MHiggins

I hate to be the bearer of bad news but as is much of the program itself, the reporting abilities leave much to be desired.

We have just switched to Safetrace TX and I am struggling to figure out what reports are best for tracking QA! Any help/guidance is greatly appreciated! Thanks! M

Ah. Well, they don't track the blood bank workload like they do the rest of the lab so it currently is a non-issue.

It is regular practice in our area (multiple facilities follow this process) to crossmatch before antigen typing when time allows in order to conserve expensive antisera. Crossmatches are cheap in comparison to some antisera. However, we would antigen type initially or at the same time as we crossmatch in a stat situation or when the patient has a negative antibody screen.

I'm unsure of what you are asking exactly? We do keep all testing records on file.

Question: Do you bill for all crossmatches performed? Or only the ones that were ordered? Example: 1 RBC is ordered. Patient has a an antibody. You grab 4 units and crossmatch through Coombs. You then antigen type the compatible units. Do you bill for four XMs? Or just one? What about antigen typing? Four units? Or just one? We used to bill for all work done. Then someone told my director that we could only bill for what was ordered or it was medicare fraud.... but, I feel like that is not applicable to patients with antibodies that require much more work to find compatible blood. Thanks, Morgan

Thank you!

For those of you who perform testing and provide blood products to satellite facilities, how do you transport the products? Do you use a transport box/cooler? How are they kept at the facility? In a refrigerator or in the transport container (validated for x amount of time)? Thank you!

Thank you all for the responses! I should also explain, I have only been in the field for 8ish years, BB supervisor for 4, and have only ever worked in a Transfusion Service at the hospital I am at now so the way things were already being done here is the only way I have known! With that being said, I do feel like there are a LOT of things that need "improved", this being one of them. My senior techs are telling me that they have always reported patients who tested positive for Weak D (our system still calls it Du as well) as Rh positive. We ONLY test patients for Weak D if there has been some discrepancy or if they are a Rh negative baby born to a Rh negative mother. In the case of the infant testing, if we report them out as negative, they might not give the patient the RhoGam. And from I am gathering, giving all Rh negative mothers would not be an ideal process either? Also, what about these reagents that are detecting Weak D at immediate spin such as the Ortho Gel cards and the Quotient reagents? Is that a bad thing? I did recently attend the AABB Annual Meeting where I heard a lecture about these Weak D positive patients developing anti-D. I had not heard that before!! So, currently we are reporting these Weak D positive patients as Rh positive. Does anyone have a literary source about these developing anti-D that I can use to convince my director/pathologist that we need to change our process? Thanks again for all of the information! I am always learning and appreciate any input! M

We have recently switched from using the Ortho ProVue to the BioRad tango Optimo. With this, we have encountered some issues. The tango does not pick up Du on the routine ABO/Rh strip. The ProVue ABO/Rh card does. So, we have had a lot of discrepant Rh types since we have started using the tango. We use the Quotient D Blend as our serologic reagent, which does pick up Du at immediate spin, as well as Du & D6 at IAT. In the last week we have had two OB patients type as Rh negative both on the tango and at immediate spin with the Quotient D blend. On one patient, the nurse called and stated that the patient had a history of being Rh Positive in their prenatal workup that was done at another lab. On the other patient, their Rh type was not questioned until their Fetal Bleed Screen was performed and was macroscopically positive. Both were testing through IAT with the Quotient D blend and with the Ortho ABO/Rh gel card (manual method) and were found to be Rh positive. I feel like when we run into these patients with discrepant types, we are chasing our tails testing by 3 methods to confirm their Rh type and am wondering if there is a better way/process? What does your facility do for routine D testing? What about Du testing? We typically only perform Du testing on Rh negative babies born to Rh negative mothers and of course when an investigation is needed like the above situations. Any wisdom is great appreciated! TIA!

What is your hospital's policy on armband expiration for outpatient transfusion? Do you allow them to be drawn one day for testing and transfused the next, even though they are not inpatient? Does your hospital allow patient's to wear their armband from their inpatient stay home to be used for a routine outpatient transfusion the next day? What if they came in through the ER and received blood, would you allow them to have a routine transfusion the next day in outpatient on the specimen from the night before? The patients receiving outpatient transfusions here are typically oncology/chronic anemia patients that come fairly regularly. Any regulation references on this subject would be appreciated!