Laboratory Medicine Updates - April 21, 2008
University of Virginia Health System
"Quality You Expect, Service You Deserve"
LABORATORY MEDICINE UPDATE
April 21, 2008
New Urine Cups Now Available in Hospital Storeroom
Urine cups provided by the Hospital Storeroom are now being purchased from a new vendor (Power). In testing during the selection process, these were shown to be sturdier and less prone to leaking than the older model (white metal cap). However, to insure no leaking, the caps of the new cups must be tightened completely. Please tighten one click past the initial point of resistance and be sure that the "sterile strip" label and the patient label are not between the cap and the cup.
Testing for Clostridium difficile Toxin A and B
Testing for Clostridium difficile Toxin A and B is now performed 7 days per week, one run per day by the Clinical Microbiology Division. The test will not be performed on formed stool and only one sample per patient per 24 hours will be tested.
Updated Medical Laboratories Web-site
The Medical Laboratory Website at www.healthsystem.virginia.edu/pub/medlabs has been redesigned and updated to include the most up to date information on laboratory testing. The Lab Handbook portion of the site details all orderable tests, general lab policies, individual laboratory details, contact information, and other valuable information. Other sections provide information such as archived Laboratory Medicine Updates, the Clinical Trials Program, Requisitions, and the Laboratory Compliance Program (login required).
There is a direct link to the website from Centricity/Carecast on the left side of the main screen (UVA Laboratory Manual).
Consults Now Provided for New Antibody Detection
The Blood Bank and Transfusion Medicine Service now automatically
provides a consultation for all patients who develop red cell
antibodies. Clinicians will receive a written report that
specifies the antibody or antibodies identified, their clinical
significance, and the degree of difficulty in obtaining compatible
units. Any questions can be directed to the blood bank physician
on call at PIC#1426.
Blood/Blood Product Transfusion: Joint Commission Preparedness Reminder
Reminder: Always keep all copies of pink slip (transfusion record tag) attached to blood/blood product units until transfusion is completed.
Reminder: Always verify the presence of a consent for transfusion in the chart and check the pink slip consent box prior to starting transfusion.
Reminder related to Emergent Situations:
The only acceptable reason to proceed with a transfusion when a blood/blood product consent is not present is when the patient is incapable of making an informed decision (e.g. unconscious trauma patient unaccompanied by family) and a delay in transfusing would cause adverse patient outcomes.
Such emergencies must be documented by the physician in the patient's chart along with a statement that harm from failure to treat is imminent. (Reference: Medical Center Policy # 0024)
New for Nursing Staff: If no transfusion consent is present, document the reason on the pink slip below the consent check box (e.g. Emergency trauma patient unable to give consent). This should be on very rare occasions.
New for Nurse Managers: Any pink slips with "No" consent checked must have a reason documented below the consent check box and these should be returned to the Blood Bank (Attention: Annette Haines) via inter-departmental mail at the time you conduct your pink slip audits.
Blood Bank Armband Number Update
During the month of May, the Blood Bank will discontinue the process of placing an actual label from the patient's Typenex armband on the transfusion slip for red cells. The location of the preprinted Typenex armband number will be moved to the space just below the patient name to make it easier to locate.
Although the red/yellow sticker will be missing, the Typenex letters/numbers must still be checked against the patient's current armband prior to transfusion. See illustration below:
New Location of Armband # is marked below in blue:
New ISBT 128 Labeling for Blood Products Beginning 1 May 2008
On May 1st 2008 the Blood Bank will implement a new labeling and barcoding information system developed by the International Society for Blood Transfusion called ISBT 128. This new system creates a standardized data structure for barcode and electronic data exchange, and it creates a method for providing a unique donor identification number for every unit of blood donated internationally every 100 years.
The major differences between Codabar (the current labeling system) and ISBT128 (the new labeling system) are as follows:
- Blood product labels will be printed in Black and White only.
- The unit number or Donor Identification Number - DIN will be 13 digits long. This donor number must be recorded in its entirety whenever manual documentation is made. Because of a limitation of our laboratory computer system, partial units and aliquots will still be given slash numbers for the near future. (e.g. W0876 08 000010/2) Please assure there is space for AT LEAST 15 DIGITS on any form where the donor number must be recorded manually.
- Location of the Expiration Date and Time has been moved to the lower right quadrant of the blood product label, below the ABO/Rh label.
- Product Code will now include the component type and product description, as well as divisions and/or splits. Autologous, Designated, and Volunteer Donor types are also part of this code.
Please contact the Blood Bank at 924-2273, or e-mail firstname.lastname@example.org with comments or questions.