Eagle Eye

We were cited last year for not labeling emergency release products.  It was deemed an unsafe practice.  Now we ask for the patients names and medical record number.  If they don't have one, a temporary one is to be assigned and that info is provided to us.  We then need to use a different system to print these stickers to place on the emergency release tags that we attach to the units.  This can take a fair amount of time, but somehow is felt to be safer.  Very frustrating.

I just answered this question.


My Score PASS  

I just answered this question.


My Score PASS  

I interpret "Transfusion Requirement" to mean the PATIENT's requirement, i.e. "this PATIENT requires Irradiated products".  Irradiation is a unit ATTRIBUTE.  So you would need to print that patient requirement on the compatibility Tag/Label along with the other required patient information.  Our tag (Cerner) would include both unit attributes and patient requirements.

Interesting standards from CAP.  AABB only requires the unit to be tagged by the transfusion service with two recipient IDs, donor unit ID number, and compatibility info.  At the bedside, ABO/Rh must be checked between patient and donor unit.  We have the patient ABO/Rh on the tag. 
Scott

Per the CAP requirement, highlighted items are added. We are using very small label with SOFTBANK which has minimum requirement. (first four items)
How is everyone complying with below requirement.
1) Are you changing your label size?   Thanks

Agree 1000% (Now Malcolm is going to say there is no 1000).

It's great having Malcolm in the lab to fire questions at! He really is a walking, talking Transfusion textbook and a true gentleman.

Welcome, anyone who has Malcolm as en employee is very fortunate.

.........And works my fingers to the bone!

Don't let the Beaker/Epic people tell you that only one day of training is sufficient for SafeTrace Tx.  And ask to have the Beaker training and Tx training environments interfaced because the steps are much different when the information is interfaced as opposed to being just typed into Tx.  Also, have someone verify the ADT/visit setup, when we went live, Epic would send a "discharge/transfer" notice across the interface whenever the patients were moved, to OR or radiology, for example.  then Tx would discharge the patient and inactivate the sample, not the most ideal scenario when a patient is going to OR...   We didn't see it during the validation because the test patients stayed nicely in their rooms the whole time!

I just answered this question.


My Score PASS  

Yes. 10% glycerol will freeze.
We use 50% propylene glycol for freezer.

Yes. 10% glycerol will freeze.
We use 50% propylene glycol for freezer.

The 10% solution (we use a simple 1:9 v/v dilution) has been what has been used traditionally and seems to be one of those things that inspectors don't get too excited about.  With glycerol being a bit more dense than water this would be more like a 13% w/w solution.
 (I believe 10% w/w is close to the thermal properties of plasma and 30% closer to packed RBCs.)
Scott

we order from Sigma-Aldrich glycerol for molecular biology >99% it's much cheaper than ordering from helmer

We just buy glycerol and make up our own 10% solution.
Scott

A friend of mine, who used to work in one of the London teaching hospitals (I won't name which one) told me an alarming story once.
Apparently, a phlebotomist took blood from a lady in a bed.  The correct questions were asked, but asked incorrectly.  Instead of asking for the patient's name, the question was asked as, "Are you Joan Doe?", to which the patient readily replied in the affirmative.  The sample typed as A, D Positive.
For some reason (fate?) someone in the laboratory telephoned the Blood Bank at the hospital from which she had been transferred, and asked what blood group they had made the patient.  They had typed her as group O, D Positive.
A second sample was requested, and the same phlebotomist bled the same patient, but did not ask the appropriate questions the second time as "she knew the patient was Joan Doe".  Unsurprisingly, the second sample also typed as A, D Positive.  This was rejected by the laboratory, and my friend and the doctor went up to the ward and, this time, the doctor took the blood (and asked the correct questions correctly).  The patient said that she had not been bled before that particular day, and this sample typed as O, D Positive.
It turned out that the lady bled by the phlebotomist had advanced dementia, and would have answered "Yes" if she had been asked if her name was "Old King Cole", and so the phlebotomist had bled the wrong patient the first time and, because she now "KNEW" that the patient she had bled was Joan Doe, had bled her again without asking ANY questions.
Fortunately, an A into O mis-matched transfusion was avoided by pure chance, and the phlebotomist was thoroughly retrained.
One can try and rule out most problems with wrong blood in tube, but it is difficult to rule out stupid!
Scared the living daylights out of me!  

BSH Guidelines say that it has to be a sample taken at a different time and, ideally, taken by a different person.  I agree with this, because, firstly, if the sample was taken from the wrong person in the first place, testing two samples taken at the same time will not identify a problem, and, secondly, if the sample is taken by the same person, they may not be as "good" (or professional) at identifying the patient properly, as "they already know who is the patient".
There, you see, I do agree with some Quality!!!!!!!!!!!!!!!!!!!!!!
Sorry, didn't see Carrie Easley's post, which says virtually the same thing.

I am planning to retire the end of January and my hospital has just posted my position.  If anyone is interested in the Pacific Northwest, I am located in Roseburg, Oregon, 3 hours south of Portland and 1 hour from the coast.  The position is posted on mercyrose.org and I would be happy to answer any questions about the community or job.

Enjoy it.  I plan to follow you in August!!

We use Hemo-Temp II on our blood issued in coolers (Trauma, MTP, OR).  Additionally, the cooler temp is recorded every 4 hours.  Nurses are instructed to request a new cooler if the temp reaches 6°C.  The coolers that we use, however, validated to hold 1-6°C for ~24 hours.  For blood that comes back from a nursing unit (no Hemo-Temp), we wrap the unit around an NIST probe thermometer.  If it exceeds 10°C, we adjust the expiration to 4 hours from issue stipulating that it has to go to the original patient.

I was wondering if Amy is a blood banker.

missing serum reactivity, or apparent change in blood type following hematopoietic stem cell transplantation.Under those circumstances, your procedures should provide for compatibility testing using serologic crossmatch techniques."
I haven't worked on the bench for a long time. Have I missed something? I fail to see how a serologic crossmatch technique will provide any meaningful information about compatibility if there is "missing serum reactivity".

Level 1 trauma center( we do all except irradiation from the list of items initial post). ...dedicated blood banker.