Implementation of a blood bank generated tube for second blood group determination: Challenges, yield, and cost

BACKGROUND: The second blood group determination or group check sample is a process of verifying the ABO group with a second blood sample prior to transfusion. It has been used to detect errors related to wrong blood in tube (WBIT) events and reduce the risk of ABO‐incompatible transfusions. To prevent the clinical team from collecting the group check sample at the same time as the first sample, a tan top tube only available from the blood bank was introduced for second blood group determinations if drawn within 24 h of the first group and screen. STUDY DESIGN AND METHODS: This is a retrospective study analyzing data from 2005 to 2020 before and after the implementation of the blood bank supplied tan top tube for group check. The number of WBIT events, transfusion delays, and health care costs were determined. RESULTS: The number of WBIT events remained unchanged throughout the time period. No delays in transfusion or procedure were reported due to the tan top tube group check. There was no increase in group O transfusions over time. In comparison to using an ethylenediaminetetraacetic acid (EDTA) tube, the tan top tube was estimated to add an extra yearly cost of $790.79 Canadian dollars. CONCLUSION: Second blood group determination using the blood bank supplied tan top tube did not increase the number of WBIT events detected but ensured an independent sample draw. A minimal incremental cost of implementing the tan top tube was noted with no delay in transfusions or procedures.