Can anyone give me a verifiable reference to justify doing away with those pesky ABO confirmation labels? I am trying to plead a case desperately. By the way, Our LIS will not allow dispensing of a unit that was not reconfirmed. Looking forward to your responses.

I'm not aware of any standard or regulation that requires a unit to have an ABO confirmation sticker displayed.  That being said, maybe there is some history at your facility, perhaps this was a process improvement to ensure that all units would be confirmed prior to selection and crossmatching.  I would also think that whoever wrote your SOP should be able to share why it is the way it is.  And to address that the LIS will not allow a unit to be issued; I'm guessing you have a validation to show that if a unit is not ABO confirmed and crossmatched to a patient that it won't be allowed to be issued.  With all that information you can make the correct decision for your facility.  

I think those pesky labels are a "left over" from a time before we had LIS's. 

Edited June 29, 20169 yr by R1R2

I am pretty sure no one uses those anymore.  As was pointed out, if your BB system is allowing units to be further tested for patients or released from inventory, they must of had tested typings entered in.  I can't believe there is a standard that would require this type of "confirmation" labeling if you are using a computer system to log routine unit typings.

Scott

Oh they get used!  We don't use the electronic XM yet.  But, we need confirmed units for emergency XM.  So we use the labels to ID the bags that have been retyped. 

Thanks for the post!  When I finally do get around to setting up and validating the EXM I'll know we don't need to keep labeling!

s

This  may be from before my time as a blood banker...

 

You're putting a sticker on the unit after its been ABO confirmed at your facility ?

We do not use a sticker either, we did away with it many years ago when we got our LIS system. The LIS will not allow units to be used that have not been confirmed.

We confirm type our units when we receive them from our supplier. While in the process, the units are NOT put on the shelves with units that have already been confirmed. That way no one accidentally grabs them to use ahead of time.

We still use the labels even though we've had an LIS which prevents release of un-typed units for two decades, our blood supplier already double types them, and we keep unprocessed units in an entirely different refrigerator. Anytime I discuss getting rid of them there's intense fear and paranoia. "What if there's a downtime? How will people know the units on the shelf are REALLY retyped?"

I'm hoping to hear from more incredulous people who didn't even know others still used them to inspire me to forge ahead and suffer the backlash.

Edited July 1, 20169 yr by goodchild

On ‎6‎/‎29‎/‎2016 at 4:35 AM, BBQuality said:

Can anyone give me a verifiable reference to justify doing away with those pesky ABO confirmation labels? I am trying to plead a case desperately. By the way, Our LIS will not allow dispensing of a unit that was not reconfirmed. Looking forward to your responses.

If you confirm types in you BBIS then there is no need for further labeling.  I don't think that in 40+ yrs in blood banking that I've ever working in a place that used the retype labels (information system or not)

I certainly appreciate everyone's feedback. Old habits are so hard to break and some techs are so nervous about this change. You would think it would be a relief given that over 2000 units a month are transfused! 

We have a shelf labeled "Blood Received Shelf"  As we get the blood in from our supplier it goes on this shelf.   After we bring it in our system and retype it the blood will go on its respective shelf.

I've been doing this for 7 years (not very long in the grand scheme of things) but I've never seen or heard of ABO confirmation stickers! 

Same as jalomahe. We do keep a small supply of labels to use when our computer system is down for an extended time and we need to show that units received into our Blood Bank have had the ABO/Rh confirmed.

We did away with those well over 15 years ago.  I agree with David and your LIS is doing the work for you.

List out the cost of those labels, even if they are a penny apiece, 2000/month, times 12 months, woo hoo $$$

These labels just add to the cost of getting the blood out the door, not to mention the time it takes to put them on and take them off of units.

The time for change is now!  Go for it, 2 weeks after you make the change they will all be saying, "what retype labels"  

 

 

If you are AABB accredited it is one less label to keep track of.

We still use the labels - no LIS. No label, no issue is the rule here even with a shelf to quarantine unprocessed blood. Once we are up on an LIS (hopefully next year ), we'll readdress the issue.

As long as you have a process of segregating unprocessed units, i do not see a reason to keep this in stock for once in a blue downtime!

Eventhough your LIS is down, if you have a way to segregate units, there should not be a reason that some one will pick unconfirmed unit. 

We haven't used the confirmation labels in  20+ yrs.  When we log the units into our LIS system, a retype is ordered and we do retypes at that time.  We have a shelf that we have reserved for these units if we aren't able to get to them right away.  Our SOP reflects that.  Meditech will not allow a crossmatch on units w/o a retype.

We stopped using ABO Rh confirmation label; with LIS in hand and shelving unconfirmed and confirmed RBCs in different refrigerator, we found confirmation label was redundant. Confirmation label rather adds unnecessary costs and labor; however, the inception of this process was uphill task. 

20 hours ago, macarton said:

We haven't used the confirmation labels in  20+ yrs.  When we log the units into our LIS system, a retype is ordered and we do retypes at that time.  We have a shelf that we have reserved for these units if we aren't able to get to them right away.  Our SOP reflects that.  Meditech will not allow a crossmatch on units w/o a retype.

Good morning!  Just curious.  It is set up so Meditech won't allow ANY type of XM without a retype?  Not just an EXM? 

s

We do keep unconfirmed units separate, usually in the bag they came in.  But we do put stickers on them-little round green Avery stickers , 3/4", and our SOP reflects that.  Our computer will also not let us use an unconfirmed unit.

AuntiS, our units go to a status of ENT until the retype is done, then goes to available.  Any antigen types it goes back to ENT.  Unless it is at status AVA, you can't use it.

On 7/8/2016 at 2:19 PM, macarton said:

AuntiS, our units go to a status of ENT until the retype is done, then goes to available.  Any antigen types it goes back to ENT.  Unless it is at status AVA, you can't use it.

Thanks!  We don't use the EXM yet here in our lab (it's on my long To Do List).  When we enter the units in they are at AVA status.  I guess you can set it up any way you like.  

So... do you retype all your units (which, I assume must have been done already by the supplier??? I'm in Canada, so I don't really know how that works in the US) and then perform an IS XM as well?  Or do you use the EXM?  Seems like a lot of extra work if no EXM.  

We do the same as mollyredone.  Little yellow dots to identify the units that have been retyped.  We use them any time we issue blood without a XM.

s

Wish we had electronic XM.  We do A, B, on Rh pos units, A, B, D, on Rh neg, no wk D

We remove a donor unit number label from back of bag and affix to base of donor tubing inlet on the front of the bag.  This visually identifies that unit ABO/Rh has been serologically confirmed (in case of Meditech downtime). 

In Meditech C/S 5.nn, crossmatch results (serologic or electronic) cannot be entered on a unit if ABO/Rh serological confirmation test results have not been saved and filed.