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    Kip Kuttner

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Showing content with the highest reputation on 01/22/2020 in all areas

  1. I think we would refer to this statement in our "Organization" Quality Program document: The Quality Unit responsibilities are defined and include: active and prospective participation in quality planning; oversight of all activities relating to quality; ensuring that policies and procedures are properly maintained and executed; ensuring that the quality of products, tests, and services provided conform to regulatory/accreditation, customer, and company standards; and maintenance of the facility quality manual
    1 point
  2. We require a ABO/Rh specimen for the current admission.
    1 point
  3. The other hospitals in our system do not require a current specimen. We don't do it at our hospital. I worry since I have seen it too often someone using a relative's Health Insurance Card and having a complete different type. We don't need a specimen though form 3 days. If they have had a specimen during the stay, we will thaw plasma.
    1 point
  4. Kip Kuttner

    Blood Shortage

    With attention to blood utilization, the overall red blood cell usage has gone down. Consequently blood suppliers have had to pair down the number of overall units they collect in order to avoid out dating products. Since we are drawing a population, the proportion of desired units in that population (All Rh negs and all group Os) has not changed, but the absolute number of the desired we can acquire units has dropped. Transfusion practices are still demanding nearly the same number of desired units as before blood utilization practices were implemented. About half of the Rh neg units distributed go to a non-Rh negative recipient, often because hospitals do not want to "waste" them. Perhaps if before making that decision to transfuse the blood bank contacted the blood center and asked if there was an immediate need to transfuse an Rh negative unit to an Rh negative recipient, we could better utilize the resources we have. Also I believe the merging of blood centers has contributed to the problem. Where the community blood center was usually able to manage the blood needs of the local hospitals, many are selling blood by contract to facilities miles away. This has decreased the amount of ad hoc blood available for export. The "low-titer group O" craze is also taking a toll because of the demand for repeat donors to fulfill the need to have Whole blood units with a 21-35 day out date, available for emergencies. Most blood centers are trying to recruit blood donors by blood group now in order to avoid out-dating Apos and Bpos units. This means that Rh negative and group O donors are approached to give 2-3 times more often than donors of other blood groups. The desired donors are complaining that they are being approached to give red blood cells too frequently and are starting to ignore our requests. All of these issues (and perhaps others) are contributing to the nation wide blood shortage of the most desired units. Importing products is also difficult. If they are available at all, did you know that in order to import four group O negative units a blood center might have to also purchase 50- 100 group A Pos units? Platelet utilization seems to be increasing. Where do platelet donors come from? Usually whole blood donors. Sometimes the blood center needs to decide whether to take a group O product or obtain a platelet product based on the needs of the day. Thank you to those who are excellent stewards of the products you receive! Blood centers are not shorting you because they are incompetent. Frequently it is extremely difficult to obtain the most desired products any where at any price. You can help your blood center serve you by being honest with your inventory.
    1 point
  5. My first question is: is the ICU refrigerator an acceptable devise for the storage of blood products? If not that should stop immediately. If so, then I suggest that any syringe loaded in the OR be discarded in the OR if not transfused in OR. If the unit goes with the patient to ICU then they could load a fresh syringe on an as needed basis in the ICU. This could still be done with out refrigeration for the 4 hours the unit has for complete transfusion. The problem is training the ICU staff to understand the limitations. While blood is, indeed a precious commodity, the risk it to great to the patients under the circumstances you have described. If there were more than one patient in the ICU with a syringe in the refirgerator..... I'm sure you can imagine all the possibilities. Good Luck. In my experience anesthesiologists can be amoung the most difficult to deal with. :abduction :abduction
    1 point
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