Patient Identification for Pretransfusion Testing
Be Aware!
The most common cause of an acute intravascular hemolytic transfusion reaction is failure to identify the patient either during specimen collection or immediately prior to initiating transfusion.
Accurate patient identification is essential for safe transfusion practice.
In-patients
All in-patients must wear an identification band on their body. This is not always easy, especially for neonates and critically ill patients (such as burn patients) but it is essential to safe infusion and phlebotomy practices.
The information on the identification band must be compared to the information on the requisition prior to drawing blood for compatibility testing. If the information does not coincide, the specimen should not be collected until the discrepancy is resolved. In a STAT situation, there should be policies in place for the provision of uncrossmatched blood until accurate patient identification can be made. Some hospitals have policies in which phlebotomists carry unique identification bands for crossmatch purposes in these situations.
Out-patients
Out-patients should be banded for pretransfusion testing. Policies differ from hospital to hospital on how this is handled for pre-admission clinic patients
but many have a continuous identification process.
Unique Transfusion Identification Bands
Some hospitals use unique identification bands for all pretransfusion testing. These are sometimes referred to by the product names such as Typenex, Identiband (Hollister), Securline, I-Trac, etc.
If patients are given hospital identification wristbands these "unique" bands should not be required. Many hospitals use these for all patients rather than requiring phlebotomists to remember who should or should not be given a band, and laboratory personnel to know if the patient has or does not have an identification band.
If these unique bands are used, it is important that policies clearly state that the transfusionist must not depend solely on the unique number and must identify the patient using standard identification methods such as checking and spelling the patient's name and asking the patient to identify himself/herself.
However used, these bands are excellent for situations, which require STAT collection of blood specimens for pretransfusion testing, when the patient is not wearing any form of identification.