Confirmatory Blood Type FAQs

June 21, 2021  //  FOUND IN: Announcements

This policy takes effect Monday, July 12, 2021

What is the Confirmatory Blood Type?

The confirmatory blood type is a 2nd sample blood type test to verify the patient’s blood type when Blood Bank does not have a historical type on file.

The confirmatory blood type must be performed on a 2nd sample when an electronic patient identification system is NOT used.

  • Phlebotomy uses an electronic scanning system to scan the patient’s armband and generate labels at the bedside.
  • RN and MD-drawn samples (e.g. ED, PACU, ICU) currently DO NOT use an electronic patient identification system and thus, the risk for mislabeling these samples is significantly higher and they will be subject to the requirement.

Who needs this test?

Any patient who has a blood type sample drawn by an RN-MD and does not have a historical blood type on file will need a 2nd confirmatory blood type before receiving a unit of crossmatched red cells.

The confirmatory test is not required when platelets, plasma, or cryo are needed as long as Blood Bank has the required testing completed.

Why is this required?

Two reasons:

  • This is a serious patient safety issue. Blood Bank has previously received mislabeled blood type samples that were drawn by an MD or RN. This is discovered when a historical blood type on file does not match the new sample, however, this is not possible for a patient without a previous transfusion, which is a life-threatening event.
  • This is a College of American Pathologists (CAP) standard requirement.  CAP accredits the Blood Bank laboratory.  CAP requires a 2nd specimen blood type when electronic patient identification methods are NOT used.  This applies to all non-phlebotomy-drawn samples.

What do I have to do?

Workflows have been created to map out a process to alert the ordering provider when MiChart is used to order the type and screen testing. The workflows can be found here.

For samples ordered in MiChart from nurse-collect floors, the system will fire a BPA to alert the ordering provider if a confirmatory blood type is needed. The caregiver can add the additional test at that time if desired.  It is not required to order the test if only the type and screen is desired. 

If the test is not ordered at the time of the TS, Blood Bank staff will order the test in MiChart when a blood order is received and the sample is needed.

For Pre-Op and OR, Blood Bank will review all samples from these locations and alert the caregivers if the sample is needed. Blood Bank will also review samples from patients in emergency situations (e.g. codes).

Until the confirmatory blood type has resulted, the patient will be administered emergency uncrossmatched universal donor (type O) blood if red cells are needed.

What is required for this sample?

The sample must be a 2nd draw (e.g. it cannot be drawn at the same time as the first sample) which includes re-identifying the patient and sending the 2nd sample.  Blood Bank will not be able to accept samples that are drawn at the same time as the first type and screen test.

What about infants?

Infants <4 months of age receive Group O red cells and are not subject to this requirement.

How do I find a blood type on my patient?

MiChart>Chart Review >Lab Tab and MiChart>Results Review will display Blood Bank testing that has been performed.  If a historical blood type displays, only a single updated blood type is needed.

Questions? 

To ask if a confirmatory blood type is needed, call the lab at 936-6888.

For concerns and issues, call Dr. Davenport (page 2982) or Terry Downs (936-6862).

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