Hi everyone!! I'm looking for information on blood warmers. Wondering if the blood warmers are kept in blood bank, on the nursing floors, or possibly another location. How is cleaning between use documented? Just wondering how others handle blood warmers. Thanks in advance for all the input!!

Ours are kept on the nursing units where they are used except for one spare in BB. I don't know about cleaning. According to manufacturer's instructions I would guess.

There is software in the BW; the blood doees not (should not) make contact with the device. Nursing/OR has mine and they also have the responsibility for the devices.

The fluid/blood warmers reside in the OR. We never see them down here. BioMed takes care of the quarterly alarm checks and gives me the paperwork for my files.

The fluid/blood warmers reside in the OR. We never see them down here. BioMed takes care of the quarterly alarm checks and gives me the paperwork for my files.

Same here. Do make sure though, that BioMed follows manufacturer's and regulatory standards in their QC protocol and that action is taken for any QC test that falls out of range. Also, I would suggest your medical director be involved in choosing the particular blood warmer rather than letting the OR be the only voice.

We do the alarm QC on all of them for our hospital.

We do the alarm QC on all of them for our hospital.

Way back when, I did too. I was on a weekend rotation at the time, and would go up to the empty OR on a Sunday morning and knock off the quarterly QC. I was doing that one time when an on-call OR tech chanced by and asked what I was doing. I told him and he said, "But we haven't used those warmers in a couple of years! The ones we use now we keep in that room over there."

Way back when, I did too. I was on a weekend rotation at the time, and would go up to the empty OR on a Sunday morning and knock off the quarterly QC. I was doing that one time when an on-call OR tech chanced by and asked what I was doing. I told him and he said, "But we haven't used those warmers in a couple of years! The ones we use now we keep in that room over there."

This can be fairly typical . . . during an inspection I asked to see the pkg insert for the BW is use . . . the directions were for one that was no longer being used . . .

Used & kept in wards and OR. When new ones were ordered, I helped set a protocol for their validation - and let them at it. If pathology doesn't own it - I don't want to know about it, but the Haemovigilance Officer keeps an eye on revalidation checks etc.

Cheers

Eoin

Thanks for all the input! Has an inspector ever asked for documentation that teh blood warmers were cleaned between use? Is this documented? Does anyone have a validation procedure? Also, since most are not stored in the blood bank, do any blood warmers go missing? What happend if biomedical can't find a certain blood warmer and it misses the recommended check time frame for biomedical?

Thanks for all the input! Has an inspector ever asked for documentation that teh blood warmers were cleaned between use? Is this documented? Does anyone have a validation procedure? Also, since most are not stored in the blood bank, do any blood warmers go missing? What happend if biomedical can't find a certain blood warmer and it misses the recommended check time frame for biomedical?

We keep 2 in the Blood Bank. The rest are distributed in critical areas. There is an administrative policy that addresses cleaning of equipment and blood warmers are listed as clean after each patient use by the user. If we issue the blood warmer from blood bank, we clean it upon return (external surfaces), and document it on the cleaning log attached to each warmer.

Clinical Engineering does the maintenance, part of which is cleaning them internally. Hope this helps.

Thanks you everyone for your help!

We keep 2 in the Blood Bank. The rest are distributed in critical areas. There is an administrative policy that addresses cleaning of equipment and blood warmers are listed as clean after each patient use by the user. If we issue the blood warmer from blood bank, we clean it upon return (external surfaces), and document it on the cleaning log attached to each warmer.

Clinical Engineering does the maintenance, part of which is cleaning them internally. Hope this helps.

Why do you keep 2 in the blood bank?

JB

We are the same as Terri and our BioMed guys rock

We keep one in BB as a loaner if others fail QC.

Has there ever been any Blood Warmers that have gone missing and therefore the biomed guys could not test at designated time interval? What is done in this case? do inspectors ever want proof that the blood warmer was cleaned between each use? how is this handled? Thanks!

Has there ever been any Blood Warmers that have gone missing and therefore the biomed guys could not test at designated time interval? What is done in this case? do inspectors ever want proof that the blood warmer was cleaned between each use? how is this handled? Thanks!

