Hi ,

I am interested to know how other blood banks deal with duplicate requests being received into the lab. For instance if there is a valid group & screen or cross- match sample in the lab and a further sample is received , how would the second sample be dealt with?

Many thanks

We send out a 'comm' set with

 

Sample receieved on xx/xx/xxxx and valid until xx:xx on xx/xx/xxxx, duplicate samples are unecessary and may create delays in the provision of blood

 

As we do EI, duplicate sample can prevent this

They are just cancelled as 'acceptable sample in lab'. Although if the sample is sent the day the previous sample is going to expire, we call to see if the patient is going to the OR late or if they will be transfusing early the next day and then make a decision on whether to cancel or process.

As long as the original specimen is still valid we add units to the original sample order and cancel the new order with a comment that testing was added to previous specimen. We also ABO retype the original specimen and this testing is added to the original order as well.

Thanks,

We are now being asked to process every sample received into the department even if we receive multiple requests for the same patient on the same day and I am struggling to see the logic in this.

NANA47, I would presume that the person who is telling you to do this is trying to cater for those extremely rare patients who have multiple BMT's on the same day!!!!!!!!!!!!!!!!!!

 

 

Thanks,

We are now being asked to process every sample received into the department even if we receive multiple requests for the same patient on the same day and I am struggling to see the logic in this.

You may not get reimbursed for duplicate testing.  

Edited October 28, 201311 yr by R1R2

I agree with R1R2. Our policy is the same as Justina's and KAPMT. I am meeting with my boss this week to discuss a quality project on this very issue. We have many doctors who do not look for completed Type and Screen and crossmatch orders and order unnecessary tests and blood products all the time.

We have the same problem with patients that are admitted from the ED.  We notify the nursing unit that the order that they entered is a duplicate and they will take it out of the system.  I don't like for us to take it out of the computer.  It could lead to the lab being accused of taking out patient orders without nofocation and it also provides a nice audit trail.

Our computer system automatically cancels them as duplicates without our intervention.  The only time we would do this is if the specimen was nearing expiration and the patient is headed for OR or is actively bleeding.

They are entered into the system as a JIC - Pink BB tube. They are kept in Processing; not delivered into the Blood Bank. That way, if for any reason they are needed, we can "see" them in our LIS.

Our system automatically cancels them, as well.  The phlebotomy team does not even receive an order to draw.

We are small enough (230 beds) that the floors simply call us to see if a patient needs to be drawn, which then avoids the whole issue of duplicate or unnecessary specimens. I know, the info is readily available in the computer, but it can be complicated by the "good for 3 days unless not pregnant/transfused in the last 3 months......" use of old specimens. So we spend a couple of seconds browsing then tell them yes or no for the draw. Volume is low enough that it's not really an inconvenience.

 

We also use a "JIC" test just like jlmoses for some ED and preop draws so you can see them in the LIS.

If only we would get these calls! I cannot tell you how many duplicates get ordered here.