Just wondering what the rest of you do in this case (this happened at our hospital last week):

A unit of blood or blood component is issued to the floor and is returned to the blood

bank after being spiked by the RN (doctor decided to cancel transfusion).

Some of the product was infused into the patient--the quantity of the

product is unknown.

Would you consider the product to have been "transfused" or do you have a certain volume limit for a product to be considered "transfused".

I would think that even if the smallest amount was infused that the unit should be considered "transfused"--just in case of a look-back. Our hospital does not have any guidelines about this which is why I am posting this question.

Thank you for your help!

Not speaking from a billing perspective, if even 1 drop is transfused, we consider it transfused. We do this for the reason your stated, lookback / recall purposes. Is this billable? I don't know.

Our policy is the same as Cliff's. This isn't something that rarely comes up- it comes up all the time, particularly when the transfusion is stopped due to a possible reaction. Nursing frequently calls us and says not to charge for the unit because only X amount was transfused. My answer: don't charge for the nursing service or the bed for the day, and I won't charge for the blood.

BC

I'm with Bob and Cliff. If the unit gets spiked and hung, no matter how long, it is considered transfused and charged.

Our policy is the same...one drop...transfused...exposed to donor.

Essentially you have to consider the unit transfused for lookback purposes if the patient received a single drop. For billing, the practices are probably all over the place. My feeling is that they used the unit - you can't give it to anyone else - so they should be billed for it. We already lose money on units that are spiked and not used at all, units that are not handled properly, plasma that is thawed and not used, etc. The money has to come from somewhere. I guess you could figure it into your overhead along with the others I have mentioned and not charge that particular patient when only a tiny amount is infused. It is a matter of philosophy.

I agree it needs to be considered Transfused. As for billing, another option would be to bill a partial or split unit. At least you would get some of the cost back, while not socking the whole thing to the patient.

We counsider the unit to be transfused and we enter a note into the product comments indicating the estimated volume infused, 5 ml, 10, etc..... and the patient will be charged for the unit (since the unit will not be used for another patient).

Same here, if you get any of it- it's yours

I bet they don't credit the patient for half a bag of IV solution.

We do the same. If even one drop is transfused...it is consider as transfused.......All of us have the same practice!! Hey our goal is patient safety SO we should be on same page>>>>