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Yes I have for both our automation and back up methods. Any methodology, or change in methodology, used in blood bank must be validated before it is implemented. That means, you must run tests using the new method in parallel with the old method and prove that it yields acceptable accurate results, sensitivity and specificity. After that initial validation, you only need to perform QC on a daily basis.

very well written! I'm going to save this for lab week. the public only hears when bad things happen with the lab, and most nurses seem to think our job is to compromise samples so they have to be redrawn. they don't realize that we do know patients by name, bad results have an effect on us, and we often wonder how patients are doing.

EXCEPT - for cord bloods - they ALWAYS have to be washed at least 3 times! I was just doing one and noticed that we forgot to mention them as the exception to the "rules" being discussed here. For adults - I do not wash - just make a 3% suspension in PBS from 1 drop of packed cells. I always do tell my students that if they use too many drops of packed cells, they should wash 1 time at least. For cord bloods, I make a 3% suspension and then drip that out to the test tubes (1 drop each) and then let the cell washer wash the those tubes 4 times. Very easy. (But it always requires telling the students that they must not wash the 3% suspension directly in the cell washer!!!)

The package insert for the reagents we use says wash a minimum of 1 time, so that's what we do with patients - 1 wash. If there is a discrepancy that isn't easily resolved we would wash the specimen 3 times - haven't had to do that in a loooong time.

Yes, we use a refrigerated centrifuge and spin down the unit. We insert an injection site into a unit port and use 60 cc syringe(s) to remove the Adsol. As I recall, we use the same injection site and more syringes to add an equal volume of plasma. Or we would if we had ever had to do the procedure.

My AABB/CAP inspection is in 2 weeks...I'll let y'all know. LOL

In the UK, the UK Transfusion Laboratory Collaborative, backed by the Institute of Biomedical Science (IBMS), Serious Hazards of Transfusion (SHOT), the Royal College of Pathologists (RCPath), the British Blood Transfusion Society (BBTS) and the Chief Medical Officer's National Blood Transfusion Committee (CMO's NBT) and equivalents in Scotland, Wales and Northern Ireland, has now published the "Recommended minimum standards for hospital transfusion laboratories" in various journals (two of which are Transfusion Science 2009; 19: 156-158 and The Biomedical Scientist 2009; 53: 744-745). The implimentation of these recommendations will be monitored, as appropriate, through current Medicines and Healthcare products Regulatory Agency (MHRA; where applicable to BSQR 2005) inspections. The impact of these recommendations on transfusion laboratory errors will be monitored by SHOT reporting via the MHRA Serious Adverse Blood Reactions and Events (SABRE) reporting system. This thing has teeth, and I suspect they will use them. I am wondering how people are getting on with implimenting these recommendations, and how much support they are receiving "from above"? :confused::confused:

I probably should not be saying this, as I am a member of the IBMS Special Advisory Committee for Transfusion Science, but I do so agree with you about your first point. I am somewhat surprised that the BBTS representatives on the committee did not kick up more of a fuss. I totally agree with your comments concerning the Edinburgh MSc (especially so, as I lecture on this course!) and, personally, I think that the Bristol MSc is its equal. On the face of it, I would agree with your comments in 3, but when you look closer, some of the recommendations could not possibly be complied with by the Reference part of the Red Cell Immunohaematology Departments of the NHSBT (although this does not apply to most antenatal work and grouping for the armed forces or the British Antarctic Expedition). If, for example, you look at bullet point 2.1, much of our work involves the investigation of auto-antibodies (or rather, what, if anything, is underlying the auto-antibodies). there is no way that full walkaway automation (or any other kind of automation) could be used to perform these investigations. Almost al of the other reference samples contain at least one clinically significant atypical alloantibody, and so the use of electronic issue (bullet point 2.2) is a non-starter for us. I think, though, that many of the general points raised in the Recommendations are already adhered to by the RCI Departments within the NHSBT. Certainly, nobody could work as a Biomedical Scientist during core hours, let alone during non-core hours, unless they were registered with the HPC. Point 4 is well made. Presumably, anyone who is taken on in this fashion would have to show capability and be signed off as such by the most senior member of staff within the Laboratory (and they themselves would have to have qualifications in Blood Transfusion), but I do agree that this should have been made more explicit. As far as I am concerned, funding is a matter for the CEO, and, as I said in an earlier post, they fail to give the correct funding at their own peril. It will only take one disaster to occur, where the CEO is implicated for not funding the requirements listed in the Recommendations, and I think that funding will suddenly be coming out of our ears! :cool::cool:

I know exactly what you mean Rashmi, but in circumstances where CEO's do get a "talking to", particularly where extra finance for the Blood Transfusion Department is required, the MHRA are quite capable of taking things much further (and higher), and have recently done just that in one of their inspections. In the particulr case of which I am thinking (not public knowledge yet, so I can't name names) the BBM was given extra budget, extra powers and was promoted a KSF Grade (so it can work to our advantage). :D:D

For some hospitals however the the responsibility for ensuring compliance is forced down to the staff with the suggestions that if you can't cope with the regulations then you aren't suitable for the job. The 'resource' word isn't allowed. Goodness knows what will happen to staff at these places whene their CEO does actually get a talking to. This UK collaborative document, which I do fully support however will potentially create an additional financial burden for BBMs on top of everything else- how much does it take for staff to finally give in?