I would like to get input to see how many of you are still using a separate blood bank armband and how many have gotten rid of them. For those of you who do not use a separate blood bank band, what is your process for obtaining positive patient identification and labeling of pre-transfusion specimens? Thanks.

 

We use them.  No plans to drop them.  There are just too many problems relying on the chart-label armbands for patient ID.

Scott

We use them; no plans to stop

Our system dropped them 5+ years ago.   We were and continue doing 2 samples for ABO Rh and electronic crossmatch.  Our process for positive patient ID is 3 identifiers and labeling in the presence of the patient.

We use them with no plans to stop. We also get a second sample for non-Group O patients that are not emergent.

We use TYPENEX and have no plans to discontinue.  The TYPENEX code is an integral part of the process of obtaining the initial blood sample, the second blood sample (if indicated) and blood issue.  The code is entered in the computer initially upon receipt/collection, pretransfusion testing and at the time of blood issue.  Cross checking of the number is done by computer and all codes must match before testing can be filed/verified and before blood issue routine can be completed in computer.

We do not use them.  We require two blood groups before transfusion (or given O).  Positive patient identification (Mobilab) is used here at our hospital.  We are lucky - PPI with majority of blood collected by MLA).

Is there such a process that is called "tagless" ? We have been requested to investigate such a topic however I can't find anything on Google or Bing regarding this topic....Any suggestions, ideas?

 

I fought against using a blood bank specific armband my entire career.  In the two 300+ bed hospitals where I was the Blood Bank / Transfusion Service supervisor spanning 25+ years, both utilized the armband system from a company named Biologics.  Their armband system was a plastic armband with a sleeve.  There was a small plastic tag that was embossed with all pertinent patient information at the time of admission.  This tag was attached to the armband and stored in the sleeve.  The company supplied a hand held label maker which utilized the plastic tag to make labels with the patient information which was utilized by all hospital departments including lab and blood bank.  The arm band and tag was attached to the patient at the time of admission.  The only time we had problems was when a patient borrowed someone else's medicaid card and lied during the admission process.  This system was simple and worked very well.  I'm not sure if it is still available but I imagine it is with all the upgraded technological bells and whistles invented since I last used it.  I hope I painted the picture well enough for anyone to be able to visualize it.  

24 minutes ago, John C. Staley said:

I fought against using a blood bank specific armband my entire career.  In the two 300+ bed hospitals where I was the Blood Bank / Transfusion Service supervisor spanning 25+ years, both utilized the armband system from a company named Biologics.  

John,

I used the same system, Biologics, Inc, out of Utah.  The beauty of this system was that all samples collected by the phlebotomists were labeled with this system.  Secondly, the specimen container labels could only be made at the bedside and that the information on the label was generated from a plastic tag (attached to the patient) that was embossed with patient information.  This was a mechanical system that has now been mimicked by electronic systems that generate specimen container label from a barcode on the patient wristband.

With this type of system, mechanical or electronic, there is no need for a secondary blood bank identification band.

We got rid of them 5 years ago when we implemented our new BBLIS and started requiring a confirmatory ABO and using electronic crossmatching. We prefer the confirmatory ABO to blood bank bands. We require the phlebotomists ID to be written on all pre-transfusion specimens. We are happy with our system and its working well.

We use them both at time of draw and time of issue.

We've never had a separate blood bank band.

We are using the FinalCheck armband and lock system.

We use handheld devices to scan armbands/ID patients at bedside. Labels for specimens are printed at bedside and only lab draws blood bank specimens. Blood products are administered with BPAM, nurses have to scan the armband at bedside to ID the patient and 'match' it with the unit.  With all that in place, we are not going to discontinue using FinalCheck band and locks. There are always some creative folks out there who don't think their little shortcut is a problem. I don't need more gray hair from thinking about scary things like that.

We still use them and have no plans to discontinue

We use Blood Bank arm band and have no plans to discontinue.  We also require ABO retype if our patient does not have historical blood type and is not type "O"

 We use them and do not plan to discontinue.

Too many reasons why!

One wristband for gen lab and BB with 3 identifiers; full legal name, dob, and MR#. We do have a 2nd sample drawn at either a separate time or several phlebotomist. We also have a system called medacopia which I don't know exactly how it works but it involves scanning the wrist band and this machine where the labels for the labs are printed.

We dropped when we switched to Epic Beaker for the LIS.  It has the scanning capability for positive patient ID and bedside label printing.  We also need two samples collected at separate times before giving type specific red cells,  We were the last health system (out of a total of 5) in our area to stop using a separate Blood Bank band.

For those of you who still use the Blood Bank armband.  Can you give examples of how the Blood Bank banding system has stopped patient identification errors?  Thank you in advance for your input

Wrong patient drawn for the crossmatch, armband placed when the specimen was drawn (WBIT). Crossmatch performed using specimen. Nurse gets ready to transfuse correct patient, can't unlock FinalCheck lock with code from correct patient's armband. The lock won't open because the specimen used for the crossmatch came from a different patient. The code that will unlock the FinalCheck lock is on the wrong patient's wrist. Electronic ID is used for blood administration, but that isn't going to stop this scenario.

We do use electronic patient ID for specimen collection, but it is still possible to get WBIT if the phleb doesn't play by the rules when collecting the specimen. One thing we have seen on rare occasion, usually with an inexperienced phleb, is when the phleb pre-prints the labels after scanning the patient's ID band (they aren't supposed to, but it has happened), fails to obtain the specimen, does not discard the labels and goes to the next patient. Those pre-printed labels get used to label the next patient. This has never happened with a Blood Bank specimen that we know of, but it could.

 

Here, a patient cannot be transfused without a BB armband, nor can blood be released from the BB without a paper requisition that has the patient's armband number (taken from the BB armband at bedside).

Recently we had a nurse call up when they were ready to transfuse a patient in ER.  She thought the T&S and XM was done, but the patient did not  have a BB armband.  This was a mistake by a phlebotomist.  She had gone down to draw the T&S, was handed labels for more tests when she got down there, and drew the patient listed on the new labels.  The problem here was that the patient on the new labels was not the same as the patient on the XM order.

In the BB, because we will not transfuse a patient without a BB armband, we had the patient for the XM redrawn.  That's when we realized the first draw was wrong, as the first specimen (the incorrectly labeled one) had atypical antibodies but the second did not (They were both O Pos).

Without the strict BB armband policies, the first patient would have been transfused based on testing from another patient.

Scott