reidhospbb

We use the four-inch carrier for the majority of the deliveries within the pnuematic system. Only one station out of the fourteen has the capability of using a six-inch carrier.

Having both a Mac and a Windows laptop at home, I nearly always use the Windows unit. I suppose it is what you are used to, but I have never been able to "get used to" the Mac commands. It always seems to me you have to do two or three more keystrokes to accomplish what Windows does in one, if the Mac can do it at all. Just one soul's opinion.,

We had trouble with attendance at the Transfusion Committee. Now, our "Transfusion Committee" consists of the blood bank manager and the BB medical director. We review charts that fall out from our QA department (we also only review approx. 10%) together and any that don't meet the established criteria are forwarded to the chief of the section of which the ordering physician is associated. A report is made to the medical executive committee as part of that section's QA function. This way we don't have to worry about getting physicians, et al. to the meetings. It has gone through several AABB, JCAHO, HFAP, and CAP inspections and meets their regulations.

We use preprinted labels with a separate Blood Bank ID number that is on the blood bank armband. The person who obtains the specimen must put their initials on the tube to allow look-back if problems arise.

We have banded all patients with the red typenex for years when the specimen is drawn (even in onc physicians' offices). One incident with that office made them realize they no longer wanted the responsibility of drawing the specimen for transfusion testing. We also have no luck with anesthesiologists cutting off armbands and occasionally have to perform an emergency crossmatch because the tags are nowhere to be found. The nursing staff does the best the can to "control" the docs, but there is a limit to what can be done. One terrible outcome will change the culture, but I hope it never has to come to that.

If you order a type and screen why would you need a hold to go with it? To me there are two options: crossmatch the blood or don't. When the electronic crossmatch becomes more of the SOP, it becomes even more irrelevant. Once a patient has been transfused we only allow a specimen to be used for three days before requiring a new specimen. I have never understood what "hold" means.

We just use the screening system that we ormally use to screen patients. If you run a positive and negative control with the different segments and the controls everything is good. We put our sickle cell patients in the computer with an anti-sickle "antibody" and the units have to be typed "sickle negative" before the units can be crossmatched and transfused.

As a type O+ and having worked in a transfusion service for the past 31 years I have seen the shortages. I also am the donor chairperson for the blood drive we have every eight weeks or so at our hospital. We have a very stable, very reliable group of donors that always makes our drive successful. The primary reason forme is that I understand that an hour of my time may make it possible for someone else to add many years to their life.

From the CFR § 493.1449 Standard; Technical supervisor qualifications. (q) If the requirements of paragraph ( of this section are not met and the laboratory performs tests in the specialty of immunohematology, the individual functioning as the technical supervisor must— (1) (i) Be a doctor of medicine or a doctor of osteopathy licensed to practice medicine or osteopathy in the State in which the laboratory is located; and (ii) Be certified in clinical pathology by the American Board of Pathology or the American Osteopathic Board of Pathology or possess qualifications that are equivalent to those required for such certification; or (2) (i) Be a doctor of medicine, doctor of osteopathy, or doctor of podiatric medicine licensed to practice medicine, osteopathy, or podiatry in the State in which the laboratory is located; and (ii) Have at least one year of laboratory training or experience, or both, in high complexity testing for the specialty of immunohematology. At our last Indiana Department of Health (deemed by CLIA) we were told that a future inspection would require the job descriptions of the various technical supervisors would have to be in line with the CLIA regs and referred us to this portion of the statute. Doesn't sound like there is too much wiggle room on this one. We have made some inquiries on this and have heard nothing yet. Any ideas?

We started requiring the nursing staff to fax a copy of the physician's orders to the blood bank any time there is a blood order involved whether it be an order for a crossmatch, to transfuse, or to disregard an order. I always felt that if it was required by the pharmacy staff that to maintain the "standard of care" that we should be doing the same for the "therapeutic" substances we dispense from the blood bank. There have been several errors averted because the blood bank staff actually read the physiican's orders and corrected an error that a clerk or nurse had made. The blood bank is responsible for the recipient's welfare (that's why we crossmatch the blood) and if we neglect to verify orders are we fulfilling that responsibility?

We keep units up for 48 hours so we can keep our inventory rolled over. If a physician requests that we hold the blood for 72 hours, we can (and do) comply with their wishes.

