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Ensis01

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Everything posted by Ensis01

  1. Ensis01
    Visual inspection, review package insert for changes, log-in and QC when opened
  2. Ensis01
    Request new safety committee to audit the trail the saline boxes take from the manufacturer to the blood bank to ascertain where this "dirt" is coming from. Or to put it another way show the manufacturer for this product is required to maintain a level of cleanliness to prevent roaches etc., the couriers the same. As mentioned above this is ridiculous
  3. Ensis01
    I have no experience in determining what is appropriate so take the following opinion with salt. It seems reasonable to save and freeze samples tested on your current Echos that include negative and a variety of positives . Then thaw and test on the new instruments and compare results. I mean this process is used to compare prenatal titers. I would suggest 40 samples as 30 is regarded as the minimum number that permits statistical analysis (if memory serves).
  4. Ensis01
    My impression (and experience) is that when instruments are initially set-up the system is not really trusted and everyone is more comfortable with manual verification. Over time change becomes harder, drops in priority and so manual verification becomes dogma.
  5. Ensis01
    Gel likes colds, the larger IgM antibodies are more easily trapped in the columns matrix. You can only really identify cold antibodies with specificity (lots of anti-M) using Gel. For Panagglutination in screen, panel or a discrepant back type we resolve using tube.
  6. Ensis01
    It sounds like IS XM can easily be part of a hospitals automated system using the neutral card. Do/can the results move over to the LIS when validated?
  7. Ensis01
    I have experienced down time for one shift. Each tech in the BB manually entered their own work when the LIS was back up. It was much harder, stressful and time consuming than expected. I do not want to imagine the logistics of two months of data. While manually entering the data would be ideal for the reasons Cliff wrote, after AMcCord’s description for entering nine days down time; I vote scan it, scan it all
  8. Ensis01
    At a hospital I worked at (long time ago) we received short dated products from several smaller facilities. There was an official agreement between participating hospitals and ARC, who provided transfer forms. When we received units we checked boxes on the form for correct packing, in temp and unit numbers. We kept a copy of the form, a copy went to the transferring hospital and a copy to ARC. So definitely a procedure as the transferring hospital received credit from ARC for the units transferred (unless they did not arrive in temp).
  9. Ensis01
    Sorry for my ignorance, I have never used the vision. Would you need two different cards, one for IgG and one for IS? If the cards exist why could you not validate their use? As jayinsat said automation helps the generalists especially when short staffed or they are inexperienced.
  10. Ensis01
    I just answered this question. My Score FAIL  
  11. Ensis01
    If you ordered Kp(a) antigen testing only. We would test, and if negative charge and report IgG DAT and the Kp(a) only. If the Kp(a) were positive we would also do the antithetical high incidence Kp(b) antigen. There would be a comment on the report saying words to the effect that no other testing was performed per your request. the DAT is required investigational testing to validate the IAT results, and is therefore charged and reported. The reagents used in testing require QC, which is not charged or reported. In my experience reference labs, like hospital blood banks, evolve their policies to better help meet their local customer requirements, which are varied. So talking to your reference lab manager to understand both positions may enable reaching an understanding. If that doesn’t work I guess you could, with lab director permission, refuse to pay for tests not ordered. I have however no clue of the ramifications of that course of action
  12. Ensis01
    I would be horrified if any reference lab did not do an IgG DAT on the patient cells prior to a IAT pheno test, Kp(a) in your example, and very surprised if it was not charged for. I would be mildly surprised if any reference lab did not also type for the antithetical antigen ordered. However if you document on the order your result (big K neg for example) then it may depend on your accreditation, for example if you are AABB accredited they won’t test else they will. I would expect an ABO/Rh done and charged for on every Work-up, with the exceptions of DAT only evaluations (eluate), and antigen phenotyping only. I suggest getting your director involved and having a discussion with your reference lab’s manager and / or director to clarify respective policy and reach an agreement.
  13. Ensis01
    I like “Reactive”, though we use “least incompatible”. I think change is the issue as the the questions about meaning would last years!!
  14. Ensis01
    I would send out for molecular characterization of the D, and give O neg
  15. Ensis01
    I’m sorry but your post indicates that you are effectively going to make things way more complicated for the nurses. In my experience this will make the nurses extremely creative in negating the safety benefits you are trying to maintain or implement. I suggest discussing the flow with the nursing staff to figure out the most practical flow that will ensure safety. Talk to all the areas (especially the ER and L&D) as there can be large differences in requirements. Simplicity Reduces the potential for confusion, which minimizes errors and thereby increases safety. All that being said; keeping the option of armbands for down time and any glitches when you switch over sounds like a very good idea.
  16. Ensis01
    We were trained that you pipette the 0.8 RBC at about 45’ down the side (not hard) this ensures the RBC sit on top. The plasma gets pipetted straight down. Inspect and incubate. I was just told that the air space ensures a space for the plasma and RBC to mix. No air space and many RBC go down the tube reducing the number that incubate with the plasma.
  17. Ensis01
    If two of three screening cells positive at 2+ but panels are negative I would recheck everything
  18. Ensis01
    It seems a waste of time and resources as I cannot see how a lab could possibly QC a pannel even approaching what the manufacturer is required to do.
  19. Ensis01
    If I remember correctly (I worked with someone who used that route) you must have a bachelor's degree (or higher) to even be eligible to apply for the H1b visa. I also do not see how it is possible to be a qualified MLS/MT without a bachelor's degree.
  20. Ensis01
    Ah, inform them that by their logic; phlebotomist's should not use needles due to the many unintended sticks in hospitals each year
  21. Ensis01
    Who is telling you to switch? Are the plastic tubes transparent enough to see mixed field and weak reactivity clearly? As far as validating I would guess you could use the centrifuge calibration that determines correct spin times
  22. Ensis01
    Am I correct is saying that having the MLS ASCP certification and being an active member will allow you to be eligible for licensure (if appropriate) and work in all states in the USA? Blood-bankers from many countries contribute to the discussions on this site. I have always assumed, but am curious to know if every country has a certification requirement for working in a blood-bank or are there several different pathways available? Also how transferable are these different qualifications between countries, ignoring the visa requirements? I am guessing that at least some countries have agreements. Thanks for any input
  23. Ensis01
    As Malcolm posted if you don't believe the IRL results why send it. The IRL gave you a B pos result, which aligns with the other history you obtained. That being said your policy may need to be scrutinized to determine if the B pos result is valid for the entire admission or needs to be confirmed for each new sample. I would suggest getting this clarified for future admissions, get your pathologist involved as they may have strong opinions on this and once clarified document clearly in your LIS the process.
  24. Ensis01
    At the last hospital I worked, we only used BB armbands during downtime. Our downtime box contained all manual forms and the armbands. During downtime a tech went round and ensured departments like ER, ICU L&D had some (plus examples on how to use). The departments that were less likely to transfuse during downtime were informed to come to BB to collect if a transfusion needed. This process was repeated after shift changes and the RN first and last names were taken during these calls/visits (including spelling).
  25. Ensis01
    My understanding is there are no WBC in plasma
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