Cliff
Content Type
Store
Profiles
Forums
Blogs
Events
Frequently Asked Questions
Gallery
Downloads
Glossary
Links Directory
Questions
Jobs
Vendors
Posts posted by Cliff
-
-
David, I agree that it may help supplement the general inventory. I guess I want it both ways. Collecting autologous costs us a lot of money, we collect several thousand a year. We will start collecting significantly more, we have recently restricted auto collections to our facility only, we do not allow our local suppliers to collect for us, except in rare circumstances. We discard about 1/2 and obviously can't get reimbursed for those.
So perhaps it's not the collection of auto units that frustrates us, but the over ordering.
-
We are moving toward 100% irradiation, first we need another irradiator though. Is anyone considering that?
-
Brian, I suspect FDA would not mandate such a thing, that would getting involved in the practice of medicine.
I'd rather see a fully leukoreduced inventory too.
-
My apologies to Jane who has posted this poll twice, and in my carelessness I have deleted it. It is now reposted, sorry Jane.
-
Cliff, I hate to disagree with you but crossmatching does not require FDA registration. As long as you do not "modify" any blood products you do no have to register with the FDA. Pooling, Packing, Thawing, Aliquoting and Dividing are not modifying. Irradiating, and Washing are modifying.(I'm sure there are others but I can't think of them now.) The reason I know this is that our corporation is the only one with the distinction of having transfusion services under a consent decree (long story). We are not allowed to modify blood products but we can do Pooling, Packing, Thawing, Aliquoting and Dividing. We do all other pretransfusion testing and are not registered.
Hope this helps.
John
Thanks for the clarification John. We are a rather large transfusion service so the idea of not being registered is rather foreign to me. I read this statement from the 2004 CFR:
(d) Manufacture means the collection, preparation, processing or
compatibility testing by chemical, physical, biological, or other
procedures of any blood product which meets the definition of a drug as
defined in section 201(g) of the act, and including manipulation,
sampling, testing, or control procedures applied to the final product or
to any part of the process. The term includes packaging, labeling,
repackaging or otherwise changing the container, wrapper, or labeling of
any blood product package in furtherance of the distribution of the
blood product from the original place of manufacture to the person who
makes final delivery or sale to the ultimate consumer.
-
Do you already perform compatibility testing? If so, then you'd need to be registered. If not and these are new processes that you'd be adding to your operations you would need to be registered for that too.
Here is a link to the appropriate CFR: http://a257.g.akamaitech.net/7/257/2422/12feb20041500/edocket.access.gpo.gov/cfr_2004/aprqtr/21cfr607.3.htm
-
Jane, there sure is, it is actually a little different / better than before.
Here are the steps:
On the main forum page, click on a category, i.e. Quality.
On the right there is a "Forum Tools" menu with an arrow on the right, click the arrow.
Click "Subscribe to This Forum".
Select the frequency for notification.
You should start to receive either daily or weekly notifications.
I am redesigning the newsletter page I had sent in the past. It should be ready in a week or two. Once done I will send updates at least once a week. Some of the newsletter features will be recent posts, tips on how to use the forum and some statistics.
Hope that helps.
-
Here are a few free tools i really love.
I listed the tool, the link, my rating, and some text from the authors site.
Google Bar
Rating - 10
• Search the web with Google from any site
• Eliminate annoying pop-up ads
• Shop faster - fill in forms with one click
• New! Browse by Name
--------------------------------------------------------------------------
Google Desktop
Rating - 10
Find your email, files, web history and chats instantly
View web pages you've seen, even when you're not online
Search as easily as you do on Google
Google Desktop Search finds:
Outlook / Outlook Express Word AOL Instant Messenger Excel Internet Explorer PowerPoint Text--------------------------------------------------------------------------
Picasa
Rating - 8
http://www.picasa.com/content/download.php
Here's what you can do with your free copy of Picasa 1.6:
Find all your photos -- and make photo albums, quickly and easily.
Edit with ease -- Crop, reduce red-eye, and enhance with one quick click.
Print at home -- No mistakes. No waiting. No hassles. Just beauty.
