Mary

Gosh, we are all going to "go broke" buying labels!

How is everyone handling the new requirement that you must have a unique facility identifier for modified and pooled product labels?

We allow them to store the armbands in the chart. They then call us to check the armbands after they put them on the patient. This is labor intensive, but it works 99% of the time.

Does anyone have an electronic copy of the AABB Weekly Report from 3/31 that you can send me?

Why do you do an antibody screen if only plasma products are ordered?

Try saving your expired panels to use for more rule out cells.

We require that a patient have a record of 2 ABO&Rhs on file before we issue plasma products unless it is an emergency in which case we issue Group AB. If a patient does not have previous records, we draw a sample and armband the patient with a Blood Bank armband and perform an ABO&Rh. The problem comes in when we issue units for a patient that had previous records, but is not wearing an armband. This confuses the nurses. What does everyone out there do?

We require the physicans to sign a consent form annually and state the patient's diagnosis, the "cut off" for the hematocrit, and the frequency of the bleeding. We place these orders in the electronic patient chart and in a patient comment in our Cerner computer. The patient also has to sign a consent form with each phlebotomy. This is an "invasive procedure" and we feel the consents are needed. If the physician does not specify a cut off, our policy states we will do a phlebotomy if the Hct is >50% or we call the doctor.

Richard, What is your source you the May 2008 date?

Does anyone know where we can purchase pooled product barcoded labels? Also, can we address why we have to have these if our hospital does not have a bedside computer system for blood transfusions?

We are still washing cell suspensions. I would be interested in knowing what those of you who do not wash them,do about package inserts for anti-sera that state that the testing should be done on washed cell suspensions?

Hi K, Do military labs get inspected by CAP? Even if they don't, they are a good guideline for standard of practices. CAP Reg #TRM.40740 states "Is there a policy to prevent or limit the administration of ABO-incompatible donor plasma in platelets to infants?" Their explaination goes on:For infant recipients, donor plasma in platelets must be ABO-compatible, as relatively large amounts of ABO-incompatible plasma may cause hemolysis or shortened red cell survival. If necessary, the plasma volume can be reduced shortly before transfusion by removing plasma from the platelet unit and resuspending the platelets in saline or albumin. We try to stock Group A plateletpheresis because they are ABO-compatible with Group A and Group O patients. It's the B's and AB's that give you issues. By the way, we still send our very ill babies to Indy! How is Germany?

Laura, I would be interested in what you meant by "creating more problems" with a second sample.

Surgery is in charge of tissues. We tried to manage the tissue inventory, but it was a nightmare trying to stock what they needed. The "quality" issues were difficult to communicate to nursing.

I would be interested in learning what others are doing when you are not using the computer crossmatch, to confirm the correct ABO&Rh type of patients that have no existing history in your computer. Does a second tech retype from the same tube? Do you retype all patients or only possible transfusion candidates?

Only IM Rh Immune Globulin in Blood Bank.

I would be interested in hearing what percentage of plateletpheresis expire inother Blood Banks with a Open Heart program. Our percentage is 45% wasted.

We added an override reason of "specimen not expired" to use in dispense. If you do not perform the crossmatch within 3 days, the system completes it. We order a new crossmatch when this happens. We used to use 14 days, but lowered it to 10 days, because many reagent manufacturers state that testing should be performed on specimens that are less than 10 days old. I think you could change the number of days in Cerner Millennium in Blood Bank tools (Preference for Crossmatch release) but then these crosmatches will remain in your pending inquiry for that many days. Cerner calls it a "NAPWAD" (Not a Problem, Working as Designed)!!

Cerner Millenium has a much more complicated build system than Classic. Making changes and additions is more difficult. When we upgraded, the only patient history that they uploaded from Classic was the antibodies and patient comments. No ABO&Rhs. Very disappointing. Programming printers seems to be rocket science in Millenium! Dispense is harder. Unit that are reserved or crossmatched do not appear on the screen. You have to enter the unit numbers. Classic was more reliable and user friendly. The icons in Millenium are pretty tho! Good luck.

Kristine: I meant here!! Ha. Mary P

CRH is still hear! Mary

Our central supply department prepares kits for deliveries and autoclaves the kit. The EDTA tubes are plastic and melt in the autoclave. Any suggestions would be appreciated. Mary

Hi Krisitine from Columbus. Good luck on conversion to IS. It's use is standard. Mary

Thanks for your input everyone. Mary

Does anyone have cord bloods collected into EDTA tubes rather than clot tubes? If you do, do they have trouble getting the cord sample into the tube? Mary