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kate murphy

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kate murphy last won the day on October 22

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About kate murphy

  • Rank
    Seasoned poster
  • Birthday 12/18/1954

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  • Website URL
    http://www.bmc.org

Profile Information

  • Gender
    Female
  • Interests
    Music, gardening, fast cars.
  • Location
    Boston Medical Center, Boston, MA
  • Occupation
    manager, Blood Bank

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869 profile views
  1. 5 Day Plasma

    We did this a few years ago. Our medical director is conservative, and we sacrificed several FFP - thawed them and took samples for factor assays. Then repeated factor assays at 24 hrs, 48, 72... What you really just want to show is that x% of factors are still present at 5 days. So you just need to set what x% is acceptable. I think we set 80% of FVII and fibrinogen.
  2. Transfusion Tag

    AABB Standards doesn't require much - 5.22.1 lists only patient's 2 identifiers, unit # and compatibility result. With more hospitals on elec medical records, you really only need that and a downtime way for double signatures. I've attached our unit tag - single ply pre-printed form in a dedicated printer for patient/unit info. We print 2 at allocation and keep one when we issue. Unit tag RBC 012417.pdf
  3. Pathogen inactivation

    Different photo-reactive chemicals. Intercept = amatosalen, Mirasol = riboflavin. Both activated by UV light to cross link DNA/RNA sections to inactivate proliferation of bugs/white cells. Lots of info with google...
  4. Nurse Collections for Blood Bank

    We do 2 folks to id all specs. Phlebs use bedside scanning/printers. Phlebs draw about 70%. We firmly reject all non-signed specs. No exceptions. Especially from ED - every hospital I've been in, the ED is notorious for mislabeling, mis-identifying specs. We're slowly getting bedside scanning/printing to nursing. L/D and ER are the most common places for WBIT (wrong blood in tube) across the country. To drop your policy requiring positive id verification because people didn't like it, and then put your phleb staff in the middle is not right. If you cannot get phleb staff to not use these specs, then I'd suggest another system - bloodloc, typenex, etc. Safe transfusions begin with the spec.
  5. Rh D discrepancies with method changes

    Here in a transfusion service, we usually say discrepancies are due to either monoclonal vs human origin, or sensitivity of methods. It depends on strength of reaction (<2+), sex and age of the patient how we treat them. Women of child-bearing age (<50) we usually go with Rh neg.
  6. CAP TRM.40690

    Here's our Clerical Check procedure. No issues on any inspection, we've been doing EXM for 6 yrs. SOP II 004 Clerical Checks.docx
  7. BLOOD BANK COMPETENCIES

    We only do once/yr.
  8. Daily Reagent QC requirements

    We do the same as DPruden - no neg control following package insert. Your 1st negative patient is your control. No issues on any inspections for this.
  9. Extending specimens past 3 days

    Thinking logically - if you are already extending specs 10-14 days, what would be different to extend to 28-30 days? Yes they could go grab a pint (blood, not beer!) at another facility, but they could do that in the 10-14 day period, yes? Is it that patients will remember something 2 weeks ago, but not 4 weeks ago? Not likely. If someone in pre-op is documenting the answer to pregnant/transfusion in the past 3 months, that someone could also document patient understanding to report transfusion between sampling and surgery. So you just really need a 3rd question on whatever form/computer order (for us Epic folks).
  10. Massive Transfusion Protocol

    Outside of the BB, there is the College of Trauma Surgeons and the Joint Commission. Both require a policy.
  11. Proficiency testing with different analyzers

    We have a Neo and a Tango. We run all automated surveys on Neo, and run instrument/instrument/manual/ comparisons quarterly. This has been acceptable to CAP for 10 yrs.
  12. There is no requirement to have medical director or physician sign off. Any rules in place would be strictly internal policy. But once it's policy for your facility, you have to follow it. So it very much depends on the comfort of your pathologist/hematologist in charge. If he/she is conservative, they will probably want to know. if he/she is progressive, then not. Either way, I'd think is should be in a policy/procedure spelled out for your staff.
  13. FDA reportable Question

    It's not required yet for 5 day platelets. That's coming soon, but the FDA is gathering comments and seeing what will happen with pathogen-reduction - how many blood centers will produce that and the cost. We are currently using Verax for 6 & 7 day platelets.
  14. FDA reportable Question

    Yep, any time a "wrong unit" is out of your control, that is issued to nursing, that's reportable. Doesn't matter if it's for the "right" patient. If a mistake leaves the blood bank, it's reportable.
  15. RBC Inventory Practices

    We utilize the National Blood Exchange and not our local supplier. The upside is financial and more group O's, the downside is blood is flown in from various suppliers and we carry a slightly larger inventory than expected for our size. Setting our target inventory range, I looked at usage over the last year by blood group. We are a major trauma service, so we use disproportionate group O's. We need to have enough O's for 3 major traumas at any given time, so we set our O inventory based on that. Then we set the range for other blood groups.
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