We have a hospital system with two campuses about five miles apart. Each campus has its own blood bank under its lab's own CAP number, but there is one manager and one director (me) over both blood banks. Patients are frequently transferred from one campus to another. In some cases, blood products have been crossmatched or otherwise assigned for transfusion, but not yet transfused, at time of transfer. We have required that when a patient is transferred from campus A to campus B, their assigned blood products are sent with them only if they are "hanging" (being transfused) at the time. Any other units being held for them are de-assigned, and the patient is redrawn for compatibility testing at campus B.
I'm not sure what the regulatory requirements are. CAP staff was characteristically delphic when our manager called. We called other hospitals nearby, and they do what we do. Our nursing staff is complaining that the patient has to be redrawn and retested after transfer, and this is redundant, since we have already prepared the units at campus A. I would like to not repeat testing, and instead send the assigned products over with the patient, but I know that blood bank rules are insane and defy logic. Any suggestions?
Ed Uthman, MD
Pathologist, Houston/Richmond, Texas, USA
YouTube Channel: http://www.youtube.com/user/euthman
Date: Fri, 17 Apr 2015
I'd transfer the blood products and, if you
do not share a computer system (which would make the issue moot, so I'm assuming
you do not), the compatibility testing records for those transferred units
(perhaps a screen dump or printout). If you use the same techniques and general
approach, I see no rational reason for repeating the work.
If you share a computer system (Wyndgate and Soft, as we do with a sister hospital), the patients and compatibility records are identical and there is no need for retesting. It's obviously suboptimal patient care to redraw patients who do not need to be redrawn, and a waste of everyone's time, energy and resources.
Blood Bank rules are made to protect patients, not for mindless bureaucracy (one hopes), so as long as you document that the i's have been dotted and the t's crossed sufficiently to protect the patient, you're golden, in my view. Do the right thing rather than what some possibly arbitrary not very nuanced regulatory or accreditation inspector suggests. You can quote me on that :).
Hope this helps,