It's a duplicate sample I would register as duplicate sample not tested.
It's a duplicate sample I would register as duplicate sample not tested.
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.
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,
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.
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.
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.
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