Share photos online -- via email or Picasa's Hello technology.
Make slide shows -- set to your own MP3 music files. …and much more!
--------------------------------------------------------------------------
ieSpell
Rating - 10
ieSpell is a free Internet Explorer browser extension that spell checks text input boxes on a webpage. It should come in particularly handy for users who do a lot of web-based text entry (e.g. web mails, forums, blogs, diaries). Even if your web application already includes spell checking functionality, you might still want to install this utility because it is definitely much faster than a server-side solution. Plus you get to store and use your personal word list across all your applications, instead of maintaining separate ones on each application.
Does not work with FireFox.
--------------------------------------------------------------------------
Mozilla FireFox
Rating - 7
http://www.mozilla.org/products/firefox/
This is a very good replacement web browser for Internet Explorer haters. It is not based on the IE structure, it is a completely new stand alone browser.
I can't possibly give even a small list of the features this tool has. Take a look at their site and also see some of the add on options available, you'll never go back to IE.
--------------------------------------------------------------------------
Mozilla Thunderbird
Rating - 9
http://www.mozilla.org/products/thunderbird/
Thunderbird makes emailing safer, faster, and easier than ever before with the industry's best implementations of features such as intelligent spam filters, a built-in spell checker, extension support, and much more.
--------------------------------------------------------------------------
Weather Watcher
Rating - 10
http://www.singerscreations.com/
Adware-free, spyware-free, hassle-free... Your weather, your way. View current conditions, hourly forecast, daily forecast, detailed forecast, severe weather alerts, and weather maps for almost any city world-wide!
--------------------------------------------------------------------------
RoboForm
Rating - 9
http://www.roboform.com/index.html
RoboForm is a free password manager and one-click web form filler with some serious Artificial Intelligence.
--------------------------------------------------------------------------
InBox
Rating - 9
Free Full-Featured Email
Send & receive attachments up to 20MB, easily organize your messages, quickly find archived messages, view full conversations, compose and read messages even when you're not online and much more...
I have been using this web based email for a few months now. I've tried them all and I think this one is just terrific. Free mail, free file storage, free photo gallery... All Free!
-
Our WB donor center will giving fleece scarves as thank you gifts and doing various events, giving out cafeteria meal tickets and running raffles.
-
So, using this technique you are essentially certifying your own weights, traceable to your NIST traceable. That's an interesting option, especially for us, we have a lot of weights, many custom.Weights used in the collection/creation of blood components have to be traceable to an NIST standard. We have a master set of weights that is sent out each October for certification. All other weights used in our facility are measured against the master set annually.
-
I am in the process of revising the database we use.
For the end user it is rather simple, they enter the donors ID number and if they have been in the database before it displays their name, if not they need to enter them. There is no link between this database and any other LIS, it is completely stand alone.
Then they enter a few standard parameters, they select a donation type (radio buttons), they enter the current hemoglobin, sample volume, we collect leukopacks so they enter that volume, plasma loss, date of donation (today is defaulted) and donation number.
At the end of this entry they print a report that lists the items I wrote in the first post.
There are many custom controls specific to our facility. Someone with moderate Access building experience can probably find these items and modify them.
I’ll be happy to post it here if people are interested. I can’t create a customized version for everyone. If you are interested in having it set up for your facility e-mail me and let me know and we’ll work something out.
Some of the big drawbacks are Access is not stable in a shared environment, we have moved ours to an application server that IS controls. Prior to that it was on a shared drive and it became corrupted occasionally. Also, access to the program is controlled at the drive level, so the application does not track who does what, to me that is huge. FDA has seen it twice and has not had concerns with that issue.
I have considered making this into a web-based product, that would eliminate all of my concerns and make it useful for many more people.
-
I too agree that directed donors may not be the most honest and altruistic; however, if we agree to take them as donors, then I feel we need to feel comfortable crossing them over. I can't rationalize it if I say they are acceptable for a person they select, but we won't allow it to go to someone else.
The autologous situation will likely be here for a long time, I don't think the donors will truly understand that autologous donation is not safer than homologous donation.
