bbville

If NO blood products are stored in a Blood Bank reagent refrigerator is there any requirement to continuously record the temperature (temp chart)? I know it must be continuously monitored, but I do not think it needs to be continuously recorded. Ours is monitored and alarm checks are performed. The temp (internal and digital) is recorded daily. We have always had a recording graph chart, but it is not working (no fluctuation in actual temp, though). We have been recording q4 hour temps, but I do not think it is necessary as long as no blood products are kept in that storage unit. Anyone?

I know this is a couple months old, but I am ready for a new plasma thawer too. I have had trouble getting the sales rep to give me any names of Plasmatherm users for reference. Does anyone out there use this?

We started a transfusion committee about 18 months ago and although few of the doctors we invited to participate show up we do have nurses from several areas, a risk management representative, infection control, perfusion and the chief medical officer represented (along with Blood Bank of course). Over a period of about 7 months we developed an 'Order Form' and require it for pick up of blood products. Although the nurses fill it out about 80% of the time we require a MD name on the order. Our biggest success so far has resulted from requiring 'reflex' hemoglobins on non-bleeding patients before a 2nd unit is dispensed. The physician must re-justify the subsequent unit(s) one at a time. Our hospital is only about 250 beds, but we increased our single unit transfusions from about 25 per month to consistantly about 75 per month every month since the order form was placed into use saving about 50 units per month. Now....this wasn't as easy as it sounds. It takes great resolve and baby steps are celebrated and you need a pathologist who is involved and supportive, but I truly believe we are providing better patient care and saving money to boot!

For sites that have a Cesium 137 blood irradiator what is your policy on techs who are pregnant irradiating products. Thanks in advance.

Weak D testing done only on Rh negative babies of Rh negative moms. We do call D testing by gel of 2+ or less Rh negative for RhIg candidates.

We set expiration to 2359 on 5th day. No problem doing this with Sunquest.

I am not writing this to be smart, but as laboratorians we must know that the acronym is HIPAA (not HIPPA) for Health Insurance Portability and Accountability Act.

We use gel cards for typing, but have had a ProVue for several years. The occasional bench typing we do is done by tube most of the time for no particular reason except it is quick. We retype units on the ProVue also with A/B/D/A/B/D cards. The discrepancies we have experienced have been rare. You will see some dual populations (non O patients who have received O blood or Rh neg pts who have received Rh pos blood) and need to deal with that in your procedure.

We do weak D testing only on newborns to determine RhIg candidacy. Our blood bank is busy enough and short staffed enough that we try not to do unnecessary testing and that is what weak D testing is in other cases.

We do KB's on all shifts and they are done in Blood Bank. (I had 2 today myself) Last year there was a questionaire with a CAP Survey that I had all techs answer along with the counting the 2 survey specimens (after the survey had been resulted). I was surprised to find how many techs needed education regarding this procedure. I find that many techs do not make and stain quality slides and I emphasize thin smears and following the procedure precisely. Changing reagents as needed is very important also. Probably making the positive control is the part that many techs dislike most. We have experimented with making slides and freezing them so they would be ready to stain with patients, but really have not had good luck with that. Our ER and OB physicians have always insisted that this procedure be offered round the clock. One other thing we have is the RhIg Dose calculator available on all computers at work in case of positive slides on Rh negative Moms. If a slide is positive it must be counted by 2 techs.

We were cited (by a different accrediting agency than Joint Comission) for not having every 6 month correlations of manual gel/tube/ProVue testing. All other departments must do this if the same test(s) is/are reported by different instruments or methods, so I guess it makes sense in that way. We now just do a days worth of work or so by all three methods.

I don't know why you would bother with a positive and negative control. You are not using it for any test of record. You are always going to confirm with appropriate antisera. I am assuming you would do this for a patient with an antibody history that is no longer reactive or you could just use the patient.

Mary - you are correct as to location. They are now saying they will send all the pathology specimens to our docs if we work with them on this (but I wonder if they really will). I did visit the facility today and it is quite impressive. It drives me crazy that they are willing to provide top of the line equipment, but will not spend the money that they should to provide safe blood products if needed. They are offering nothing for what would be professional consult services. We would have to start from page one on writing policies and procedures. I can't imagine how they were inspected by the State Board of Health and the Joint Comission and the topic of blood never came up.

A new physician-owned surgery center wants our hospital to provide transfusion testing and blood supply. They are located about 5 miles away and do not want their patients to come to our hospital as in or outpatients if they need blood. They provide no laboratory services there other that some POC I-Stat testing. Somehow they have gotten Red Cross to provide them with 4 units of O neg blood to keep on site. There are so many things that need to be in place for me to agree to this. They have no written policies or procedures as far as I can tell. Does anyone have experience with a situation like this? No one there even knows what I mean when I mention atypical antibodies and I do not trust the person who manages the center.

I am also from Indiana and the Board of Health is VERY insistant that the lab monitor transfusions. We get nothing back from the floor, but we look at post computer charting and I definitely know the Blood Administration Nursing procedure better that 95% of the nurses in the hospital. I send a daily report to each area nursing supervisor and it is up tp them at that point to follow up.