COLA transfusion questions
Not exactly POC related but we end up wearing many different hats so I thought someone out there might be able to help!
I am the technical consultant for 2 off site locations that are COLA inspected. One of these is a special care nursery physically attached to a different hospital system, but the nursery is Children's owned and operated and they do much of their testing with a glucometer and iSTAT, hence my involvement.
The new neonatal group out there wants to start doing transfusions. The hospital attached to them does really not want to be responsible for the pre-transfusion testing or blood administration because they had no pediatric experience. So the next option would be to have this nursery send type and screens downtown and then send blood out to them in coolers.
Is anyone out there doing anything like this? The regulatory mess it creates is giving me and the transfusion manager a headache!
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We have a LTAC that is about 3 blocks from the hospital that has their own CLIA certificate and is surveyed by Joint Commission. (Glucose and non-waived ISTAT) They also give transfusions at the LTAC but we supply the blood products and do all of the work up. We have a contractual agreement with them to provide laboratory services. For JC, the surveyor looks at anything that has to do with blood and blood product administration.
With my other employer before this,
I monitored small hospitals that used PCT for lab but also used our transfusion services.
They send us the blood, we did type and cross, and send them the blood units .
They followed all the procedures ( and paperwork) we required of them.
The blood units were sent in approved blood bank coolers with a thermometer in a bottle inside.
The units have temperature tapes that would show if the units got warm during transport.
The coolers are monitored very well and can hold cool temperature for the approved length of time.
The local community blood bank supplied our blood. They are blood from volunteer donations not bought .
The nurses are trained by our blood bankers.
They have to be certified and proven competent before they can do the transfusion.
They follow through our competency procedure, exam, oral exam, etc.
Checking all vitals before transfusion, after 15 minutes, and I think at the end.
They know what to watch for transfusion reaction.
They have to make sure they have to change the transfusion set after the required # of units.
All the paperwork has to be completed before and after transfusion.
The nurses have to follow what AABB required.
WE monitored them very closely. It worked and we never had problems with them.
TJC and CAP approved the policies and procedures written.
The blood bank in our base hospital was also AABB approved.