This is a two part question regarding what you are doing with type and screens and the order for the T&S.

 

1) Does your blood bank have extended hold T&S (example 28 day hold)? And for how many days/weeks? If so, is the extended hold only for your pre-op patients?

 

2) If you use EMR for ordering T&S, do you have hard stops in place? For example, must they  answer yes/no/unknown for has the patient been transfused in the last 3 months? Or is the question there and a requirement but no hard stop? Or no question at all?

 

Background is we are looking at changing the EMR order because often this question is not answered. This is causing pre-op samples to become a 3 day sample instead of a extended hold. We have to do a lot of calling/e-mailing to let them know and it's a waste of tech time. I should say that in our current epic order this is not a question but rather a statement which if true one needs to click to highlight (also very confusing and needs to be changed). Since we are looking at changing the order and the length of our extended samples, I was wondering what other places are doing. Thanks!

1. Yes, we do 7 days. It's pretty much just for the pre-op patients. Off the top of my head, we might have used it for individual cases that weren't pre-op related.  The specimen is considered valid for up to 7 days from date of collection (day of collection is day zero) or up to 3 days from date of surgery (day of surgery is zero), whichever is shorter.

 

2. The pre-in statement in regard to 3 months isn't a part of the EMR. We have a paper form that the patient checks off on and signs prior to the specimen collection. This form gets delivered to the transfusion service with the specimen. The tech receiving the specimen selects a canned comment "Yes" or "No" in regard to the pre-in form and we extend the specimen in Meditech as appropriate. We save the forms until a week after their day of surgery and shred them. The person who does daily specimen review also double checks that everything is straight.

Our pre-admit (pre-op) patients specimens are good for 21 days, if not preg/trx in past 3 months. There is a hard stop in Meditech for the pre-op questions. I'm not sure how we are going to handle the new CPOE system and this topic, but for now it is just for inpatients. good luck

Our pre-op specimens are good for 28 days. The question as to whether the patient has been pregnant or transfused in the past 3 months is asked by the pre-op nurse during the pre-op interview and is documented in that database. We rely on Nursing to ask and document this information. We do not get a hard copy of the answer.

Anyone other than pre-op patients, whether they are inpatients or outpatients, regardless of transfusion/pregnancy history, have specimens that outdate in 3 days.

_{Simular her to Goodchild, above.   We extend outdates for pre-admit T&Ss (require patient keeps BB armband on until they come in for procedure).  We have switched to our EMR recently and it currently has no requirements for history--we use paper forms that are submitted to the BB along with the specimens.}

 

_Scott