A philosophical query relating to the use of "BB armbands".  These would be armbands issued and maintained primarily by the Lab.  They would be, in most cases, in addition to a regular hospital armband.

Any comments for or against thier use?  I would be interested in any observations.  Are the put on pre-admit outpatients?  How do you handle it when they are cut off for some reason?  Do you use a scanner to read armbands? etc...

Thanks, Scott

 

I don't know any other way other than using BB armbands for patients who need or may need blood products.

Ours are currently not barcoded but manually checked.

We do put them on pre-admits,  we are not doing extended pre admits. So they aren't wearing them around prior to surgery for very long. 

If they are an In-patient and the arm band needs to be cut they must call the blood bank. We will cut it off and reattach it with a special band to reattach the original info.

If they are out-patient and cut if off, we are starting over.

We recently eliminated the armbands for inpatients, ED and pre IP patients that are drawn at our hospital based draw site.  Nursing is documenting transfusions in the computer now and are scanning the armband and unit of blood.  We use the patient's financial number, which changes with each visit, as one of the identifiers.  This has cut down a lot on mislabeled blood bank tubes.  No more misspelled names, wrong DOB, etc.  If it is cut off, it can be replaced without a problem.  We can also use hematology tubes for subsequent specimens, since they all have the financial number on the label.

For outpatients drawn at other lab sites, we still use a separate band.  These are usually for our outpatient transfusions.  We don't do extended pre-admits either.  if there is an issue with the band when the patient is in the hospital, we would change to the hospital armband and use the financial number, but request a new specimen.

I am not a fan.  We got rid of ours about 4 years ago and are very happy.  They were nothing but problems...nurses and patients cutting them off, requiring too many redraws.

We made the decision to get rid of them when we put other safety mechanisms in place:

• New BB LIS that requires 2 independently drawn blood types before allowing non-type O red cells. 
• Drawing specimens at bedside with barcoding and bedside printing.  No more grabbing the wrong patient's label if you are doing it right.
• Very strict labeling policy with no corrections allowed.  Any mislabeled BB tube is reported to quality team, which monitors them daily and follows up with the nursing directors.

We don't extend the 3-day window for PST samples.  They are drawn at PST and then again on OR day.

 

We use BloodLoc bands/codes.  Admitting will band all admits that get a hospital ID band.  Lab bands preops.  We have very few cases of pts removing the bands - requires a redraw.  Same for clinical staff removal - very rare.  These devices are considered barrier protection - there is no need to obtain another specimen on our patients.  Our experience is that these are a positive component of our transfusion process.

I am about ready to implement blood bank armbands here. So happy to have this finally happen! I have a lot of patients that get drawn the day before as out patients for transfusion the next day so this will put me at ease since they have nothing on them at the time of draw. And help with my preop. The only thing that is up in the air with management is banding the preop patients at the time of the draw and having them wear the band until surgery date. I feel that this is the safest, but also feel that I will have a hard time getting this one approved, along with patietnt satisfaction. What is everyones thoughts on this one? I can have pleb give the band to the patient and they have to return with band, or have band placed on chart so when they return it gets placed on patient then. I am also extending our expiration date/time of specimens during this change, but have not picked one yet. Thinking 28 days (just so is a nice 4 weeks, easier to see on calender in my mind) if the patient has not received blood products or not been pregnant in last 3 months. It looks like my preop blood work is being drawn 3 weeks before at this time. What is everyone's expiration date for No patients? I need to make sure the questions are being asked, so that is the next tasks in all this.

I'm pretty much in line with David's plan. We use the Final Check lock system and band. We lose very few bands, usually a new nursing staff member, and they won't make that mistake twice - nursing is very proactive with education.

If a patient is drawn as a preadmit, they get an ID card which goes home with them. We hold the corresponding band in Blood Bank. Once they are admitted, preop is supposed to call us and we swap the ID card for the band. The downside to that is that preop may fail to notify us that the patient has been admitted (patient's rarely forget their ID cards). Every time preop goes through a cycle of new employees, we lose some IDs and specimens. In the past we had a lot of patients drawn for PAT work so the preop staff saw a lot of the ID cards. They knew what they needed to do. The process worked very well. Currently our surgeons refuse to use the PAT process for the most part, so staff sees the card only on rare occasion - not hard to see why there are problems. Still working on that.

We do not use extra BB armbands here.  We use the hospital armband for patient ID.  Phlebotomy is done primarily by the lab (MLA) and almost all is done using a bedside scanner/label system (Mobilab), which has drastically reduced patient ID errors.  I am hoping, in the near future, that we will be moving onto electronic XM which will then include a 2 blood group policy as well.

That being said... many years ago I worked with at a place that used Tympanex armbands.  It was before the LIS (the horror!!!) and in a situation where many people had the same name and hospital fraud was rampant.  It worked well.  Would I want it now?  No way.

s

We do exactly as Terri Bostock except that we use the MR# which does not change with each admission.  This also also allows us to use hematology tubes when needed.

We use BB armbands that are placed on all inpatients at the time the blood bank specimen is collected.  Our specimen labels print with a label for the tube and a matching label for the armband.  Unfortunately, we receive several specimens where the armband was not placed on the patient (even though 2 people are supposed to double check that).  Then we start over.  If the armband gets removed for any reason and the blood bank was not involved, we start over.  We do not place them on presurgical patients because we are going to do a new type and screen day of surgery.  That is when the armband will be placed.  OP that come in day before transfusion are asked to keep their armband on.

We have had barcode armbanding in the budget for about 5 years and it keeps getting pushed back.  My last employer (a much smaller community based hospital) had Mobilab and it was awesome!  My personal opinion is BB armbands are no safer than using the regular armband for ID.  At that point, it is still up to humans to ensure things are right