Dear All,  

There are a number of clinicians who are very keen to use labels, placing them directly onto the sample, completely doing away with the request form.

Another group of clinicians are keen to retain the paper request form as this is used in the lab.  I would welcome any information you have regarding the "to label or not to label" process.....

Thanks

Dave.

Hi Dave and Emma,

Here at Ashford & St. Peter's Hospital we are about to go live with a local pilot and we intend to print barcoded labels with request numbers on the forms. However, our Lead for Blood Transfusion has raised an issue with regard to BT specimens. The BCSH Blood Transfusion Task Force wrote up some guidelines for compatibility testing in 2004 (Transfusion Medicine, 2004, 14, 59-73) which essentially state that "...It is therefore recommended that any labels preprinted away from the bedside should not be accepted for either grouping or pretransfusion testing samples". Are others using preprinted labels for blood transfusion tubes? How have you got round the above guideline (doing a local risk assessment?).

Hi,  we are still having local ongoing discussions regarding the entire "to label or not to label" process.

With regards to preprinted labels if the staff collecting the blood had a trolley PC they could print labels at the patients bedside??

We use exactly the same media I think. We get ours from Jones and Brookes (I can provide a contact if required). They have done quite a few of these already and have templates for quite a few designs. I would heartilly recommend though that if you are going down this route, choose a design where the labels are at the top, it makes it a LOT easier when aligning the printers.

We are using it in GP land and whilst there has been a bit of grumbling because the printers only have a single tray for A4, they do, in the main, change the paper over to print forms. Some have managed to use the manual paper feed on the printer but these can be a bit tricky and the settings seem to differ from device to device.

As for the Transfusion issue, the guidelines clearly state that unless the label is produced at the patient bedside, it shouldn't be used to label a transfusion sample. Basically, I got Sunquest to alter my form template for a Transfusion form so that it doesn't print any labels but prints a message across the stickers stating that a Transfusion sample MUSt be hand written.

Pathman

I think you may have misinterpreted what I meant or I haven't explained it very well which is probably more likely. I agree with you 100% and think that labels is the way to go and this mechanism is the easiest and cheapest. Label printers are fab but it's an added expense. However Transfusion managers are king when it comes to interpretation of the guidelines and to be honest I don't blame them as the MHRA are a fearsome bunch. They are very very keen on "positive patient ID" which in the context of labels means they must be generated at the bedside using data supplied/provided by/from the patient. Which in this case would probably be an electronic wristband scan.

The only issues I have come across are with Transfusion samples. , on the wards, they aren't too taxing and to be fair, are not commonly taken by phlebotomists as they don't serve our wards anymore. Having to hand write the Transfusion sample is not a big deal.

In a GP environment, the numbers are negligable and not even an issue.

As I said, I'm totally comitted to the label scenario (I've just ordered half a million form with them embedded so I've got to be!). If there are any doubters and  complement your post, I asked one of the GP's to do an audit after one month of trialing the order comms with labels and the sample rejection dropped from 10% to ZERO!!!!!

Excuse the English in the above post - I just re-read it and it's bloody awful - however, I'm sure you'll get the drift.

Note to the mods - can we have an edit button (or if there is already, how do I enable it?)