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If you feel that you are not being heard or appropriate action is not being taken you have the option of reporting to your accrediting agency AABB, CAP, TJC. This can also be done anonymously. The agency will contact the lab for information/investigation. If patient safety is being put at risk then you need to do everything you can to get these situations addressed which it sounds like you are doing. The other thing I would highly recommend is that you keep written/hard copy documentation of everything. You may need it sometime in the future to have proof of your diligence in trying to force compliance. Always remember the old adage "If it's not in writing, it never happened" Good luck

This is a scan taken from Petz LD, Garratty G. Immune Hemolytic Anemias. 2nd edition 2004, Churchill-Livingstone. George may not have been medically qualified, but Lawrie Petz most certainly is, but the two of them were regarded as the world authorities in this kind of thing. The chapter on HDFN was added to the second edition. It was not in the first. It shows what a waste of time, money and reagents it is to perform a DAT on all babies born to group O mothers. This has not changed within the last 15 years.

You are not overreacting. You are being responsible, which is what all healthcare workers need to be. Other than discussing all of this with your department administrative director (your manager's manager -- maybe you have done this already -- at our hospital, this is at the department director level), I am not sure there is much else you can do within your department. You mentioned talking to the FDA and your risk management department. Your hospital should also have a corporate compliance fallback for things like this (that cannot be resolved through management -- you can report anonymously if you desire) For corporate compliance issues, the business must respond to your concerns and report back to you within a limited amount of time. Good luck. Scott

To the elution question: if the results of the test will never alter the patient's treatment, it is hard to justify having the policy to always do the test, even if the results are academically interesting to understand causes and what is really going on.

Are you asking about which labels can be placed on the bag and which have to be on the base label?? Some irradiation indicator tags - both Rad-Sure and Rad-Control - have a type of adhesive that can touch the actual bag. Both can go above or below the base label (or at least that is what I have always been told). Most little labels/stickers, like the original Irradiation label in this thread, do not have this type of approved adhesive and are not allowed to be placed directly on the bag. You have to find somewhere to stick it on the base label without covering anything else up.