Hello,
Our policy about changing blood tubing and filter has been updated to follow the INS standards (Standard 66, Practice Criteria B and Standard 43, Practice Criteria VI.A). This makes good sense to our IV Standards Team. I have been surprised at the resistance from staff, however. They are asking for rationale of the EVP.
I will request the references and read them, and in the meantime, could anyone tell me what the evidence(s) behind that standard say? Is anyone familiar with it?
Our team has many educated guesses on what the evidence says, but if you have read them and know, could you share?
Thank you!!
It comes from American Association of Blood Banks. Check there many resources, standards, etc. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
If anyone is interested, here is the rationale to the standard:
The 4 hour time frame is related to the fact that once you spike the blood bag, it becomes an open system. “Aseptic technique must be employed during preparation and administration. If the container is entered in a manner that violates the integrity of the system, the component expires 4 hours after entry if maintained at room temperature (20-24 C), or 24 hours after entry if refrigerated (1-6 C)”. At about 4 hours the blood is so warm that it becomes good culture media and bacteria can grow. There are references in the Circular, which may support this thinking.. Also check the AABB Technical Manual. In most hospitals, procedures indicate the unit should not hang more than 4 hours; this is probably derived from the Circular.
This is from "Circular of Information for the Use of Humand Blood and Blood Components." You can find this at www.aabb.org/marketplace.
Thank you,
Kathleen Wilson, CRNI