We keep 2 in the BB to issue to patients in areas that do not have their own warmer, only a handful of times a year. All the warmers are tagged with biomed ID numbers and are quarterly PM'd. We have a cleaning log attached to each blood warmer that we are in control of, to show it was cleaned between use. Users with their own blood warmer are supposed to clean between each patient use, but I'm not sure if or where it's documented.

When we all get RFID chips to put on all of our equipment so it can be tracked wirelessly throughout the hospital, then you will know where they have stashed your blood warmers--and those pesky migrating wheelchairs.

Be careful because the Joint Commission requires that the actual TEMPERATURE of alarm activation be recorded, not just place a check mark in a box that the alarm activation was done. I believe this is a good requirement to make sure the instrument is warning the user at the proper temperature.

On 6/22/2012 at 7:57 AM, Dr. Pepper said:

Same here. Do make sure though, that BioMed follows manufacturer's and regulatory standards in their QC protocol and that action is taken for any QC test that falls out of range. Also, I would suggest your medical director be involved in choosing the particular blood warmer rather than letting the OR be the only voice.

What are the regulatory standards for checking the temperature alarms and verifying the temperature calibrations on blood warmers?  Our BioMed guy has been doing these checks quarterly but just noticed in the operator's manual that the manufacturer's recommendation is to perform the checks annually.  He asked me if AABB or the Joint Commission had standards for the quarterly checks.  I looked through the AABB standards and TJC QSAs and can't find anything about quarterly checks.

I will stay with the quarterly checks because that is good practice, but wondered if I missed the regulatory standards somewhere.

Thank you!

Catherine

 

On 6/22/2012 at 7:57 AM, Dr. Pepper said:

Same here. Do make sure though, that BioMed follows manufacturer's and regulatory standards in their QC protocol and that action is taken for any QC test that falls out of range. Also, I would suggest your medical director be involved in choosing the particular blood warmer rather than letting the OR be the only voice.

What are the regulatory standards for checking the temperature alarms and verifying the temperature calibrations on blood warmers?  Our BioMed guy has been doing these checks quarterly but just noticed in the operator's manual that the manufacturer's recommendation is to perform the checks annually.  He asked me if AABB or the Joint Commission had standards for the quarterly checks.  I looked through the AABB standards and TJC QSAs and can't find anything about quarterly checks.

I will stay with the quarterly checks because that is good practice, but wondered if I missed the regulatory standards somewhere.

Thank you!

Catherine

 

Our blood warmers are in the OR, ER and on the floors. The area that keeps them/uses them would be responsible for making sure that they are cleaned between use, just as they would IV pumps. Biomed does an annual check and I get a copy of it for each blood warmer (which includes the actual temps for alarms). However, they wouldn't have done the same checks on the new rapid infusers unless I had told them that the same type of checks were needed - apparently no one in nursing thought that the functionality of the devices was something Biomed needed to know about. We have no control or input over what they purchase. In fact we wouldn't know they are getting something new unless I happen to hear about it at some committee meeting or other. They can deal with Joint Commission, not me. I have been asked for the Biomed annual checks by CAP but nothing else. So far so good.

Blood warmers have come up in our Joint Commission inspection. I know this string is old, but I am wondering if folks still have different practices on who maintains blood warmers. Our JC inspector feels that blood warmers should be under the jurisdiction of BB/TS, but I disagree. Although I understand the concept that the Transfusion Medical director has oversight over all things having to do with the blood products, as a tech and blood bank supervisor, I do not feel that I should be responsible for aspects of the infusion process.

The JC standard states that 'All blood warmers must have a warning system to detect malfunctions and prevent damage to cellular components. This system should be checked per manufacturers' specifications.'

The AABB standard states: Warming devices shall be equipped with a temperature-sensing device and a warning system to detect malfunctions and prevent hemolysis or other damage to blood or blood components.

Neither standard dictates WHO should be checking these devices nor at what frequency, other that ensuring that it comply with the manufacturers' recommendations, which for ours, states annually.

Bottom line from the FDA, AABB, TJC, etc. is that the Blood Bank medical director is ultimately responsible for every aspect of the transfusion process from crossmatch specimen to infusion. Actual practice - the Blood Bank lead is going to be responsible for wrangling everything. Job security I guess. Definitely more grey hair.