We have been using Cerner's ISBT product since last fall and have been very pleased with our one-to-one build. I learned a long time ago if you take shortcuts in blood bank, you know you are going to have a huge problem on your hands eventually. Since going live we have had to build additional products and are finally getting the steps down so that it goes smoothly. We are interfaced with the Digitrax printer and once our IS got everything set up, that has gone well. It all goes back to the effort (and $$$) that you put into any project. Do it halfway and you end up with an inferior product.

We do computer crossmatches and electronically scan the patient's armband to assure identity of the patient. If a historical blood type is not in the system, a different technologist will perform a second ABO and Rh on the same tube if that is the only specimen available. If a different specimen is available from a separate draw a second technologist will perform the ABO and Rh recheck. I feel it is not always in the patient's best interest to require a separate specimen, e.g an infant or an emergency situation. CM

At our 235 bed hospital, we have more than enough workload to keep a person busy on dayshift nearly all the time. On those days they are not busy in blood bank they do go into to hematology or chemistry to assist. On 2nd shift, a person is assigned to blood bank, but helps out as necessary in other areas. On 3rd shift, the person in hematology is respponsible for covering blood bank. We do NOT have personnel that specialize in one area; all are generalists. A laboratory tech is a unique creature with many talents. To squander all those skills in one are is not efficient use of these skills. In much larger institutions the workload may demand more attention being given to the different departments, but I still believe generalists are the best use of techs.

We have used the Cerner Millennium QC package for over two years and find it to be a major improvement over paper. It all depends on whom you have helping you build the module. The two associates I worked with at Cerner were extremely helpful and knowledgeable and the two specialists I work with are helpful as well. If there are problems they are quickly resolved. And as with most problems, it's not the system, it is the operator trying to make it do something it isn't designed to do.

When we moved into our new facility a year ago, everything was revalidated including monitoring of refrigerators. Our move was a little over two miles. With a move no matter how near or far, it is an opportunity for every piece of equipment to suffer minor damage that affects its operation.

We try to audit 10% - 15% per month.

I have used S&P Consultants, Inc. two times and have been very pleased both times. I have been through one inpection cycle (AABB and CAP) and had no problems. Deb, Kim, and Peggy have been most helpful pointing our minor inconsistencies that pop-up in protions of the build outside of their current "scope".

I will concur that you have to get very close to the armband to read any information. My older eyes need much larger type to be viewed. Once the patient leaves the premises with the armband on I feel it is their responsibility to maintain confidentiality.

We start with the poly tube method because of the cost of the gel cards. If the poly is positive we do IgG and C3d in gel.

We have had two of the Helmer Ultra CWs with one ranging back nearly 10 years. Neither have had any of the problems that we had with CW2's that we used previously. No saline getting into the electronics, no problems with tube breakage, etc. The techs love them.

As with others who have been in the laboratory field for more years than we would like to recall, this is eerily similar to Abbott. We received the same sort of conciliatory letter from them. How many Abbott products do we have in our lab today 15 years later? ZERO!

As with several others, we use the red armband to assure continuity from the time the specimen is obtained until the unit is hung for that patient. we use computer generated labels on the red armbands and the tubes. The phlebotomists, nurses, aides, etc. that draw the blood must put their initials on the tube along with the date the specimen was obtained. Since we are using positive-patient ID software (scan the armband) I am considering dropping the red armband. The hospital issued patient ID has MR# as well as the DOB and financial number to be used as unique identifiers. The armband is scanned at the time the specimen is obtained. We generally have a 1% or less mislabel rate. Good relations with nursing administration is a must.

The SOP is the SOP. However, when a process is a problem look at changing the process. Why is it required to have two labels. Our SOP is to identify the cord blood with the mother. If there are twins one is labeled "A" and the other "B". In addition, to me this is what we would classify as a "precious" specimen. Would you discard a spinal fluid sample because it was mislabeled or a surgical specimen because of a labeling error. All situations call for some common sense as well as following the SOP. Telling someone to disregard the SOP is outrageous, but asking someone to modify the SOP is sensible. If you take it to the extreme, if an 'i' is not dotted that counts as mislabeled and the specimen should be discarded, even if you can never get that specimen again. Not really providing excellent patient care.

The date the EXM is is verified in the computer.