We are looking at starting to implement barcodes at the bedside for blood administration. What type of barcode labeling systems are people using and how are they working for your hospitals? Also, in cases of massive transfusions or multiply transfused patients, how are you obtaining enough barcodes to label your units?

Does your HIS/LIS/ and/or BBIS support this function? You don't need barcodes - the blood comes with one and there should be one on your pt id bracelet.

The software is essential. You need it to have the results of BB testing so that when the nurse scans the unit (product code and unit #) and the patient wristband, the software confirms that this unit is crossmatched on this patient, is not outdated etc. If not a full blood administration module as above you still need some sort of logic for your scanners to compare barcodes. If you just put patient barcodes on the units you have crossmatched for the patient then the nurse can scan the patient barcode and the one on the unit, but what tells them whether it is the same or not?

What system are you using? We use BCTA (in Meditech) and if we run out of the barcoded unit labels I print labels for the units on Avery 8167 mailing labels that I either print out on MS Word, or hand write. But for scanning at the bedside, we scan the patient hospital armband, our blood bank barcoded band, then the 4 quadrants of the unit. Works fine as long as the scanners themselves are working correctly.

Hello magnum, what are the different barcodes at 4 quadrants that are scanned.

Thanks.

Yes, check with your LIS. Our LIS, SoftBank, has a hand held blood administration module called SoftID Tx. I saw a demo about a year ago, looks really good. I also understand that Meditech and Sunquest both have something like it.

We use Neoteric BloodTrack, both the manager mode in the lab, hooked to the blood transfusion PDA scanners in the ward. When armbands are produced, it has a 2D barcode (with 3 patient identifiers (name, DOB & medical record number) on it. When blood is issued for the patient, it has a compatibility label, plus a traceability label with all this info on it as well. At blood administration the nurse scans her ID (traceable), the patient 2d barcode (plus usual checks (Now have positive patient identification (PPI), and the unit number) - (variable ypes of barcode language can be used). It will then issue a GOOD visual and audible confirmation. By the way, they would only have got this far if when they scanned their ID, the patient barcode on the pick-up slip at a kiosk at the Issue Fridge and if there is blood for that patient, the door unlocks and they then choose the unit for the patient and scan the unit number. Again they will get the GOOD audible and visual signals. If it fails set rules (e,g, outside 72 hrs if previous units, unit has been out for of controlled refrigeration for more than 30 mins previously, wrong unit (wrong patient) or older unit in the fridge for that patient).

We like it, the nurses like it - we consider it worth the money.

Good luck with it

Eoin

Hello magnum, what are the different barcodes at 4 quadrants that are scanned.

Thanks.

They are in order of Unit number, product, type, and exp date.

Is there anyone out there NOT using a separate blood bank armband system, and if so, how does your process work from specimen draw to transfusion? We are about to begin a new LIS project for our entire lab and are considering various process changes. We currently use a typenex band and require a sticker on the the transfusion pick-up slip prior to issuing blood. We anticipate changing to the barcoded armbands, but we were questioned about having a separate blood bank armband at all. (almost heresy to this old-timer blood banker!) Thanks for your comments.

We still use a BB armband even though we have barcoded wristbands on all patients. (We do not yet have software for nurses to scan the wristband and the unit and record the transfusion.) We find that there are too many "workarounds" to using the barcoded wristbands. When we rolled it out with the new LIS/HIS it had some problems for the phlebs so they developed work arounds. They also intended to use it for nurses that draw in ICU but that went so poorly with the handhelds that they took it away from them. Yet the software is still set as though they draw using the scanners. As I understand, the workaround for line draws is for the phleb to scan the patient's band, print the labels for the tests, hang them on the patient's door for the nurse to grab when she draws the blood. This pretty much goes around the intent of barcoded wristbands. Nothing will work well unless everyone does it right and is convinced of its value. If the equipment is percieved as wasting time or steps people will find ways around it so make sure it has been proven to work well elsewhere and everyone is well trained so they don't get too frustrated with it.