Ensuring timely completion of type and screen testing and the verification of ABO/Rh status for elective surgical patients.
BACKGROUND
A blood bank can provide compatible blood for an elective surgical procedure, provided a blood sample is received by the laboratory with sufficient time to allow pretransfusion testing and acquire enough compatible red blood cell units. With the push for same-day admission surgical procedures, a patient's pretransfusion blood sample is often collected the morning of surgery. However, if blood is needed, compatible units might not be immediately available.


OBJECTIVE
To define and improve the process of completing presurgical/preadmission type and screen testing and verifying the ABO/Rh status of scheduled surgical patients before they receive a transfusion.


METHODS
A list of surgical procedures that might necessitate blood transfusion was created. A checklist was used to ensure that the preoperative clinic nurse collects a baseline pretransfusion blood sample for type and screen testing from patients scheduled for a listed procedure. A new pretransfusion specimen was received on the day of surgery, if needed, so that a current specimen would be available for compatibility testing and to verify the accuracy of the patient's ABO/Rh status in case blood was requested.


RESULTS
During the 1-year study period, 666 patients qualified for baseline type and screen testing. Cholecystectomy was the most commonly scheduled surgery. In 99% of cases, a baseline type and screen specimen was received in the laboratory at least 1 day before surgery. The interval between the preoperative clinic visit and date of surgery varied from same day (6 patients) to 3 months.


CONCLUSIONS
Timely receipt of a presurgical specimen for type and screen testing and verification of a patient's ABO/Rh status can be ensured when clinical services collaborate and when the hospital blood utilization committee provides oversight to improve compliance.
Saxena
Sunita
S
Los Angeles County-University of Southern California Healthcare Network and Keck School of Medicine, Department of Pathology, Room 2900, 1200 N State St, Los Angeles, CA 90033, USA. ssaxena@lacusc.org
Nelson
Janice M
JM
Osby
Melanie
M
Shah
Mrugesh
M
Kempf
Raymond
R
Shulman
Ira A
IA
D000017:ABO Blood-Group System; D001788:Blood Grouping and Crossmatching / Q000379:methods* / Q000592:standards; D001800:Blood Specimen Collection / Q000379:methods / Q000592:standards; D001803:Blood Transfusion; D003955:Diagnostic Tests, Routine / Q000379:methods* / Q000592:standards; D017558:Elective Surgical Procedures; D006801:Humans; D012204:Rh-Hr Blood-Group System; D013997:Time Factors
D000017:ABO Blood-Group System; D012204:Rh-Hr Blood-Group System