinfect them?

We disinfect every coolers after they are returned from OR/floor. 

[Ensis01 120]

Quick wipe down after every use (Cavi wipes) if not bloody. Disinfect thoroughly quarterly or if bloody. 

OR are meant to return coolers clean i.e. No blood but does occur. 

[DebbieL 150]

Do you document that the cooler was cleaned or is that something you automatically do? Trying to keep up with cleaning documentation of multiple coolers sounds like a nightmare. Our coolers sometimes go out several times a day.

We have never consistently cleaned our coolers. Sounds awful doesn't it

We currently have tape on the outside of our coolers and were told by Quality that it has to go. The thought of a "naked" cooler going to surgery scares me. I have thought of using one time use disposable paper tags that we could put a patient label on and attach to the handle so it would at least have the patient name on the outside.

How do others make sure the correct cooler gets to the correct patient? How do others document cleaning after use?

 

[AMcCord 1,274]

We are getting ready to use coolers - mostly to our Cancer Center for outpatient infusions, but will also use for Mass Transfusion Protocol. I got some small cardstock tags that we'll label with the patient's name (using a patient label/sticker so small print not readable from a distance). For the Cancer Center checking the patient name on that tag will be part of the process we've worked out.

Following the cleaning part with interest.

 

[Dan87 18]

4 hours ago, DebbieL said:

Do you document that the cooler was cleaned or is that something you automatically do? Trying to keep up with cleaning documentation of multiple coolers sounds like a nightmare. Our coolers sometimes go out several times a day.

We have never consistently cleaned our coolers. Sounds awful doesn't it

We currently have tape on the outside of our coolers and were told by Quality that it has to go. The thought of a "naked" cooler going to surgery scares me. I have thought of using one time use disposable paper tags that we could put a patient label on and attach to the handle so it would at least have the patient name on the outside.

How do others make sure the correct cooler gets to the correct patient? How do others document cleaning after use?

 

......by disinfecting, I mean using the wipes. We wipe our coolers every time they are returned. And, we don't have documentation after they are cleaned. So, depending upon tech and work load; sometimes they are cleaned and sometimes not.

We have plastic pocket that is attached to the cooler where we put the piece of paper with patient's name, date/time of issue and date/time it must be returned.

[jalomahe 132]

We have a log book that we use to keep track of coolers. We indicate what cooler went where, when so we know when they are approaching 4hr being out of the department and if they go missing we have a way to track it down. When the cooler is returned it is cleaned and that is documented on the form also.

COOLER LOG.doc

[jdepew 1]

We clean each cooler upon return with a Sani-wipe^TM and record the initials of tech cleaning the cooler on the cooler sheet. This sheet has the name, medical record number, patient's ABO/Rh and units in the cooler listed on it. Also, it contains a place for nursing to check the cooler and unit temperatures at 4 hour intervals. it is kept in a plastic sleeve on the cooler lid.

[mollyredone 318]

The only place we use  coolers is our outpatient transfusion.  I validate them annually, but they are kept in the therapy clinic, so any cleaning is done by them.  We use insulated boxes for anything else.  So often we don't get the box back, and I would hate for that to happen with coolers!

[macarton 40]

We clean coolers when they come back from ED or OR.  You don't know where they have been, esp if blood was used, and the empty coolers made a trip to the smoking shack on way back to BB. I don't want to be implicated in a surgery infection.

[exlimey 376]

Just curious: Other than common sense, is there a regulation that says coolers or blood boxes/transports need to be cleaned?

Obviously, if there is some overt issue, they should be cleaned, but in practical terms, the OUTSIDE of blood bags do not claim to be clean/sterile. I can't imagine that the coolers themselves are taken into "clean" areas like ORs, but if they are, that's a different story - they should be clean INSIDE and OUT. While the Blood Bank is probably cleaner than the "smoking" shack, I'm sure it's not claimed to be clean in the clinical sense.

As a parallel.....how often are blood storage refrigerators and freezers cleaned? Certainly not every time they are used.

Perhaps more focus should be on coolers returned with noticeable blood contamination: where did it come from?, was the blood inside compromised?, did a unit of blood with a hole in it get transfused? Of course, that still implies an inspection process, but doesn't necessarily mandate cleaning.

Just a few brain drippings, no soap box or intent to offend.

[Gnapplec 15]

44 minutes ago, exlimey said:

Just curious: Other than common sense, is there a regulation that says coolers or blood boxes/transports need to be cleaned?

Obviously, if there is some overt issue, they should be cleaned, but in practical terms, the OUTSIDE of blood bags do not claim to be clean/sterile. I can't imagine that the coolers themselves are taken into "clean" areas like ORs, but if they are, that's a different story - they should be clean INSIDE and OUT. While the Blood Bank is probably cleaner than the "smoking" shack, I'm sure it's not claimed to be clean in the clinical sense.

As a parallel.....how often are blood storage refrigerators and freezers cleaned? Certainly not every time they are used.

Perhaps more focus should be on coolers returned with noticeable blood contamination: where did it come from?, was the blood inside compromised?, did a unit of blood with a hole in it get transfused? Of course, that still implies an inspection process, but doesn't necessarily mandate cleaning.

Just a few brain drippings, no soap box or intent to offend.

Good point.  Focusing on how clean the cooler is does not help the fact that the blood bag itself is probably fairly dirty and dusty. With all of the production steps st the blood center, centrifuge cups see hundreds of units a day and are only required to be cleaned once per day.  Add the handling at the blood center from tray to tray and transport, it's not the cleanest after all those steps Unfortunately. 

[DebbieL 150]

Our interim infection control person said TJC was cracking down on coolers. She liked that I had validation of temps but no proof of cleaning. She said I had to get rid of the tape on the outside because they couldn't be cleaned properly. She went all thru the hospital leaving havoc in her trail and then left.

The coolers are taken into surgery but not into the sterile field. They leave them close to the door and only get into them if blood is needed. We have only cleaned if we thought they looked dirty which is not often since they are not close to the bloody patient.

I agree with Exlimey. Even if we sanitize the cooler inside and out, multiple people touch the outside as it is passed from hand to hand. They won't be clean because we don't wash our hands before we touch the cooler with the gloves we are wearing while we are crossmatching. The blood bags themselves are not sterile, they have been thru multiple hands before they ever reached the hospital. The blood bags actually do make it close to the sterile field. They pose more of a threat to the patient than a cooler in the corner.

Now if surgery tells us a patient had a particular bad something, I would clean to knock down the cooties.

[carolyn swickard 212]

Does anyone use any type of spray cleaners?  We tried a Virex spray and had to take them outside to avoid inhalation hazards!!  Or just the wipes?

What kind of tape?  We have LabelMaker tape on ours with instructions and cooler ID #s - but no one time use type of tape for the pt's name.

Only the units have ID on them - a paper label attached to unit.  The cooler itself has no pt. name on it.

 

 

[DebbieL 150]

We just use regular clear tape like you would use to seal a box. About 3 inches wide. I do admit the tape starts peeling up after a year or two, so she could have a valid point. I have typed up instructions for the outside and "laminated" with the tape. A lot of good it does since they don't seem to read what is in front of them. A different lady in Quality suggested we use the sticky pouches so we could put the patient name on the outside. I don't see the difference between a sticky pouch and sticky tape but whatever.

I think I will redo all the coolers with new tape and see if I can get it past the next infection control person. We have had several in the last few years. One concentrated on corrugated boxes and upended the entire hospital.