Blood bank test orders as “add-ons”

A Blood Bank System Supervisor with extensive experience recently began managing a transfusion service that routinely allows providers to “add-on” blood bank testing to an existing sample drawn for CBC testing. She states that the lab uses a collection system that captures the sample phlebotomist and date collected. In addition, their policy is that all tubes are labeled with two independent identifiers and the tubes are labeled at the bedside. Once a sample is tested by blood bank, the sample is retained in blood bank.

The Supervisor and her medical director want to discontinue this “add-on” policy and require a separate blood bank sample be drawn, but since all AABB Standards (5.11) appear to be fulfilled, they are not sure what objections can be raised other than their discomfort with the practice. The supervisor notes that she has worked in multiple hospitals and performs CAP and AABB assessments and has never seen blood bank orders being done routinely as add-on testing. She asks, are there any ideas as to how to persuade other managers and the laboratory director to discontinue this practice?

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