To AMcCord and ALLOURBEST NLR,

 

Regarding the incident AMcCORD described, was your facility using a secondary blood bank ID band or did Nursing remove the hospital ID band from one patient and re-attach that same band to a different patient?

 

Blood Bank ID bands like TYPENEX are designed so they cannot be reattached.  At the time of specimen collection, both the blood sample container and the patient are identifed with a unique number-letter code.  This code is transferred to the compability label attached to the blood container.  Nursing must match code on patient's blood band with code on form.  In the incident you describe, the Nurse would arrive at the bedside and discover that there was no blood band on the patient.

 

Properly designed electronic systems mimic the TYPENEX system..

 

Dan

 

Yes, what I'm talking about is a nurse removing a hospital armband because it was placed on the wrong patient, then placing a new copy of that hospital band on the correct patient. That has happened at our hospital. I'll bet it's happened at every hospital at one time or another. The Blood Bank nightmare scenario that I described has NOT happened at our hospital. That is exactly why we use a secondary ID band - specifically to catch that kind of problem.  

 

If the armband for the electronic system is put on the wrong patient originally, then removed and the correct patient rebanded for the electronic system, you can still get wrong blood in tube and wrong everything else up until the time the ID error was detected. The original error was failure to ID the patient properly in the first place when the armband was placed. That is a human failure that can still occur no matter what armband system we all use. That is why we must stress to our employees that they must properly ID every patient every time they have contact.

Hi all,

For those of you using a bar coded version of Typenex or Securline, how do you read and verify the random bar code numbers from bags to patient.  I don't see the relationship between the bar code numbers on the Typenex/Securline product and any way to scan/verify. 

 

Any information you could provide would be really helpful.  Please reply.  Any other comments on this process are welcome.

 

Thanks!  Richard

Our facility has used a separate identification band for patients who are going to be transfused or who may be transfused. This would include patients who come in pre-surgically to have their pre-surgical lab work done. The patient is requested to keep the blood bank identification band on for when they arrive at the hospital for their surgery. We also have an 'infusion center' where patients come in to have infusions as an outpatient procedure-for example, chemotherapy patients who may need blood or platelets. These patients are also required to arrive at the hospital for their procedure with this band on. As inpatients, a blood bank is attached to the patient with their first blood bank order (i.e. type and screen and/or crossmatch) and this band can be used for this patient throughout the admission. If the blood bank specimen expires (72 hours) the patient can be identified for further blood bank testing using this blood bank I.D. number-in this case the blood bank I.D. number is written on the new sample that is drawn. We have very strict rules regarding these bands and who can draw blood bank samples and who can or cannot remove blood bank bands from a patient. Floor personnel and phlebotomists cannot remove a blood bank I.D. band until blood bank is notified. I have worked at this same facility for 35 years now and this system has worked very well for us. We have never had a case of a unit of blood being given to the wrong patient and have never had a 'sentinel event' involving any blood bank issue (mistyping, wrong patient drawn and misidentified etc.) I would really hate to see this method of identification eliminated at our facility just because this extra level of security is considered cumbersome or time consuming. Safety is always the way to go in blood bank as far as I am concerned.

Does your facility have a policy requiring a separate ID band for patients who may require transfusion (Typenex, etc.)?

If you do, and you draw a Pre-Op Type and Screen, do you require the patient to wear the band from the time the sample is drawn until they return for surgery?

Please include the name/location of your facility in your response. Thank you for your help.

 

We have always used a separate BB Armband (Typenex bar code BB Band).  We will be implementing a bedside barcode ID scanning system to print specimen labels at the bedside within the next year; however we are not planning to give up our BB armband when it is implemented, at least not in the foreseeable future.  We use the one band/visit method and require BB Band for all blood products.  Outpatients/pre-op patients are required to keep the band on until they return or will have to be redrawn and retested if they don’t. Sharp HealthCare (6 hospital system), San Diego area, California.

What was the deciding factor that got your group to committ to a fully electronic bedside specimen collection and does it include transfusion verification at bed side?  Might I ask the name of the system you are adopting and is it from the same vendor that is your current LIS?

 

Richard

One more scary story - we've used the additional armband for blood bank samples for years and haven't had a problem until last week.  The transfusing nurse realized the patient didn't have the armband on but chose to transfuse anyway because they needed to "hurry up and infuse FFP so the patient could go to surgery".  Not good - A pos patient received type O plasma, we were lucky and I'm still not sure why the patient didn't have a transfusion reaction.  So, it really does come down to compliance with established policy.