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Final disposition for units transferred with a Patinet to another Hospital


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This is a real issue for us lately.

Medical staff toss the units in the stretcher with the patient and off they go. More often than not, we're not told the patient was transferred and if the units are transfused. Or we get a call from the other hospital telling us the unit(s) were disposed.

We keep educating...

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We can usually find out from the flight/ambulance crew from their documentation if units were infused enroute. We're lucky - one company is based at our hospital and the other is local. Both are responsive to requests for information. If a unit was hanging when the patient was received on the other end, we can usually confirm that the unit was given by contacting the other hospital. If possible, the flight/ambulance crews will bring unused blood/boxes back to us. Not guaranteed, but usually works out.

The facilities we transfer patients to will not accept blood products - it will go in the trash in the ER w/o documentation (GRRRRRRRRR!). I understand dealing with regulatory issues that are preventing them from accepting the blood - I do NOT understand why documentation of what was trashed is ' impossible '. A quick note in the patient chart wouldn't be that difficult or send it to the lab for proper disposal. We try very hard not to transfer blood with patients unless we really really have to do so.

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We don't send units with the patient unless they are already hanging.  We found out years ago that units sent were discarded by the destination hospital and the explanation is simply that the other hospital didn't do the work and didn't want to responsible for someone else's work.  I understand the reasoning thus we don't send units...

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We fill out a transfer form from the blood supplier to send with the units just in case the new facility will accept our units.  With that paperwork, we include a note for them to call us if they receive the blood.  We are also able to get the information from the flight team, if necessary.  One of the major hospitals we send patients to in the "big city" will also send us a letter informing us of the disposition of any units they receive (that they were discarded!). 

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Wow! I'm thinking that, even though this happens rarely, that this has been handled incorrectly here. Whenever we send blood with a patient, we issue it in our LIS and we're done. The patient gets charged whether they receive the blood or not. The LIS also changes them to "transfused" after 48 hours. I assumed (which I'm always told "makes an ### out of you and me") that it was up to the receiving end to document anything further. So I will be keeping up with this post to see what I need to do differently. Any and all suggestions are welcome!

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18 hours ago, TreeMoss said:

We fill out a transfer form from the blood supplier to send with the units just in case the new facility will accept our units.  With that paperwork, we include a note for them to call us if they receive the blood.  We are also able to get the information from the flight team, if necessary.  One of the major hospitals we send patients to in the "big city" will also send us a letter informing us of the disposition of any units they receive (that they were discarded!). 

Bless your major hospital for the notification! What a grand idea.

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We just consider the units issued unless we are notified by the hospital they were transferred to.  Many times they use it en route, or don't keep it stored properly, so the hospital won't accept it.  I will sometimes call and ask if I know where the patient has been transferred.  If they accept the products then they put them in their inventory and I change the status of the units to transferred.

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We complete a transfer form and include the information "Please call (phone #) when blood arrives - placing it in bold letters.  Most of the time our patient can be traced to a facility about 60 miles away and we can follow-up easily.  That being said, we encourage everyone to hang a unit immediately prior to transport.

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