hello, i have a question for anyone who may be able to help. A recent request at my facility to transfuse a patient using a blood bank sample drawn and tested from another facility was posed to my supervisor. To my knowledge any patient drawn for a type and screen and an order for blood transfusion must be completed by the testing facility only, unless a reference lab is needed. This poses a serious issue of using the correct specimen for a crossmatch and identifiying the patient using a facility-specific medical record number. I have looked through the seventh edition of the AABB reference manual and have not found anything specific to my question. Has anyone else experienced this methodology and can a policy/procedure be created that would not contraindicate the AABB standards of practice?

            We often transfer a patient to the larger hospital in our system that has had a type and screen completed here. They will get their own specimen and would never use ours. I know we would not accept a specimen from another facility. I would do an emergency release first. I agree that specimen identification would be a big danger. I would think that you could say no just as a patient safety issue or do an emergency release if the blood is needed that quickly. That way the Blood Bank would be covered is anything happens.

We are a community hospital and  frequently transfer patients to a larger facility.  We also have had issues with dialysis patient's needing a blood transfusion during dialysis where there sample has been collected at another facility.  We do not crossmatch or transfuse blood from a sample that has not been collected within our hospital system governed by our patient identification and labeling policies.   The  larger hospital where our patients are transferred does not crossmatch or transfuse based on any tube we have collected at our facility.  There is far too much risk in patient safety in my opinion when you loose control over collection and identification of the patient.

We have a policy that forbids transfusion based on a specimen collected at another facility. If a patient is transferred to us with blood, we send the remaining units back to the hospital it came from if we can (their stock is usually much less than ours) and collect our own specimen. If the units are antigen screened/autologous/directed I would use them, but only after collection of a new specimen and appropriate testing. This is included in nursing policy as well. The ED is pretty good about calling and asking what they are supposed to do with incoming boxes of blood. If they unit is running when the patient arrives, the infusion is completed. This seems to be standard policy for the larger facilities that we transfer patients to as well, though they do not accept transferred blood products into their inventory.

We accept certain T&S specimens (for later transfusion or as a pre-admit) from other facilities, but only if they are drawn and the patient correctly identified with documentation that links the specimen to the patient based on our protocols.

Like most hospitals, we will give universal donor no matter what other specimen or history we have, never using a specimen drawn somewhere else.

Scott

I want to preface the following remarks by saying that I am, or at least spent over 35 years, a blood banker in various capacities.  I am one of you. 

Blood bankers, with good reason, can generally be described as untrusting to the point of paranoia.  No one can do the job as well as we can and that includes other blood bankers.  I have never known one of us who would willingly trust a sample drawn at another facility.  It's hard enough to trust our own phlebotomy staff!  I don't even want to get into nurse draws!  We are this way because we understand the potential dangers and in all honesty most of this comes from a true concern for patients we never personally see.  I had one staff member quit a blood bank day shift to work as a generalist on the night shift because she was convinced that the use of the new automated analyzer would result in the death of all of her patients because she would not personally be doing the testing.  Granted that's a little extreme but it is an example.  

So to answer the original question of this thread, I am fairly confident you will find little or no support for "using a blood bank sample drawn and tested from another facility".

We are a system of 4 hospitals and we collect a new specimen when the patient is transferred to the bigger site.  We use a blood bank banding system and the ED is instructed to cut off all bands a patient comes in with so that would make the original sample unusable by us.  Also, if serologic crossmatches or a transfusion reaction workup are needed, we need a specimen here, at our site.  Besides that, we are not responsible for training and competency of the testing staff at our small hospitals so would not accept responsibility for their work.  We share a computer system so historic blood types count toward electronic crossmatches but we would want the patient ID to be for this facility for the specimen of record.  Many of our transferred patients are emergencies and the logistics of getting a blood bank specimen transferred here in time to be of use for the patient make it pretty much impossible.  We also don't want nurses to start thinking that it is okay if ID numbers etc. on patient bands don't matter in cases like this so they end up ignoring them on other cases when there is an error.  We do allow pre-ops to be drawn at any system draw site because have a consistent phlebotomy competency program across all sites. 

On ‎1‎/‎18‎/‎2018 at 7:52 AM, John C. Staley said:

I want to preface the following remarks by saying that I am, or at least spent over 35 years, a blood banker in various capacities.  I am one of you. 

Blood bankers, with good reason, can generally be described as untrusting to the point of paranoia.  No one can do the job as well as we can and that includes other blood bankers.  I have never known one of us who would willingly trust a sample drawn at another facility.  It's hard enough to trust our own phlebotomy staff!  I don't even want to get into nurse draws!  We are this way because we understand the potential dangers and in all honesty most of this comes from a true concern for patients we never personally see.  I had one staff member quit a blood bank day shift to work as a generalist on the night shift because she was convinced that the use of the new automated analyzer would result in the death of all of her patients because she would not personally be doing the testing.  Granted that's a little extreme but it is an example.  

So to answer the original question of this thread, I am fairly confident you will find little or no support for "using a blood bank sample drawn and tested from another facility".

John, it's hard to believe that you have to explain who you are after all these years but I guess there are lots of newbies and you aren't on here as much as you were "back in the day."   We've probably been talking online for over 20 years now.  Wow!  Remember Y2K???  We probably hashed that out together online. 

13 hours ago, Mabel Adams said:

John, it's hard to believe that you have to explain who you are after all these years but I guess there are lots of newbies and you aren't on here as much as you were "back in the day."   We've probably been talking online for over 20 years now.  Wow!  Remember Y2K???  We probably hashed that out together online. 

In this day and age it can be very easy to offend people and while I don't mind offending them I just want to make sure they know where I'm coming from.  

Your right Mable, it's been a while.  I've met some great people online and especially here on this site.  Some day I would like to meet you and Malcolm and Cliff, Dave, Ann, Steve and all the rest in person over coffee.  I'll bet the stories would be entertaining.  

i am in for cofee John.

Could it be something stronger than coffee??  But coffee is good too!!

15 hours ago, Likewine99 said:

Could it be something stronger than coffee??  But coffee is good too!!

I'm fairly certain the chat could last well into adult beverage time.  Once that started the stories will get even better!