In our hospital system we currently have 4 sites with active Blood Banks.  In a few months, they are looking to close the lab at one of our sites.  At this particular site, there is an infusion center that probalby tranfsfuses about 100 blood products per month (not to mention an O.R. that utilizes some frozen bone).  I was researching some older posts and saw one that mentioned a pyxis type refrigerator.  Does anyone know what the name of it is?  Wondering if anyone has any experience and/or advise with this type of set up in a non stat setting.  We were thinking of having a BB refrigerator right in the infusion center that we would stock in the AM for the current days patients.   My second issue is the bone freezer that is currently located in the lab at that site.  If we moved it to the O.R. (which makes me cringe)- we can hook up the alarm to security but there is no one in the O.R. on the weekends or holidays so I dont see how they could actually check the temps daily.  Looking for any advise.  Thanks in advance!

We issue blood each morning to a remote refrigerator in our outpatient infusion center. The center is in the same building as our blood bank, but it is minimally staffed so they cannot come pick up blood on each patient as they need them. You are definitely going to have to have some considerable trust in your infusion staff if you do this in the same manner we are, as the units are issued in Meditech in the morning and we know they will be transfused to the correct patient only (they are VERY adamant that they will not transfuse blood if anything is incorrect or questionable), and if something happens they let us know and we pick up any untransfused blood as soon as possible, and it does not stay there after hours. If the patients need platelets, we deliver them as they are needed because they do not have a monitored platelet rocker there.

 

As far as the Pyxis-like fridge -- we also have a Haemonetics blood kiosk in our trauma bay for emergency release/MTP products -- I know Haemonetics offers a system that allows nurses to scan a 'pick up slip' for their patient, then open the fridge and remove a crossmatched unit that was pre-loaded by blood bank and scan the unit label. That might be an option for you.

We have remote Issue fridges. But we have BloodTrack (Neoteric) and as above, pisk-up slip needs to be scanned & fridge only unlocks if there is blood available for the patient. Not cheap, but they have removed a Lab - and it can't be replaced by fresh air. Risk assess any process you have (FMEA is good) & put in systems to mitigate that risk.

 

There are plenty of remote monitoring systems for fridges / freezers as well, with notifying call to landlines, cell phones, pagers etc if there is an out of range temp.

 

Good Luck

 

Eoin

Thank you, I will look into those options.  The site is about 5 miles down the road so my thought was to stock the fridge in the morning and have any unused product returned in the evening.  Not sure what we are going to do about platelets short of getting anothe rocker/incubator.  Its going to make staffing interesting for maintenance checks etc.  especially doing alarm testing in a patient area...cant imagine that will go over well.

Mediware and Haemonetics are the 2 vendors. Install an electronic temperature monitoring system for the freezer and while you are at it put it in your lab so you don't have to take temps every day.  

The Joint Commission won't like the tissue freezer being "unmonitored" on weekends and holidays.  You will have to get an electronic system as Mabel mentioned and have email/phone alerts set so that someone is immediately alerted if the temp is out on weekends.

_{Ah yes...the wireless alarms and temperature monitoring.  We actually do have that in our BB on all freezers and refrigerators (and room temp and platelet incubator).  The O.R. on this campus has it as well.  They will need it for the O.R. on that site and for the infusion center if this whole thing goes through.  Right now, an email alert goes to engineering, lab admin, BB supervisor and security.  I am curious - In the AABB manual it says that daily checks of temp recordings need to be done.  How do you document that?  Just have someone pull up the screen online and initial that they checked it?  Thanks in advance!}

_{Ah yes...the wireless alarms and temperature monitoring.  We actually do have that in our BB on all freezers and refrigerators (and room temp and platelet incubator).  The O.R. on this campus has it as well.  They will need it for the O.R. on that site and for the infusion center if this whole thing goes through.  Right now, an email alert goes to engineering, lab admin, BB supervisor and security.  I am curious - In the AABB manual it says that daily checks of temp recordings need to be done.  How do you document that?  Just have someone pull up the screen online and initial that they checked it?  Thanks in advance!}

One of my techs logs in to our temp monitoring system (TempSys) each day to make sure everything is logged.  When they log in it is time stamped and I could prove to an inspector that our staff monitors it daily.