Baby Banker

We are experiencing all of that.  
The fact that my hospital refuses to even think about sign on bonuses makes it even worse.  The hospital down the street has an $8-12K bonus and their benefits and pay were already better than ours.
I saw a few weeks ago that a hospital in Philadelphia is offering a $20K sign on bonus.

We are experiencing all of that.  
The fact that my hospital refuses to even think about sign on bonuses makes it even worse.  The hospital down the street has an $8-12K bonus and their benefits and pay were already better than ours.
I saw a few weeks ago that a hospital in Philadelphia is offering a $20K sign on bonus.

We are also experiencing this.  My system isn't offering sign-on bonuses for technical staff but up to $30,000 for acute care nursing.  Our lab has at least 12 vacancies on 2nd shift and similar for 3rd shift.  1st shift technical staff are working incentive contracts for bonuses  - double shifts for some or weeks without days off - and are burning out so morale is at an all time low.  Retention of staff is a big problem.  My lab is staffed by long-term staff - all the recent hires (within last 4 years) have quit - gone to school, out of the profession completely, gone to other facilities that are closer to home and pay more, gone to other labs that pay more for less work stress.  We just started hiring travelers for some of the technical positions and phlebotomy because there just aren't applicants for full-time, permanent positions and the pay just isn't enough and there are so many vacancies - definitely a buyer's market for lab staffing.

We are experiencing all of that.  
The fact that my hospital refuses to even think about sign on bonuses makes it even worse.  The hospital down the street has an $8-12K bonus and their benefits and pay were already better than ours.
I saw a few weeks ago that a hospital in Philadelphia is offering a $20K sign on bonus.

Agreed. Anything less than a full phenotype is useless. We don't even do that for Screening Cells, which are arguably a lot more important.

I could NOT agree more, particularly as most of the antibodies available are exceedingly strong monoclonal antibodies, which will QC NOTHING, and as the equilibrium constant of a truly weak antibody is quite different from that of a diluted strong antibody, particularly a strong monoclonal antibody, so just what do these inspectors think we are "QCing" using such antibodies.  It is utter nonsense.

It seems a waste of time and resources as I cannot see how a lab could possibly QC a pannel even approaching what the manufacturer is required to do. 

John C. Staley, in my 30+ years also, we have never QC'd panels and have never been cited )we are AABB, CAP and FDA inspected).

In all my years (30+) in blood banks and transfusion services I never QC'd panels and it was never addressed in any inspections/assessments.  When ever the subject came up I figured that if you were not QCing every antigen on every cell you were doing little more than providing some random inspector with smoke and mirrors so they would think you are doing something worth while.  A some point you need to trust the manufactures to do their job.  

We do this too, but the sops already posted have everything in them that is needed.  
I would caution you to not use saline as a diluent.  We had a physician insist on it ages ago, but it doesn't work.  You really need the oncotic pressure from plasma or albumin.  If the concern is kernicterus, some places will use albumin.  That's not usually why we do an exchange.  We are usually confronted with a sickle cell patient with chest syndrome.

In my opinion, you can run an antibody screen on the last wash instead of a full panel.  Of course if the screen is positive, you'd want to run a full panel.  I have never known the last wash screen to be positive.

We've had it for a couple of studies, but we don't routinely stock it.
We have SafeTrace Tx.  
I built a new product type for solvent detergent treated plasma.  That prevents anyone from filling an octaplas order with regular plasma and vice versa.
The product code for the pictured product is X0003.  It will change to X0007 when it is thawed.

Also, if you waste time and effort on validation that is not necessary, you have less of both to do necessary validation.  
I mean what's next?  Validating the change is the oxygen/CO2 ratio due to staff breathing?

In my opinion, you can run an antibody screen on the last wash instead of a full panel.  Of course if the screen is positive, you'd want to run a full panel.  I have never known the last wash screen to be positive.

In my opinion, you can run an antibody screen on the last wash instead of a full panel.  Of course if the screen is positive, you'd want to run a full panel.  I have never known the last wash screen to be positive.

You may be able to find something on the Pediatric Trauma Society site.
https://pediatrictraumasociety.org/education/Journal-Scan/2018/august.cgi
 

We use fresh (less than seven days old) irradiated RBCs.  We wash the units only if they are not fresh.

Easy, give group O only. 
We used to allow directed donations and we would do a back type on the baby.  We stopped allowing directed donations years ago and only give O Neg to our neonates.

Get to know your staff, but remember that you are not there to be their buddy.

I used to use a 10mL tigertop tube, it was an excellent brake!

I'm using the Hettich with the brake set for soft braking. We just live with the increased time. 
I miss those old centrifuges, too. Flip the lid open, apply pipette bulb, eraser or fingers for brake....  OSHA would have a fit today!

I especially like the way you phrased it as "transfusion error stories" and not transfusion horror stories.  Looking back I sometimes think I could write a book on the subject.  Well, maybe not a book but at least a novella!  Some of the stories would be comical and others terrifying.  Luckily, in over 35 years in the business none of my stories are fatal but a few had the potential.

 

When I was a very young tech, our supervisor had us carry every Rh negative result through "Du" as it was called then.  I also had an O Neg labeled unit test O "Du" positive.

Get to know your staff, but remember that you are not there to be their buddy.

What do you do with a syringe aliquot that is made from a unit that has had bacterial testing?