-
Have you figured out a really great option that is available in the forum? Please post it here for others to see and learn from.
Looking for something you can't find or want to see more option available, please post that too.
-
We decided to recertify our existing weights.
Obviously this will not be a small project. We first need to determine what weights we have, then figure if this fits what we really need.
Next we'll need to order a duplicate set of weights so we will have a working set while the duplicate set is being calibrated.
Then we need to enter them all in our equipment database and ensure they are properly maintained.
Doesn't it seem that we blood bankers make a lot out of small issues?
-
There are two new CAP surveys that we will be subscribing to.
They are Eluate and Antibody Titer.
Is anyone else subscribing to these? They sure aren't cheap. Our total order is now $4510!
-
Thanks for the valuable input.
I will be presenting this topic tomorrow at an Operations meeting.
I will propose we purchase weights identical to what we have now so we can send the others out to be calibrated, then rotate annually.
-
You can, you will be very unpopular with your surgeons though.
I suspect that autologous donation is more of a "right" than other types of donation. It would be fairly hard to eliminate them altogether.
Some things you can try are too educate the ordering physicians.
In our institution we discard roughly half of what we collect.
We recently stopped accepting auto units from suppliers, we hope this will save us a lot of money. We collect our own autos and patients will need to come to our facility from now on. Of course we will make exceptions.
-
Thanks for the reply.
I find the second approach the safest compromise. IT does allow for the risk of the quarantined unit being mistakenly introduced into the inventory.
Do you only have one instance of this? About how many product do you collect annually?
-
Here is an interesting topic from AABB 2004 Baltimore.
A donor presents to your center. This donor indicates that she is a female. During the interview process she indicates that she was born genetically a male. Post 1977 and until present she has had male sex partners, including while she was a biologic male.
She now will not be asked if she has had sex with a man even once since 1977. Also if her prior relationships as a man where monogamous, she might not answer that she had sex with a male who had sex with a man even once since 1977.
So, what would you do? If you were to defer her, what would be your logic?
-
At what level do you protect you donor information?
Here is an interesting scenario that came up at a meeting in AABB 2004 Baltimore.
A husband and wife arrive at your center to donate. The wife answers all questions truthfully, qualifies and successfully donates.
The husband indicates that he has an ongoing sexual relationship with another man.
Obviously you permanently defer the husband, but what will you do with the wife?
-
Thanks for the replies. I developed an Access database that our pheresis center uses to track the items I listed in the first post. It calculates the losses for the last 56 days as well as the last year, it also gives a count of the number of successful collections. Warning messages are also printed if they get close to our limits, or go over them.
So I am not worried about the work it takes to track the info, but to see if others are tracking the 56 days loss at all. We collect an occasional granulocyte or leukopack from these donors, and they often come close to what we allow for 56 days which is 221 ml.
Our Medical Director is considering dropping the 56 day tracking. I wanted to present some alternatives, it is my preference to continue to collect this information and act on it.
-
We collect about 4000 pheresis a year. We measure on day 0.
We often feel it might be better to measure on day one after they have rocked for a day, but the few times (not scientific) that we have needed to measure on day one also, the counts are not always higher as I hypothesized.
-
When we purchase new weights they come with a certificate ensuring their accuracy. The certificate expires 1 year after receipt.
Does anyone recertify their weights?
-
Sorry you had trouble uploading, I looked into the problem. There was a folder permission that was wrong, I have reset it.
You should be able to upload it now.
I do like it when people post their files for all to share, but I also understand that not everyone will be comfortable with that. Either is fine. If I see posts where people are sharing files, I often ask the person offering the file to post it for all to see.
I added a test file here to make sure it worked.
100% leukoreduced
in Transfusion Services
Posted
The patient should only be getting billed for the features of the product they require, similar to antigen negative units.
The reasons are very complicated. We transfuse about 50,000 products / year. We have a very large oncology transfusion population and identifying these patients can be complicated. Our IS system has a few triggers to help, but sometimes these patients sneak into the OR or ER and get transfused. Irradiated products can't hurt anyone; however, the disaster from a patient who needs it but doesn't get it...