Karen Olsen
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Everything posted by Karen Olsen
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We use slips of paper to pick up blood products. They contain the patient Id information, the TS Ident-a-Band number and the products they wish to pick up. We keep them for a month, but I have never had to look anything up on these slips.
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We culture via the unused port if available and set up blood culture bottles. If there is no blood left in the bag to draw out whatever we can from where-ever. Usually the tubing.
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We have criteria for our refrigerators and freezers which state that the top and bottom temps are within 1 degree for refrigerators and 2 degrees for the freezers. I can not find a reference for this standard anywhere. Can anyone help??
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We monitor product wastage and expense,improper storage,phlebotomy TAT, recollects,>4 hour infusion times,Transfusion Slip completeness,logs for refrigerators in surgery and cardiac ICU, blood usage in surgery, C/T ratio, and then anything else each year where we perceive there may be a problem.
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As long as type O blood is used we only require a crossmatch if the mothers Ab screen in postive. This can be performed with the baby's plasma or mother's plasma. If there is no antibody involved but non-group O blood is being used, we require a crossmatch performed by taking the baby's reverse cells through coombs.
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We had an unusual occurance the other night and I was wondering if anyone would be willing to share what their policy would be in this situation. A patient requiring emergency release blood due to incomplete testing was refered(passing the buck) to another physician (at home) who requested that we give one unit at 11:30 PM and he would sign the emergency release slip in the morning when he came in. We had never had this happen where the actual physician requesting Emergency Release was not on site. In the end the testing was completed prior to transfusion, but we were still left with the question of whether we would have insisted that he come in to sign the request prior to transfusion.
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billing for Antibody identification
Karen Olsen replied to Eagle Eye's topic in Immunohematology Reference Laboratories
We bill for ABID for each specific methodology used. Even if the additional testing did not lead you to an additional antibody, you still performed the testing and should be able to charge accordingly. -
We routinely pool 10 Cryo units. We will do whatever the Dr. orders, like John S. stated, as long as the order is reasonable! We also have conversations with Dr's if they need a little help.
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Hemocare Support - Third Party Company
Karen Olsen replied to JERSEY's topic in Computer Systems / Software / ISBT128
Our parent company made a special deal with Mediware to offer support through Dec.2007 because they have so many facilities to try to get switched over to HCLL. -
Everything I read lately talks about this being the next topic to attack since the bacterial testing of platelets has been taken care of. We are not stocked addequately for the most part to be able to give type compatible cryo to our patients. It seems lately that we have been getting mostly type O cryo from our supplier - ugh! I guess we will just have to wait for a mandate from the FDA or AABB.
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I agree! Thank you so much for all you do! This is a great resource for all Blood Bankers.
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Welcome! I am a Bucs fan, but would just LOVE for Tony Dungy to win the big one - he deserves it - since Gruden got his win off of Tony's hard work! This is an awesome site. I spend a lot of time here - it seems as though after every conversation out in the BB where a tough topic comes up - I go in my office and pull up BBTalk and there are great discussions at my fingertips! Even though they dropped their first game yesterday - I'm still hopeful that the Colts can hang in there the whole way this year!
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We have refrigerators in both Surgery and CVSI. We use a documentation card that includes patient name, unit numbers, and then in and out times x2 and return to blood bank times. Surgery has been using this system for many many years and has it down pat with very few "issues". CVSI however always claims they are two short staffed and have multiple issues with getting the documentation when and where needed. I am interested in the locked refrigerator idea! I have never been a proponent of blood coolers because of the chance that one will be left in the OR room and blood used on the next case. I have heard too many horror stories. I think it probably works best to use whatever system the Surgery department is familiar with. You will get better compliance that way. Good Luck - this is not an easy one!!
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I completely agree with your last statement. We do not require two separate draws at this time. We do, can you believe it, hand label our transfusion samples from the patient's armband. We also spend a lot of time on training and competency of all those who draw transfusion specimens. In addition we have two people identify the patient prior to drawing and document such. We have avoided the 2 separate draws so far due to the issues you raised in your post. I am hoping for an electronic solution soon.
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Our policy doesn't state exact numbers but we say any change in BP or symptoms would constitute a possible reaction. Whether they all follow this is doubtful. We do state that a change in BP of 30mmHG as a trigger to culture the unit once the reaction is called. We are educating our nurses to call any symptom a possible transfusion reaction and not give the physician a choice. We have them call us first and then the physician unless of course the patient needs immediate attention from the physician!!
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We insist on a name prior to issue of emergency release blood. It is often a Doe name but never the less a name to put in the computer. This is also helpful if there are multiple patients.
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We perform a T&S on all moms. We have found that on rare occasions the blood type provided by an outside source is incorrect or incorrectly documented on the chart. We also have a large population of patients that have had little or no pre-natal care. To make matters worse we have had patients who use someone elses identification when admitted with obvious negative impact. I realize these are unique situations but thought it might help to explain the why behind the T&S on all moms!
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We try our best to leave the bubble but do not require it. I do train to hold the pipet at a 45 degree angle, stabilize the pipet, dispense as close to the far edge as possible and "slow down". This works quite well.
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We also only use Anti A,B for retyping of donor units.
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One of our Pathologists is questioning our policy on Transfusion Reaction investigations for non-severe reactions to FFP and Platelets. I have searched the manuals including the AABB manual on transfusion Reactions, but have not found anything that gives specifics on handling these cases. If anyone has any input or would like to share how they handle their investigations - I would greatly appreciate it.
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If you are refering to complement control cells - yes! We have the same issue. The incubation at RT does improve the reaction however. It's not like there are several vendors out there that we can try either!!
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We use a piece of paper with the patient's ID sticker on it with the additional information of product, quantity, and Hollister Ident-a Band Number hand written on it. We do have an actual form for Surgery that allows us to track Autologous/Directed units usage.
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Billing for the provision of antigen negative units
Karen Olsen replied to kbadjie's topic in Transfusion Services
We also charge per antigen typing regardless of the result and use CPT code 86903. For the antigen typing of the patient we use CPT code 86905 and when we use the patient's serum to screen units first to limit the number of antigen typings we use CPT code 86904. We bill these charges to the patient manually. -
We have seen this same thing when re-spinning a card with another patient later on-it goes to negative. It is usually rouleaux or some other clinically insignificant problem. We have never had a true antibody go away when re-spun - that we know of - it is not something we would be actively looking for! We also have had the pre-diluted Ortho cells miss a Jkb that I knew was there from previous results. That was many years ago and the reason that we started diluting our own cells. The only problem we have had with using Immucor cells with the Gel system is that they are not screened for Gel use and may cause false positive reactions.
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We try to send segments to our referrence lab for crossmatching with the adsorbed sera and of course use antigen negative units if alloantibodies are also present.
