Karen Olsen
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Posts posted by Karen Olsen
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Bob,
Your contibutions to this site will be greatly missed! It is a shame when this field loses yet another fine brilliant mind. I keep waiting for the day that this stigma finally changes...........
Best wishes in your new position! Please keep in touch.
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Since you can't get the MTS incubator at 37 degrees, the pre warm method does not always work very well with Gel. We usually end up reverting to the good old tube pre-warm!
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Our facility does require a photo ID - BUT - if they don't have one they just put a note in the patient's file in the computer, stating that there was no photo ID available at time of service.
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Our procedure for Auto/Directed is exactly the same as John's as described above. It works well for us. The computer system takes care of all of the safety and regulatory issues for us.
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Most of ours are just a preliminary recall - they usually don't turn into the full fledged look back involving sending the info to the physician and they in turn contact the patient and offer counceling and free testing (as appropriate) to the patient- with us documenting all of the above actions and sending a copy back to the blood supplier.
Usually, all we end up performing is a check for the unit - if it is still in inventory we discard it or if it is already, transfered, discarded or transfused we send notification of such actions to the blood supplier. At this point we do not notify the physician or patient unless further testing by the blood supplier indicated its necessity.
Hope I understood your question correctly.
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a co-worker was researching centrifuges for me and ended up on BBT - we were hooked from then on!
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Explain to them that it is the "Standard of care" in the area and nationally. How can they argue with that!
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I agree it needs to be considered Transfused. As for billing, another option would be to bill a partial or split unit. At least you would get some of the cost back, while not socking the whole thing to the patient.
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Must be a Florida thing. We have had the same situation occur several times in our ER and occasionally in L&D. Therefore we never go by a historical type and always request the patient be re-drawn for a blood type prior to giving out RhIG.
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Sorry - should have used spell check!!!
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Pharmacy has always handled it here. The only problem I have with it is that they determine wether they have enough on hand to use for plasma exchanges ( when appropriate). So they often say they don't have any available and we have to substitute plasma for those exchanges! We don't have any idea how much they have so we can't really question it.
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If you do this a lot, I would agree with John!
If we run out of sample on a patient within the three days, our P&P states to collect additional sample, leave the outdate the same as the original sample and perform a T&S on the new sample and go from there. To avoid all of this trouble I would guess that most of the techs would just have the patient restuck with a new I-Denta-Band and treat it like a brand new specimen. Thus extending things for another 3 day period!
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I have had the same experience with the "new" Jewett. We have a Jewett Freezer and have had the same problems with it icing up! Our BioMed department just keeps replacing the same part and we keep rolling along with it. I have had much better luck with Helmer lately.
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We do not blot our DAT's. We have not had any issues. I preferred the DAC II to the Sorvall's we have now. Just a personal preference. I agree - the pinch valves are a pain.
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We issue Platelets for transfusion only. Our OR has a monitored refrigerator for RBC's.
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Very Interesting!! Thanks for sharing! I like John will be lucky to remember this discussion if I am ever so unfortunate to find myself in this nightmare situation!
Does this discussion mean that you do not routiinely have a T&S or at least an "extra" specimen on your Cath Lab patients. I have polled various sites to inquire about this and have received mixed reviews. We are trying to get a specimen on Cath Lab patients prior to procedure but have had no sucess as of yet.
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We give O neg leukoreduced < 7 day old units in Adsol to babies and then keep them on that unit until it expires or is gone. We do not use cord blood specimens for transfusion purposes. We draw a bullet in EDTA. We use Mom's Ab screen status if available. We irradiate as stated above by Shily and then give the unit a 24 hour outdate - so we also irradiate the aliquots instead of the entire unit.
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How do you "create" new product codes? The P codes are created by Medicare and are very specificly defined. We also can not have different charges for the same CPT code so as of yet we have not found a way to charge for all of the additional fee charges (like after hours and stats)
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Mary,
What CPT code do you use for that Bill Only charge? The misc. charge?
We had quit charging for any of those miscellaneous charges a while back when corporate didn't want anything w/o it's own CPT charged. It is my understanding that the billing department would have to send a special form in with any non CPT charges. I can't imagine them filling one of those out every time the Laboratory had additional charges!
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We have incredible lab weeks year after year - it just seems to get better every year. We have many many games. We do a plant/bake sale and gift basket raffles for the entire hospital with the procedes going to toys for Pediatrics or some such worthy cause. We also do a very good job of including all shifts. We have breakfast and lunch provided every day on day shift and then fresh dinner provided for each of second and third shift every day. Yes, they get a lot of leftovers from day shift because we never eat it all. But they also get their very own fresh food! So I guess they potentially gain even more weight than we day shifters!!!! We figure nobody else is ever going to recognize the laboratory so we might as well do a good job of recognizing ourselves.
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We have set criteria that needs to be met prior to switching to positive blood. We also have to have Pathology approval and inform the attending physician. Beyond that we have stickers that go on the units stating that "due to inventory limitations, a medically appropriate blood group substitution has been made". Normally these stickers are used when we switch blood groups due to patient special needs - like antigen negative blood. But we could also use them for the Rh substitution to allow the RN to feel more comfortable about the transfusion.
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I would love to see what you have for your educational power point. My e-mail address is Karen.Olsen@mmhhs.com
Thank you
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Our Emergency department typically draws a rainbow on almost everyone and a "hold clot" for BB when they think there may be BB orders. They draw the Hold Clot following the same procedure as any other BB specimen. The "Hold Clot" is sent to BB as soon as it is drawn. Orders can then be added on at any time for 72 hours.
The "Extra" tubes in the rainbow are labeled properly, sent to the lab and are stored in the appropriate department.
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Debbie,
I agree that it is pretty clear cut that TRM.30575 states that a separate BB ID band will not meet this standard. I am a little surprised that they would mandate so specifically what needs to be in place to meet this standard. Other than the separate draw which creates a lot of time constraints, excess use of type "O" RBC's, and patient dissatisfaction the options take considerable time and money to implement! We all know how hospital administrations react to those two things! Also Phase I's usually end up as Phase II's in the next cycle which will really put the pressure on! I'm all for patient safety but I'm not real happy with how quickly CAP seems to be reacting to things lately. Just my opinion.
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Record retention
in Transfusion Services
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Since CAP requires Clinically significant antibodies to be kept indefinately, I error on the side of caution!! I keep the panels for two years in house and then send them off to the archive warehouse til the moths eat them! I know this is over kill since all the information is in the computer. But those of us who are older don't always trust that computers are not going to crash and our back-up tape will be nowhere to be found and and and......
However, I would agree that for those more trusting individuals - 5 years would be adequate as long as you had a permanent record of the identification somewhere else.