For how long do you extend samples for preop patients with no history of pregnancy, antibody or recent transfusion?

11 hours ago, VTN said:

For how long do you extend samples for preop patients with no history of pregnancy, antibody or recent transfusion?

We extend for 14 days.

We do 7, but this facility did 14 days about 10 yrs ago. 

I've also worked at a facility that did 30 day samples.  As long as you have a clear policy I believe it's up to your discretion but I haven't seen anything greater than 30 days.

We do a week vs 3 days.  RRay is correct.  It is up to you to determine how long.

We do up to 30 (33 actually) days.  If sample collected 1/21/23 and surgery is 2/21/23 - we set exp of sample to 2/21/23.  On DOS if all documentation is rec'd from OR - then extend 3 more days.

We do 21 days.

When you use extended sample expiration, how does this affect electronic crossmatch? The sample collection date would cause our LIS to reject the EXM rule. Do you just perform IS serological crossmatches?

54 minutes ago, jayinsat said:

When you use extended sample expiration, how does this affect electronic crossmatch? The sample collection date would cause our LIS to reject the EXM rule. Do you just perform IS serological crossmatches?

Our LIS is set up to allow an EXM for PAT specimen outdates of 14 days if the patient qualifies for EXM. 

On 1/25/2023 at 11:48 AM, jayinsat said:

When you use extended sample expiration, how does this affect electronic crossmatch? The sample collection date would cause our LIS to reject the EXM rule. Do you just perform IS serological crossmatches?

Cerner allows us to extend the date of the Preassess sample. If no pregnancy or transfusions, and a prior history or second sample drawn for confirmation of ABO/Rh, sample good for 4 days with OR day being day one. Not to surpass 30 days sample date. EXM still applies when sample date is extended.

Edited February 6, 20232 yr by NicolePCanada
add info

I am going to tag onto this thread for another question about pre-admit specimens.  How do you document that the patient has not been pregnant or transfused?  Do they have to sign a form?  If so, is that form legal document that must be kept in the records?

Fill out and sign form during sample collection. Phlebotomist is responsible the form is filled out. Patient label goes in box, patient ticks boxes to transfusion and pregnant questions with yes / no option, signs at bottom. Form goes to BB and is then scanned into record. 

17 minutes ago, Ensis01 said:

Fill out and sign form during sample collection. Phlebotomist is responsible the form is filled out. Patient label goes in box, patient ticks boxes to transfusion and pregnant questions with yes / no option, signs at bottom. Form goes to BB and is then scanned into record. 

That's what we have been doing but we are wondering if we have to keep the signature in the permanent record.  We were planning to go to an electronic documentation process and then there would be no signature.  Is it any different from asking a patient for drug allergies and recording them?  They don't sign for that.

To my understanding the process of having to sign a document made the patient think and take the questions seriously. Obtaining and documenting accurate information is the objective.

We hold that document in Blood Bank. We haven't discarded any of them to date, but we don't have a huge volume to hold. I've been thinking that it's something we could/should scan into the BB LIS patient profile so we can dump the paper copy.

We used 14 days. We chose that number mainly because of specimen storage space. Preadmit nurses were required to ask and document the recent transfusion and pregnancy questions in the computer on all their patients. These showed on the blood bank requisitions from preadmit and had to be answered “no” to extend the specimen. Patients signed an overall form regarding the accuracy of their history and that was part of it. Years ago, we once had an autologous unit on the shelf for a patient and the ”transfused in last 3 months” question was answered “yes”. On checking, we learned the patient lived in another state, had a unit of autologous blood drawn when he had a doctor’s appointment in our city, had returned home, and gotten a transfusion there before the surgery.  

We extend it to 7 days but are considering extending it to 15. The transfusion questions are answered by the ordering physician concerning prior transfusion and pregnancies. Antibody hx is established when the screen is completed. If positive, we require a recollect on day of surgery.

18 hours ago, JJSPLAYHOUSE said:

We extend it to 7 days but are considering extending it to 15. The transfusion questions are answered by the ordering physician concerning prior transfusion and pregnancies. Antibody hx is established when the screen is completed. If positive, we require a recollect on day of surgery.

We also recollect the day of surgery, but don't test unless we need to set up units that day.

We extend our samples to 10 days.