On July 5th, Tom Lash, one of our CBBS e-Network members, requested your help. He was looking for a video to be used for RN's to view that would impress upon them the importance of drawing and properly labeling samples sent to the Blood Bank for pretransfusion testing and the importance of checking to make sure the patient's ID is verified before transfusion of blood products. This request came to Tom from a worried Blood Bank manager who was having difficulty with nurses drawing the wrong samples and hanging blood on the wrong patients. The manager felt that a video would help to educate the nurses to do a better job. Here is the feedback that the e-Network provided to Tom.

1. Please contact a lab manager at a Kaiser Permanente Hospital. That organization has all kinds of videos that may help. The manager can put him in touch with the right person within the organization.

2. A hospital transfusion service has had success using a blood drawing identification system that has a unique number tied to a crossmatch sample and a patient wristband. Absolutely no exceptions are allowed. If a sample identification is not complete and transfusion is extremely urgent, uncrossmatched O neg blood is issued. RNs and anesthesiologists get very angry that they have to redraw a patient, but only rarely is it really necessary to issue O neg units. For the recipient identification part of the procedure: periodically a blood administration audit is conducted where an auditor follows the unit from issue to the start of the transfusion and checks off a detailed checklist of each step of the SOP i.e.. issue form identification, unit label, patient identification (name, hospital number, unique ID number), temperature and blood pressure of recipient etc. This seems to be a very good educational tool as well as an audit. It is also very helpful to have a nursing administrator be a part of the audit process.

3. ASCP has a video "Blood Collection: Special Procedures" (26 min.) which covers collecting samples for transfusion. The tape was made in the early 90's. Please contact Maddie Josephs at Community College of Rhode Island, Lincoln Campus. (This video may no longer be available.)

4. Several individuals suggested that Linda Chambers, MD might have a copy of a video that addressed the issues. Linda can be reached via the American National Red Cross Blood Services.

ADDENDA Aug 11, 2000)

5. From Tom Lash: "I received a video entitled 'Preventing Fatal Transfusion Reactions' from Kay Elliott recently. It is a five-minute video that does a fair job of bringing to mind the major considerations in transfusing the proper patient with the proper unit. Martha Pascual of the West Los Angeles VA hospital now has the video and is satisfied with its content. She feels this video will address the need that initiated this query.

6. Also, a multimedia department has authored a computer-based training (CBT) program concerning administration of blood. The training program is said to be a very interactive program that has been well received at selected conferences over the past year and a half. At a recent JCAHO inspection, the institution presented this CBT to the survey group as a part of their Performance Improvement "show and tell". This program received major positive attention from the survey team, particularly the physician. If you would like more information, please contact Sherry Haizlip, Clinical Manager - Learning Center, Medical Center of Central Georgia in Macon, GA.

Please submit comments to the e-Network Forum.

Ira A. Shulman, MD
CBBS e-Network Forum Editor & Moderator