Results 1 to 9 of 9

Thread: Interpretation of Current Sample

  1. #1
    Forum Member
    Join Date
    Nov 2016
    Posts
    2

    Interpretation of Current Sample

    The BCSH guidelines for pre-transfusion compatibility procedures in blood transfusion laboratories (2012) criteria for EI states:

    7.5.6 If all the following patient and sample criteria are met, then electronic issue is acceptable for that patient sample:

    iii. The current antibody screen is negative

    vii.. The current sample meets the sample timing and storage requirements ...

    How should the term 'current sample' be interpreted in routine practice when unsolicited requests appear in the laboratory after components have been issued on a sample that is still 'current' and meets the criteria above?

    Which of these options are appropriate?

    1. Discard the unsolicited sample without testing
    2. Register and process the unsolicited sample but do not take any action re any previously issued units etc. until results are available
    3. De-reserve any issued units while unsolicited sample is being tested with the option to issue emergency group O if necessary
    4. Any other option ...



    Thank you.
















  2. #2
    Forum Member
    Join Date
    Nov 2016
    Posts
    39
    Just my thoughts- hopefully others will suggest other ways:

    Option 1: If you noticed at the point of entering onto the LIMS then you could call this “not tested” due to availability of a current sample.

    Option 2: Seems ok too if your staff or LIMS has not identified that a suitable previous suitable is available.

    Option 3- Possibly time consuming for staff. If you have already issued blood then why make more work, potential for confusion and increase risk ?

    Of course, if you start looking at exact timing of samples and the time ( is this set in minutes, hours etc?) range of acceptability- then we can discuss forever. No system is perfect, though a more intelligent LIMS may help- are there any out there?

    bw

  3. #3
    I agree with Orr Thoughts and Concept.

  4. #4
    Forum Member
    Join Date
    Nov 2016
    Posts
    20
    It's a duplicate sample I would register as duplicate sample not tested.

  5. #5
    Forum Member
    Join Date
    Nov 2016
    Posts
    5
    It is worth keeping in mind that if you reject the unsolicited/duplicate sample this may have an impact on your remote issue capability as the most recent sample will be a reject sample and blood tracking systems generally checks for the most recent sample before releasing blood.

  6. #6
    Forum Member
    Join Date
    Nov 2017
    Posts
    3
    just putting a tracking system in a hospital where duplicates are an issue and hadn’t thought of this as the previous hospital group I set one up for did not have a problem with sending excess samples.
    Does it depend on your IT system? Duplicate requests do not stop issue on the IT system if there is a valid sample prior to it,

  7. #7
    Forum Member
    Join Date
    Nov 2016
    Posts
    5
    I guess it does very much depend on your LIMS system and your tracking system - our LIMS is an episode based system so the tracking system will always go to the most recent episode/sample in the system and if this happens to be a rejected duplicate, RA won't be allowed. In the lab we can select the relevant sample for EXM and it doesn't matter whether a duplicate sample has been rejected subsequently. Best include all these scenarios in the validation of the system to assure yourself that rejected duplicates won't be an issue.

  8. #8
    Forum Member
    Join Date
    Mar 2018
    Posts
    1
    Appendix 2 of the current guideline explains in detail the rationale behind the recommendation of a sample being no more than 72 hours old at the time of transfusion, up to 3 months post-transfusion. It is not possible to predict when antibodies might appear following transfusion, so this offers a solution that balances risk against achievability. There is no risk in processing a new unsolicited sample when you have issued blood against a previous sample that is still valid. Of course if you detect antibodies in this new sample, then you would want to recall the issued units. On the other hand, unnecessary re-bleeding is a problem for patients and increases costs, so reporting samples as duplicates might help to improve clinical practice. But not having a new G&S sample tested in a timely fashion for patients needing further transfusions can cause delays in their treatment.

    So either of solutions 1. or 2. are valid, you might just want to define in your SOP at what point in time before expiry of your "current" sample, you would dismiss a new sample as a duplicate, or process it to ensure continuity of transfusion support. It's also an interesting point of Barbara's regarding the LIMS reporting only the most recent sample blood tracking rather than the most recent one that is suitable for electronic issue - I guess it depends on the LIMS but worth considering.

  9. #9
    If anyone has a sample transport policy to cover pathology and would be willing to share on this site-I would really appreciate a copy. Trying to update our one, which is going to be a rather onerous task.

    I gather some of the UKAS inspections are focused on sample transport/ training of drivers etc, so I have attached our latest ppt, if of any help. I am sure there are some really good presentations out there- if we could share these it would make life a lot easier.

    Many thanks
    Last edited by Stephen-Grayson; 9th May 2018 at 03:37 PM.

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •