kate murphy

Has anyone used any validation software for thier computer validation? Software such as Cyrano, which runs a script on a PC to simulate normal and stress testing. Was it really a time saver? Did the cost of the software balance with the time savings? Were you happy with the results? And have you gone through any inspections (FDA or AABB) post validation?

We just stopped doing weak D on women <50 - our new policy is only donors and cords of Rh Neg moms. Our OB's had no problem with that.

We use 3 days as a cutoff, with the exception of pre-op specimens with signed forms stating no pregnancy/transfusions within the previous 3 months. Those pre-op specs are 14 days.

Has anyone used any validation software for thier computer validation? Software such as Cyrano, which runs a script on a PC to simulate normal and stress testing. Was it really a time saver? Did the cost of the software balance with the time savings? Were you happy with the results? And have you gone through any inspections (FDA or AABB) post validation?

Carl, I have not heard or read of that being done before. Do you have any excess products from deceased pts you could try this on? Check viabilities pre/post for several aliquots. Progenitor cell assays will also tell you if cells are still viable. Interesting...can you let me know how it turns out? kate.murphy@bmc.org

We heavily utilize our computer's "mailbox" function. (Misys). Postings go to everyone in the Blood Bank group. Mailbox is different than e-mail in that it automatically pops up when you log onto the computer. We also utilize white boards extensively. These 2 seem to give it more of a team approach.

You've done much more validation than we did when we implemented dump freezing 10 years ago. Split products were compared for viability and progenitor cell assays. We then monitored engraftment rates. For the past 9 years, dump freeze is our SOP. We are FACT accredited.

We validated both aerobic and anaerobic, but we only culture aerobic. The theory being you are looking for skin contaminants.

We aer using Pacific Hemostasis SickleScreen kit - a Fisher Diagnostic product. It too has the same restrictions for anticoag, but as David says, the segs are not in additives. We also do a lot of exchanges for sicklers.

We are a large trauma center. Our randoms are tested by collection facilities. Any randoms from a center that does not test, we dip for both pH and Glu. Our own pheresis plts are cultured using VersaTrek (which we validated)

We are in process of validating/training Immucor Galileo. Staff is very excited and looking forward to having it live. We did look at both Provue and Galileo - Galileo has more versatility as far as test menu, is continuous access and therefore readily accepts stats without disrupting the run. (We are a large trauma center.) A big point for our administrators is that the operating cost is much less than Provue. For the capital cost: 1 Galileo meets our needs, but we'd need 2 Provues.

We've made it part of our transfusion audit/utilizataion review. Twice a week, we look at all the transfusions from the previous day. We check the pre-trans H/H against our cutoff (8.5/27). Any that fail that first pass, go to nursing utilization review. They check the charts for documented reasons for transfusion (surg bleeding, cardiac, etc.). While they have the chart, they also check for signed consents, pre/post vitals, and completed unit tags. Any that fail the second pass, go to the BB med director. She may accept the utilization after review of chart, or bring the case to the trans committee, who may accept or request a letter of documentation from the ordering MD. If no reply, then the letter gets sent to the chief of service. Stats on all these reviews are presented to the trans comm. End result is that 5-10% of trans are randomly reviewed. Unit tag completeness results are also sent to VP of nursing. We've seen a marked improvement in this area in the past 2 yrs since we've gone this way. JCAHO also remarked favorably on this system.

Are donor centers reporting positive infectious disease testing on donors to their stat Dept of Public Health? Which diseases are you reporting? I've been told that we need to report West Nile, but when I checked the Massachusetts DPH web site, I noticed that Hep B, Hep C and Syph are also reportable.

We also have an old one from Haemonetics. It is called a Color Comparator and is part number 18501A. Don't know if they still make them.

We do it annually and after repairs. We also use RadSure for each batch.

BD plastic EDTA as well as Greiner plastic EDTA tubes have been FDA approved for use in blood banking.

We had the same issue some years ago. We streamlined the form - all the FDA/AABB/CAP want is an acknoledgment that the transfusion physician knows the units are uncrossmatched or incomplete in some way. Our form only requires a pt identifier stamp and a physician (or designee) signature. We made the forms bright red, we stock them in the ER. We do not release any red cells without a presenting form (though that took a while of chasing after the fact). The BB techs complete the unit numbers and what testing is incomplete in the BB. I'd be happy to share our form and procedure with you. One large help in implementing this form was our medical director who met with the ER docs to train/explain. We presented it as a way to save them time and expedite release of product. We did not present it as a regulation or helpful to the BB.

We've been using Misys (formerly Sunquest) since 1985 in the whole lab. We are currently on version 5.3, though I am looking forward to version 6.0 in the coming year, mainly because we need interfacing for automation. I like many of Misys' features, though I do wish for LIS support that really understands both the system and the BB.

Hi, I'm Kate in Boston - and I guess I do it all. We still do not have a QI person, so I manage the people, the transfusion service, the donor area, and therapeutic pheresis. Nice to see that you've put this together, Dawn/Cliff. I would classify myself as a bb geek, too.