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I think this might be the report for Dr. Marik's statements. Also keep in mind, that most of these patients were already in sepsis status which compounds organ issues with or without transfusions. http://jama.jamanetwork.com/article.aspx?articleid=195310

Happy Lab Week to all of my PathLabTalk friends and fellow Blood Bankers and laboratorians

I was on a CAP inspection team this January. Donna, you're correct about the shift in emphasis. The pre-inspection training for inspectors was beginning to show that shift compared to the training we did prior to our last inspection trip.

I agree with Malcolm and Anna. Donna

I got a strong 'recommendation' for the lack of facility ID on my ab panel sheets from a CAP inspector who used to be an AABB inspector. I was cited for not having a through enough SOP for a water bath - outside of keeping it full of water, clean, the temp set/checked, and what we use it for.........how much more do you need to know???

I like this topic: THE WEIRDESTTHINGS I WAS EVER CITED FOR For me that was not having my facility ID on my ab panel sheets. I knew I was in for it when the inspector started off saying she knew she'd have to dig to find something "in Dave's lab!" This was in the day when the inspector sent the report to the AABB Area Chair and he/she decided what was actually citable. I called my area chair and told him 1. that I couldn't believe he cited me for this and 2. I wanted to inspect his blood bank (aganist the rules).

The two weirdest things I was ever cited for: Not logging the expiration date of non-sterile gauze (I had no idea such a thing even expired...) Inspector found 1 balance tube in the entire lab that was expired. We were cited that it was expired and it did not say the words "BALANCE TUBE ONLY" on it.

For #6: Evaluation of problem solving skills. I decided not to do a written exam, because if the tech answered incorrectly I would have to show re-training, re-competency, etc. I handled this element by putting a "scenario-based question" for each test/task on my competency. While I am directly observing them and tubes are incubating, etc, I have the discussion with them (for example for the antibody screen "What would you do if you had a patient last week with a 4+ reaction on an antibody screen, result was an Anti-K, and now they are back in the ER this week with a negative antibody screen? What steps would you take to troubleshoot this?"). What's nice about this is you get to have a good conversation with the tech and go over all of the possibilities and they ask other good questions. If they answer "I have no idea", you can ask "so what do you do when you have no idea"; hopefully they answer "refer to the policy, ask my lead tech, call the supervisor, etc" and can still show good judgment. I will change the scenarios every year. See attached for a good article about tips for competency in the Blood Bank. Competency assessment in the transfusion service, MLO article Oct 2013.doc