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Karen Olsen

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Everything posted by Karen Olsen

  1. Karen Olsen
    We have done exactly that - written a policy stating that the service is under the direction of the provider and their medical director. I agree with the N/A. If you start taking responsibility for one standard it gets very hairy with which ones are legitimately N/A in that same section. It begins to appear that you are just picking and choosing which standards you want to live by.
  2. Karen Olsen
    If our blood supplier is just giving us the information as simply that it is hand written on the unit and is only historical info-we don't do anything with the information. If the units were requested by us as Ag negative - the units will come to us with a tag stating Ag status. We re-type all of our units for Ag status and enter our own results in the computer - so it would probably not be an issue with this inspector. I agree that they need to show the standard not cite on opinions.
  3. Karen Olsen
    KKID, I have posed this same question on this forum in the past with zero response! I am very interested in how Transfusion Services are handling minor reactions to FFP and PLP. Obviously you would not retype the patient and or unit, say for PLP when you haven't even given type specific product in the first place - so what do people do routinely for possible reaction workups. We have a policy due to the age of our population, that we consider all symptoms significant and stop the transfusion and call a possible reaction. Do they routinely perform a DAT on the post sample as you would with packed cells? I have read every textbook I can get my hands on and they all infer that the possible hemolytic reaction work-up is with red cell products.
  4. Karen Olsen
    I have used the Thermogenesis for years and absolutely love it. So quick and easy. No wet bags to deal with!! Good Luck!
  5. Karen Olsen
    We are about the same size facility as you. Our Phlebotomy team and staff from select areas of the hospital(ER,Surg, Dial,NICU) are trained by the BB supervisor to draw BB specimens. We have an additional staff member identify the patient at the time of the draw and sign as such. We also HAND label our BB specimens from the patient armband. I know - I know!! But we do not have mislabeled tubes! We are holding our breath for the electronic PID system! Everyone is very tired of hand labeling tubes. Our Inspectors love us though!
  6. Karen Olsen
    We keep the segments in the refrigerator for 2 months in bins labeled for each month. We remove 2 segments when the units are entered into inventory. One for testing and one to keep in case it is needed later. We put one of the small DIN numbers on the segment. We rotate them each day when processing inventory - throwing away the segments from that date 2 months ago and replacing them with the ones from today. Works well for us.
  7. Karen Olsen
    At our facility it is required to have a physician order blood products. PA's and Nurse Practicioner's can not order blood products under any circumstances as of yet.
  8. Karen Olsen
    We have been Gel users for over ten years and have chosen not to use the pre-diluted .8% screen and panel cells. I can't tell you how many times I have been so thankful for this decision as I receive letters from Ortho with issues and as I read on BB Talk Forum of issues!! I did try the .8% Ortho panel when it first came out but had nothing but frustration :cries:with it and went back to diluting our own cells. We love Gel as long as we stick to our guns on this.
  9. Karen Olsen
    I am one of those Rh Negative mom's who knows that my husband is the father of my babies and that he is also Rh negative. I want to keep my right, as a medically informed patient, to refuse the Rhogam shot. I understand completely what you are saying about lying or being misinformed and taking the chance of not receiving Rhogam when they really need it. It is just not always best to make blanket policies.
  10. Karen Olsen
    Worked for me with Office 2003:)
  11. Karen Olsen
    We do not use the Biohit but we cal our BB pipettes quarterly. I believe this frequency is dictated by state requirements which are more stringent than CAP, manufacturer etc.
  12. Karen Olsen
    I have been through many CAP inspections and have had conducted several as well. It is a great opportunity to exchange knowledge and information. As stated above - if you are compliant with each of the CAP standards for BB and lab general - you will have no problems. I am also responsible for the BB at a sister facility which is JC certified. I find CAP to be much more user friendly than JC. Maybe just because I am more familiar with it, but it just seems so much more straight forward to me than JC. Also, JC has been big on tracers for some time and now CAP is joining in and recommending that inspectors use this method to inspect. In the past CAP spent a lot of time looking at P&P's but not necessarily correlating it to the fact that you actually do what you say you do. Good Luck!
