Cord Blood Collection

[JaneyW]

Do many of your patients bring in those cord blood collection kits?? The hospital where I've been for the past couple of years doesn't get them too often. The MDs aren't too used to them. We had one the other night that I had never seen before. It was a bit more complicated than others I've seen and had a huge bag for the collection--like when you donate blood!

Anyway, it has been my experience that the MDs collect the cord blood after delivery and we as RNs just do a maternal blood draw if necessary and help the parents with the packaging--as a courtesy really. Well, the other night I was working with a new OB--new MD as well--and she insisted that I do the cord blood draw as she would be busy 'taking care of the patient' after delivery and couldn't be bothered with such things. I wondered what she thought I might be doing after the delivery that I would have all of this time, but what do you do?

She went ahead and delivered the placenta before I was able to draw the blood so of course I didn't get enough--at least I don't think I did. These people pay a lot for these kits and I feel bad that it might have been wasted. Other nurses told me that I should have insisted that the MD do the draw as it is between the MD and patient and not a hospital issue. I am inclined to agree. With this particular MD I think she is just not sure of herself and also has a bit of a superiority complex going on.

What do you do at your facilities???

[crystalbluern]

I have seen about three of these kits come through our unit so far, and have heard about a few more that I was not involved with. The patient should bring this up in the OB Clinic with the Doctors so that there is good communication. We just review the instructions, one was a bag, like blood donation and the others were large syringes. The doctors always get "cord blood" in two red tops for the lab, so this is done instead and always by the doctor. The labels are premade and usually you date and time one. We draw mom's blood right after delivery for the last specimen and then give the kit to the family. They are required to make the call for pick-up. for CYA, I make a note in the chart that the draws were done and handed to the family, I also note when the pick-up of the kit occurs. I think it is great some families are doing this. What I don't understand is why they have to pay so much, and WHY IS IT NOT ROUTINE for everyone. We are a military hospital, so there is no hospital charge to our patient from us for this, they contract with the companies individually and pay from their own pocket for this service like everyone else.

[4Blessings]

We get them once in a while. In my last facility the Care Providers all did the collections, no questions asked. Here they do try to get us to do it. However, I discovered the the kit that usually comes in (from Viacord) states that the collection is to be done by the Care Provider so that helps convince them that it is their job.

I think we should have a policy for this though that clearly delineates the lines of responsibility and the appropriate procedures. Any thoughts on this?

My facility has done a few collections and there have been the same problems stated here. I tend to agree with the postee that stated that if a nurse is involved then the hospitol could be implicated if there was an error. We are currently writing a new P&P for this situation that clear defines this issue. Strongly encourage you to bring this up and have one for your facility.

[BETSRN]

Our hospital policy is that we don't do anything with the kits. Supposedly people pay like $5,000 for the kits and initial storage then $500 a year for the storage. I don't want to b responsible for that. All the kits are so different and I've never been trained on their use. Some of the docs try to make us draw the mothers blood but we make them do it. If there were any problem with the kit the hospital could be liable if Rn's are involved in any part of the collection.

The most I have done is to call the company although I resented even being asked to do this because the guy on the other end wanted very detailed information about the patient and I don't have time to spend on the phone. I ended up telling him "I'm sorry I don't have time" and hanging up. Maybe that sounds a bit harsh but the patient came in labor and needed a repeat C/S so I really didn't have time.

We nurses handle the kits but it is the doc or midwife that does the actual collection. I make sure I read the directions before I start as they are all so different. After the collection (and we have to draw the mom too) then the family takes the responsibility for calling the courrier to come and pick up the kit. We don't see too many and we haev not had any problems with them.

I have a question....if you draw other bloods and do IV's why would you refuse to draw a tube of blood from Mom? seems to me that you are getting all hyped up over nothing.

[palesarah]

nurse involvement with these kits is pretty much limited to us reminding the provider that they need to do it and then sweet talking the lab into drawing that extra tube for it.