First, there is no barrier requirement- just a suggestion of using a barrier system as one way of reducing misidentification. Second, using the secure drop code sounds like an excellent way of meeting the intent of the CAP question provided you use the armband number as the code as you do. Do you tell the nurse to plug in the last 4 numbers of the patient's armband to get the blood to drop? I don't think it wouldn't work as well if you gave them the code. I think it would meet the intent if you said something like, "The blood for Mary Smith is ready to drop when you enter the last four numbers of her amrband as the drop code."

BC

When the nurse is ready to transfuse, they call us with the name and bb id number. We do a dispense in the computer and tube the blood up. So normally there isn't any more conversation, they wait a few minutes for the tube station to start beeping, then they type in the last 4 digits of the id number that they just gave us over the phone. Thanks!

Do the nurses copy the BB band number into the chart or go to the patient's wrist each time they need to request a unit. How do you handle surgery? We issue blood in coolers so don't use the tube.

The nurses are not supposed to copy the number into the chart, though I can't say it never happens. When a sample is collected and the unique id number assigned, we require the rest of the number 'sheet' to be sent down to us. We just toss it so it is not hanging around on the chart. When a subsequent sample is collected, the blood bank id number must be handwritten on the tube.

We tube blood to the OR, they also type in the last 4 digits of the id. Then they place it into a monitored refrigerator up there.

Ideally nurses should not write BB number in the chart but I have seen nurses applying sticker in the chart.

The answer to your question regarding mechanical barrier's. Yes the bracelet does apply. Please contact CAP and have them confirm this for you. I did and I had my CAP inspection with no deficiencies.

MWL

I want to be sure I understand correctly. Are you saying that CAP has approved, as a mechanical barrier, using the pneumatic tube system's secure transport function (code required) with the unique BB wristband number as the code?

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We have been doing second blood type checks for over 3 years. When we began we had 2 facilities that used BB bracelets. They have decided to get rid of them since the second check policy is so effective. Just get rid of them and go with the second check. It's the best patient safety initiative out there.

Some good replys to rcurries reply #3, I Really like reply #4 by birder and I reply to that.

That was a good reply, and I would like to add that our hospital recollects critical values and or compares the value to a previous value of hematology or chemistry! And the recollect helps rule out IV fluid diluting the sample.

It seems to be consensus across the country that when one specimen determines a patients blood type and that when nurses compare the blood unit tag to the patients ID that additional ID bands and other means to force the nursing service to go to the patients arm to positively ID the patient is proving to greatly decrease the number of ABO incompatable transfusions. In our system we have not had any since we implemented the blod-loc system.