  13. Karen Olsen
    We would only perform the eluate if the patient had been transfused or was pregnant in the last 3 months. Or if a physician specifically ordered it - but that would never happen!
  14. Karen Olsen
    I am also very interested in what others are doing as far as reactions to components are concerned. Do you check for clerical errors,hemolysis and perform the DAT and ABO on post sample just as you would for RBC's?
  15. Karen Olsen
    We do a re-type when a specimen is added on to by another Tech. Yes-it is documented in the computer as a re-type. (This is a totally separate issue from the possible solution to the new CAP requirement of positive patient identification which can be accomplished by performing a second type on a second phlebotomy.) We only perform DAT's when we get a positive screen and are doing an ABID. We are a 350 bed hospital with active ED and Maternity.
  16. Karen Olsen
    We have always performed an antibody screen and crossmatches. We did however skip the Antigen typing of the unit if the patient had a known Ab detected in the auto unit. We would just crossmatch through coombs.
  17. Karen Olsen
    We have not received a copy of the transfusion record back from the floor for probably 20 years now. We do spot checks on the floors and our PI department has retro access via the electronic medical record -this data is included in our QA report each month. One of our sister facilities is very disappointed in this untimely data reporting and would like to go back to sending a copy to the BB for immediate review and resolution. I like Franklyn's procedure of the Nursing manager getting the second copy for review and resolution. Put it back on them! We do keep a copy in BB which gives us the issue record documentation - this has been invaluable to us! Eventually we are going to migrate to an electronic record such as Carefusion where all of the desired information will be available in the computer-real time! Can't wait!!
  18. Karen Olsen
    We do not routinely screen for cold agglutinins nor perform thermal amplitude studies. Although we have been asked to on several occasions. We do let the perfusionist and surgeon know that their Open Heart patient has a cold agglutinin if we happen to detect it in our normal testing and at what phase it was reactive. We do not go looking for them! This topic comes up about every 7 years!
  19. Karen Olsen
    We document the initials on the requisition. This rule is for all patients. Of course with emergency release it would be done post the patient getting the O Neg units-as soon as the specimen is drawn. This system has provided our Techs with a much better sense of security that the specimens are from the correct patient.
  20. Karen Olsen
    We use manual logs for recording typing results and then have it in front of us when labeling the unit. However, we are a Transfusion Service not a Blood Center, so our numbers are not astronomical.
  21. Karen Olsen
    We are doing as most have already indicated - just what is required by regs and then only doing additional testing if indicated. I would like to ask if everyone is performing these clerical checks and initial testing for reactions only to Red Blood Cells or for all blood products? I am also wondering if anyone has added anything for TRALI. What initial indicators are used to cause suspicion of TRALI? I have read MANY articles and it all sounds great - but in practice what are people looking at initially to cause you to look further? Thanks
  22. Karen Olsen
    Ditto!
  23. Karen Olsen
    Yes, we are in the same boat - our blood supplier only allows us to return PLP's with a 24 - 48 hour outdate. We would eat the cost if they could not pawn them off on some other site that had give orders. FFP we would again eat the cost if we couldn't use them for another patient or find another facility that could. We do track this financial loss and try to make the Doc's feel a little guilty about it anyway?!
  24. Karen Olsen
    Anna, I looked it up in the 2008 Publications from aabb. The $100 (member price) CFR Mini-handbook which contains the most important portions of the Code of Federal Regulations was in it. ISBN #978-1-56395-258-6. It is a soft cover 512 page book from Sept. 2007. Hope this helps!
  25. Karen Olsen
    We experienced the same problem. It was so sporadic that we did not worry about it. We skipped those wells. The next lot cleared up the problem so we figured all was well (no pun intended) that ends well. Thanks for the update!
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