Accessible, quality healthcare for the underserved
A mid-sized urban medical center and teaching hospital with two acute care academic hospital locations has a mission to provide accessible, state-of-the-art quality healthcare to their community regardless of the ability to pay. As a safety net hospital, the downtown campus is also one of the busiest Level One Trauma Centers in the city – serving the underserved and often uninsured, people who arrive in situations that would probably be less critical if they’d had earlier care.
Establish protocols to ensure RBC units stay below the recommended 10°C
While the medical center’s transfusion volume may not be considered terribly high at around 3500 units of red blood cells (RBCs) transfused each year – the majority of their transfusions are related to trauma, which means demand is both critical and unpredictable. They also support surgery, labor and delivery, oncology and the sickle cell clinic.
Their average use each month for massive transfusion is about 54 units of RBCs and their team can have 6 RBCs, 6 liquid plasma and an apheresis platelet packed and ready to go in 1 minute and 20 seconds. In addition to the MaxQ MTP coolers they use, the medical center also needs a way to make sure that any RBCs returned to Blood Bank storage have stayed below the recommended 10°C.
Safe-T-Vue 10 irreversible temperature indicators that provide an easy-to-read visual cue if RBCs have gotten too warm
The medical center has been using Safe-T-Vue 10 blood indicators – a temperature-sensitive indicator that attaches directly to blood bags – since 2015. When the indicator turns from white to red, the temperature of the blood bag has reached or exceeded 10°C. Any time a team member puts RBCs in a cooler for transport, a Safe-T-Vue 10 is on it.
The hospital also has Pyxis™ locked blood refrigerators containing emergency release RBCs and liquid plasma in their trauma bay and operating room. All remote storage RBCs have Safe-T-Vue 10 indicators attached and activated. Their gifted, dedicated team of people worked together to develop a specific protocol, which includes an important safety step where the transfusionist makes sure the Safe-T-Vue 10 indicator is white before a transfusion and checks it off in the protocol documentation.
Ensuring regulatory compliance while delivering quality, patient-first care cost effectively
One of the things the medical center appreciates most about the Safe- T-Vue 10 is that it’s nonreversible, which means it indicates that a high temperature existed even if it eventually returns to a lower level. This helps minimize the regulatory risk associated with not knowing when a unit exceeds 10°C. It also helps the team be sure that a unit of RBCs pulled out for an ER trauma isn’t put back in the refrigerator or cooler if it’s been sitting out long enough to warm above 10°C. Without the Safe-T-Vue 10, they’d have no way of knowing if the proper temperature range had been maintained.
Nurses are well-trained and respectful that they need to get blood transfused immediately or return it to Blood Bank storage – and the Safe-T-Vue 10 allows them to be advocates for patient safety when it comes to distributed transfusion.
Some hospitals and blood banks still work on the 30-minute rule, but in this medical center’s experience, RBCs will exceed 10°C closer to 15 minutes out of refrigeration. That’s why they chose Safe-T-Vue 10 over other indicators. The team didn’t feel that reversible indicators would work well in their environment because they need to know if RBCs have exceeded 10°C, even briefly. The Safe-T-Vue 10 is also easier to read than others they evaluated, which were too small and made it difficult for nurses to see a tiny indication line in the heat of trauma.
As a safety net hospital, cost is also obviously a factor. Safe-T-Vue 10 is cost comparable to other indicators, so the team decided on the solution that best met their needs to provide exceptional patient care. Another factor in their preference for Safe-T-Vue over other blood temperature indicators is that the Safe-T-Vue can remain on the blood bag for the life of the unit, and does not go to waste. When unused blood is returned to the blood bank, Safe-T-Vue can be kept on the unit to continuously monitor temperature – unlike other temperature indicators.