Karen Olsen

We pay $155 and charge the patient $215. We are in Florida where blood products are historically lower priced due to all the many snowbirds coming down to donate!

With our current procedures, we wouldn't even be aware of a positive DAT with a negative screen unless it was specifically ordered by the physician. We would do IS crossmatches with a negative screen. A DAT is a reflex test with a positive Auto Control run in conjuction with the ABID panel. Therefore we would do AHG crossmatches because of the positive screen, not necessarily because of the positive DAT.

We use a competency on their first day of training just to be sure that they are somewhere in the ballpark. That way you could catch it before they have been working for you for a long time and would become offended at being questioned. We actually have never experienced anyone not grading reactions consistently.

I had the opportunity to observe NICU nurses performing the transfer of packed cells from an aliquot bag to a syringe a few years ago ( yes it was NOT labeled!). That was when we switched to providing them with the blood product in the syringe. We stick the label right on the syringe and place the Transfusion Tag on with the Tack-It Gun right under the edge of the sticky label, so that it stays attached. It really works quite well and the nurses are thrilled with the system.

Thanks for this discussion. I just went and changed my set points because this really did make sense when you think about the set points for refrigerators. I agree that you would have plenty of time to remove your platelets and place them in a suitable temperature range. But I figured why not change my set points and be done with it! Thanks again!

Jane, I am in this same process. Our Administration is considering changing from a physician presented and signed informed consent to having nurses perform this task. Our PI department states that according to national law an informed consent must be presented and signed by the physician, whereas a general consent form can be performed by a non-physician. I have contacted all of our governing agencies and read and re-read all the standards involved. I am still not convinced either way. CAP states that they don't care whether a physician or nurse presents the information as long as each aspect stated gets presented and that the Medical Director is involved in the P&P process. AABB states that even though it isnt stated in their standard it is assumed that an informed consent is required and that if the patient has the opportunity to ask questions wouldn't the physician have to be there. JCAHO states that there are no national regulations on this matter and that they have moved the standard out of the laboratory section and into the general section. They leave it up to each facility to decide which procedures require an informed consent and which ones a general consent. If anyone has any additional discussion on this I would appreciate it as we will need to make a decision soon. I can understand why the physician compliance is poor at best when you think of all of the chonically transfused patients. Thanks for your help! Karen

Thanks for the info on pooling FFP in the HCLL system. I am not yet on the HCLL system, but I had tried and failed to be able to pool FFP in the old Hemocare system. This info will be very useful when we do convert to HCLL. We pool FFP or CPP for plasma exchanges - just to be nice!!