Baby Banker

We use clear zip lock bags and we fold the product ID tag around the unit so that none of the information on the tag is visible.  We used to use Biohazard bags, but someone pointed out that the patient or patient's family might think that we are giving them units with positive viral markers.
When we release multiple units at one time, they go in a validated thermal container.
Either way the unit and patient information are out of sight during transport.

We use clear zip lock bags and we fold the product ID tag around the unit so that none of the information on the tag is visible.  We used to use Biohazard bags, but someone pointed out that the patient or patient's family might think that we are giving them units with positive viral markers.
When we release multiple units at one time, they go in a validated thermal container.
Either way the unit and patient information are out of sight during transport.

We use clear zip lock bags and we fold the product ID tag around the unit so that none of the information on the tag is visible.  We used to use Biohazard bags, but someone pointed out that the patient or patient's family might think that we are giving them units with positive viral markers.
When we release multiple units at one time, they go in a validated thermal container.
Either way the unit and patient information are out of sight during transport.

I avoid giving O Pos to male trauma patients because if we give them an anti-D and they manage to show up as a trauma patient in the future, they are at grave risk of a serious reaction.  I would note though that since I am in a pediatric institution, this is more likely to occur than in a general hospital.
 
Thankfully, we have never been faced with having to use O pos for a female patient.  There is usually not much delay in getting a sample;  we generally go to type specific pretty quickly.

I avoid giving O Pos to male trauma patients because if we give them an anti-D and they manage to show up as a trauma patient in the future, they are at grave risk of a serious reaction.  I would note though that since I am in a pediatric institution, this is more likely to occur than in a general hospital.

It is my understanding that if you use a computer system that is validated and has been set up with logic to recognize valid typing reactions (and reject others) that you meet this requirement.

I love the 3 cell vs the 2 cell screen for positive ab screens. it is sooo helpful in ab id use with the homozygous cells.

Congrats!

And then a comprehensive validation to show that it would work in all situations.
Best to stick with what the manufacturer requires in their directions.

And we do aliquots in syringes and bags.  We also reconstitute whole blood to a specified crit.

We are a pediatric hospital with about 330 beds.  That does not include the bascinets.  We have a very active Heme/Onc program, as well as CV and neonatology, and Level 1 trauma service.  Those are the services that use the most blood.  
We do stem cell, heart, liver, and kidney transplants.

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

Both of these are good examples.
We do our validation in three parts:  Installation Qualification, Operational Qualification, and Production Qualification.
The IQ just shows how it was installed.  For a piece of equipment it could be the installation checklist.  For a test it could be screen shots of whatever was changed in the computer to create the test.
Operational Qualification shows that a piece of equipment does what the manufacturer says it will do.  What I do for a test is build it in my Validation Environment and test it there.  If that passes, I build it in the Production Environment and test it again.  I can't move a computer build from one environment to another.  So the testing method for OQ and PQ for a test is usually the same.
However you validate, be sure to get your Medical Director to sign off on it.

We give all of our neonates group O blood so I wouldn't worry about getting a second type on them since we can't give the wrong blood group if the first type was wrong.

Send him on his way now, while he is in his six month probationary period.  It will be much harder to do later.  You cannot manage an employee whom you cannot trust.

Send him on his way now, while he is in his six month probationary period.  It will be much harder to do later.  You cannot manage an employee whom you cannot trust.

Send him on his way now, while he is in his six month probationary period.  It will be much harder to do later.  You cannot manage an employee whom you cannot trust.

Send him on his way now, while he is in his six month probationary period.  It will be much harder to do later.  You cannot manage an employee whom you cannot trust.

Send him on his way now, while he is in his six month probationary period.  It will be much harder to do later.  You cannot manage an employee whom you cannot trust.

As you describe the events, these are not mistakes.  They appear to be wanton disregard for procedures and protocols.  Most facilities have a training period, usually 3 - 6 months wherein a new employee can be discharged without jumping through the usual hoops.  I suggest you use this escape route if it is available. 
Just out of curiosity what is this person's back ground and how well was it checked out?  

One way to document the persons non compliance is through event management and training. 
Part of the training should require documented competency before they start submitting patient test results on their own and direct observation should be a part of that.  If this person cannot pass their competency then you have documented evidence.
If you know this person is not following SOP, you should be able to document such in your event management system.  Hopefully your SOPs also out line that concurrent documentation is required.
Based on the Fair and Just Culture of event management, this sounds like the Reckless behavior where the person is making these conscious choices and disregarding the risk involved.  This type of behavior should not be ignored and requires corrective action. 
Patient Safety and the "Just Culture."  A Primer for Health Care Executives Prepared by David Marx, JD 

That's an awful situation!  I have had to retrain several techs who made mistakes.  How long do you usually train them?  I would document everything he does wrong.  Does your procedure state that you have to put your results in immediately?  Ours does, since that is what CAP requires.  What's worse is that your higher ups aren't alarmed by your observations.  If he is not following procedure, or changing his actions based on what you have communicated to him, I would not sign him off as being competent.

I would agree with mollyredone, but would go further,
Not only do you need to record everything you say to him (and get him to counter-sign the record), you need to record everything you tell your own seniors, and get THEM to counter-sign what you have told them.  THIS PERSON IS DANGEROUS.  You, as a conscientious employee, should not have to take responsibility for this person, but, if the worst happens (and it well could), you want to make certain that you are not held responsible in law, but that the finger is pointed in the right direction.  If you get your own seniors to counter-sign your written concerns, you will, not only be protecting your own future, but will also cause them sleepless nights until they do something about the situation.

The Technical Manual used to have a list of antigens that must be represented in screening cells.  I haven't checked the newest edition.  I circle the required antigens at the top of a panel antigen profile, and then circle the cell number of each cell selected for the screen on the left of the profile.  Remember to take zygosity into count.  It almost always requires more than three cells.  
I usually do this when a patient has a known antibody.  I omit that specificity, and what I am left with is a screen/short panel that will only be positive if the patient has developed a new antibody.