PO Box 322
Commack, NY 11725
Dear Laboratory Manager:
Do you remember the last useful blood bank performance improvement initiative in your laboratory? . . .
Did it produce a distinct and reproducible benefit for every patient receiving a transfusion of blood or blood product? . . .
Did it save any red cell units from discard? . .
Did it guarantee that every unit received at the bedside was in the same condition as when the blood was released from the blood
Did it guarantee that every unit returned to the blood bank unused, was within the allowable temperature limit? -
As we all know, hospitals are facing a national crisis regarding the use and availability of blood and blood products. Restrictions as to
the source of the collections have pressured blood banks across the country. The medical community has tried to respond by making
efforts to minimize the utilization of blood by strictly setting trigger points for transfusions and working toward avoiding transfusions
Transport-r Inc. offers a practical solution to eliminate the potential for blood wastage during the critical period
prior to the starting of all blood transfusions.
JACHO, CAP, and the various states have been performing unannounced inspections of hospitals and their laboratories, the focus being
patient safety and strict adherence to mandatory identifiers such as name, date of birth, and read-back of critical test results and changes
in patient status.
In addition, these agencies have begun to follow blood units to the patient floors in order to view the entire cycle of blood selection,
preparation, transport, handling on the unit, and finally the transfusion procedure itself.
A concern for all blood bankers is the actual increase in temperature of the blood unit following release from the blood bank during its
transit to the patient unit, handling on the unit, start time of the transfusion itself, and of course the length of time for the completion of
Protect Your Patient . . .
WHAT ARE THE EXPERTS SAYING?
Transport-r Inc. provides a vital package that will assure JACHO, CAP and State Inspectors that blood units are being maintained at
temperatures within the approved guideline of <10 deg C, for a minimum of 1.5 - 2.5 hours and longer, following release from the blood
bank for transfusion start.
In addition to the transport of blood, our transport carriers permit safe transfer and protection of platelets or FFP at room temperature
Answering a question from a reader of CAP Today, Dr. James P. AuBuchon, M.D., former Chair of
Pathology at the Dartmouth-Hitchcock Medical Center in Lebanon, N.H., former Chair of the CAP
Transfusion Resource Committee and now the Director of AABB, pointed out that:
"laboratories performing electronic crossmatching may be performing needless work in
monitoring the C:T ratio, and that monitoring other staff issues may be more productive"
....."how many units released to the patient floor and returned to the blood bank, UNUSED, ......
.....could not be placed into inventory because of the time outside refrigeration."
"The Blood Bank should track the rate, and investigate sources of the problem,.remembering
that the current thirty-minute time limit is very short considering typical internal travel times in
hospitals, concurrent activities on the patient unit, staff indecision as to the transfusion start
because of sudden changes in the patient's condition, and other factors."
Transport-r Inc. has a simple answer for all of the questions listed above...
Your blood unit will be protected through any event that may cause transfusion delay, and when you save and
protect just a few units from wastage in the first year, your costs will be zero ($0.00), by eliminating loss of the
blood units and the re-crossmatching costs of a new unit for replacement. (not taking into account the time and
effort of blood drives, collection teams, administrative costs and laboratory testing prior to making the unit
available for shipment to the hospital).
Conserve the Blood Supply. . .
Dr. AuBuchon's first suggestion for performance improvement was to monitor:
LET'S NOT KID OURSELVES, MOST LABS ARE SO BUSY THAT A PROJECT SUCH AS
MONITORING EVERYONE ELSE'S PROBLEMS, WILL LEAD TO LACK OF ENTHUSIASM,
AND WILL ULTIMATELY FAIL FOR LACK OF PURSEVERANCE WHEN EVERYONE
POINTS TO THE OTHER DEPARTMENT AS THE CAUSE!
REAL ISSUES TO BE CONSIDERED:
1. Currently, how is the crossmatched blood unit transported throughout your hospital to the patient unit?
2. Is it simply carried in a biohazard specimen bag?
3. Is it transported through a tube sytem?
4. Is it carried on public elevators?
5. Where is it placed upon arrival at the Nursing Station?
6. How soon after arrival does the unit get hung and the transfusion started?
7. What occurs if the patient is not immediately ready to accept the transfusion?
8. Suppose the IV drip begins to infiltrate?
9. What occurs if there is a delay caused by a rapidly changing patient's condition?
10. What happens if two transfusionists are not immediately available?1. What is
Transport-r Inc has developed a line of carriers that are lightweight, strong, and are designed to carry your
blood unit and a protective gel pack that has an exceptional capacity for maintaining a low temperature during