Cliff

Still wondering about this. It looks like FDA has not changed their stance. I know it's only a few less questions, but... Does anyone know if FDA is considering lifting this?

We have the same problem, we can get them (Igloo) to validate under 10 for at least 8 hours, but under 6 is about 1-2 hours, and some won't do even that good. We still have a few "old" blood coolers in the lab, unfortunately we don't have the ice blocks for them. They are large with an orange lid and hold at least 6 units. They have an insulated cover that is sealed when closed. We are looking for a similar type cooler, one with an insulated cover that actually holds the temp. Does anyone know of a vendor for these?

AABB and FDA clearly define the storage (1-6 C) and transport (1-10 C) temperatures for blood products. We have many (30+) coolers that we have validated can hold a temperature between 1-10 C. Most of them will not reach a temperature below 6, and those that do usually only hold it for a couple of hours. Previously we had considered these products to be in transport; however, I will agree it is more appropriate to consider them often being used for storage, especially in the OR when they may remain there for many hours. Does anyone have a cooler they have been able to validate that maintains a temperature of 1-6 C?

We are a large facility, processing about 90-100,000 samples per year. We perform a confirm type on all samples that do not have a historical type, regardless if they are to be transfused. This includes baby samples.

I agree, we only give type compatible (non-O) after performing a circulating anti-A/B.

We also have a donor center and collect our own heterologous cells. We keep them frozen in aliquots so they are ready to use. This process has saved us a lot of time. I attached our SOPs, they are a few years old, but work well. E4.001.doc E4.002.doc E4.003.doc

Thanks for the reply. I looked through the CFR's and did a few searches and could not find anything either.

When labeling a blood product, I am aware that the product name and additive solution (if used) must be listed. My question is, does the mEq of sodium need to be listed? I see it on some labels, but not others. See the attachment for examples.

That's very easy to add. Please post the possible poll selections and I'll add a poll to this post. Or: If there could be many different questions related to this topic, I can create a new survey. That allows members to answer many questions on one topic. Again, just post the different questions to ask here, or send them to me in e-mail, and I'll create the survey.

What about check cells. I am not sure what they are coated with though. We've used them in the past for a competency, but only to see if staff were detected a positive DAT, we did not ask them to elute it.

Hi bloodbankbrother, and welcome to BloodBankTalk. This is a great suggestion, I developed a web site for the hospital I work for that partly does what you are speaking of. I'd be happy to develop it for all to use at BloodBankTalk, but... I see several problems with developing something like this. First there is a liability issue, but I suspect I can get around that with a disclaimer the user agrees to with each visit. Second, malaria risk areas are updated by CDC on a regular basis, I do not want the responsibility of keeping the list updated. Also, it might be a little harder to search than it initially appears. For instance, take a look at Mexico, that is a tough country to determine suitability. As for medications, aside from the ones listed in Standards, and FDA (I believe there are 4), all other medications are cause for deferral based on the medical condition, not the medication. That would be a Medical Director decision. Again on our site we have thousands of medications listed; however, they have been reviewed by several of our Medical Directors and nurses over the years that we have used the list and is highly customized for our environment. If other users have suggestions on how to make these projects feasible and will post them here, I will be happy to develop either / both of these modules for use at BloodBankTalk.

I just returned from AABB in Seattle. What a great conference. I hope some of you were able to attend. While I was there our Platinum Sponsor generously allowed me to leave pens at their booth. The pens had the BloodBankTalk web address on them. This was an effort to help attract new members. Did anyone get one of these pens?

I agree in principle; however, what about other circumstances? Let's say the program was generally a macro tool that first copies my keys strokes then iterated them as many times as I wanted, let's say 100. I did the first one and that reflects the way I would use my software. Also, it could be helpful in stress testing, especially in smaller facilities that might not have many staff available to attempt simultaneous data entry. I agree that a third party tool can't do the entire project, but I think it can add a lot of value.

This has been solved and all of the forum should be functioning as expected now.

It's determined by the total number of posts. Currently there are three levels, they are the default levels from when the board was installed. I'd be happy to change the titles and post requirements if someone had some catchy suggestions. Here is what we have now: Junior Member 0 Member 10 Senior Member 50

Sorry about that Gail. You should be able to open them now.

I recently ran across this in the JCAHO Q&A. I found it troubling that they require a specimen to be 3 days old or less when used for an antibody screen or crossmatch. I looked through their Standards and could not find the same requirement. How long you you use a specimen for ABS / crossmatch?

Hi Lu, It's timely I re-read this today. I just finished photocopying for the last five hours. We need to send in four months worth of QC data as part of our follow-up to JCAHO. We aren't a 20 rack facility, but we do have 6 routine racks, and it hurt a little. We also have a Rosys that we need to do QC on. Plus we were not following the manufacturers directions and testing with dilute anti-A and dilute anti-B. So in the past 6 months our QC has changed quite dramatically. My opinion, we didn't do a single thing to improve patient care. We are spending time and money needlessly to meet a foolish requirement. Phew, I fell better now.

We have a very active delivery service. We defined this in our policies: "Rh positive platelets must not be given to Rh negative females <50 years of age unless approved by the Medical Director." We also have a fairly significant inventory, so this is not an issue.

We do the same, but we don't make staff sign. They know it's there responsibility to read it each shift. It has worked well for us. We also have a white board in our coordinating (central) area.

Hi Gloria, Not saying I agree or disagree with the policy, but we give leukopoor (CMV safe) to women known to be pregnant. Possibly that is the origin of this policy.

We have a great pole made by Haemonetics just for this use. You can hang several units at once, there are hooks at the top and bottom of the pole, and there is a wire tray to site the final bags in, not on the floor. It's called a RBC Filtration Pole. It has a List Number 8170 on it. I looked around on their site but could not find it, I'm sure you could call and get more info.

Our institution has a bone / heart valve bank, and had a separate tissue bank on a burn floor. Both of those areas had repeated concerns with JCAHO surveys. It's more than just tracking, it's also a storage issue. Both places had fridges, freezers and room temp storage. The easiest solution for the institution was to move the tissue from the burn floor into the blood bank, the volume is rather small. The bone bank in the OR is not staffed all of the time and there is a log book that nursing is "supposed" to use to track products. It's a lot of work for the bone staff to try and reconcile the products each month. The institution approved a significant amount of money to install a medication cabinet (http://www.omnicell.com/solutions/medication_use_process/medication_dispensing_systems/medication_cabinets/unit_dose_center.asp) to assist in tracking the products. We are waiting for an upgrade to our pharmacy server to install it. It will attach directly to the hospital IS system.

Nancy, Looks like you got lot's of terrific suggestions, now you'll need to work this out with your director. I was involved once in a situation where a 12+ year phlebotomist collected a sample from the wrong patient. The patient was transfused with 12 A units and they were actually an O. The patient did well, settled for an undisclosed amount. The directors were all in favor of letting this person go. I adamantly voted against, and fortunately policies were changed that included disciplinary action, not immediate dismissal. You might also want to remember that these forums are public, and this 3rd shift employee might hear about their imminent demise from here.

We are in the process of installing it now. We are going from a home grown system to HCLL, so as you can imagine it is presenting some challenges. We are a large organization and our home grown system is very integrated.