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Andrea Pointer

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About Andrea Pointer

  • Birthday September 30

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  • Gender
    Female
  • Occupation
    Blood Bank Supervisor

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  1. Our facility uses Cerner Millennium. We have a lab orderable that we place on the chart as "verbal" order type that routes for signature. As for the emergency crossmatch tags we use, we designed them with a space for two people to mark that they ID'd the patient, then space for who transfused and data/time. If not signed/returned, I follow up with the director of whatever unit for follow up. I will either fill in the info myself or have the person back to fill out the paperwork. If the person who didn't fill out the paperwork only emails me the information, I will fill it out, then save the email with the rest of the paperwork for audit purposes. After two months of this, the nurses are at 7% compliance. the Lab is at 100% compliance with our part (does that surprise you??? LOL). So, not great. But, everyone I have talked with (and all of you) seem to have the same struggle. This may just be something we never fully hash out.
  2. Hi all, this is a late response to the post, but I have some valuable info to add. I searched "vital signs" in the forum so it's still a relevant topic to me. We just transitioned from CAP to TJC (JCAHO) for lab accred (before you ask why or judge, it was a legit reason; I also was hesitant, but it's been good so far!) and learned that CAP doesn't really care. It's all TJC. TJC follows AABB guidelines for their standards. AABB published in the 19th Ed Technical Manual (the only one I have; not sure if a more recent version would change the info) indicates a pre-transfusion check, within 15 min of starting, during transfusion "at regular intervals", and after transfusion is done is advised, but there is a lack of published study evidence to actually assign the intervals. TJC will hold you accountable to whatever is in your policy and their transfusion tracers will review charted vitals. I'm keenly interested in the topic because we are needing to address our policy, which is a pre, 15 min in, 30 min in, hourly from there, and one hour post. Our initial surveyor is an SBB and said that the majority of facilities she had personally inspected were doing pre, 15 in, hourly, then one hour post, and her suggestion was to adopt that model. Anytime there is a lack of distinct guidance, TJC will direct you to check out the industry best practice. My suggestion is to take all this advice and check with your friends in other hospitals. I came here to ask about traumas/emergencies/MTPs and how often THOSE vitals should be taken. Like I said, we have to make a change and it was just suggested by an exec MD that we basically publish our policy to say whatever the hemorrhagic emergency, the patient's vitals will be trash until stabilized so we aren't going to check the vitals until the patient's bleeding event is stabilized. Unstable vitals in an unstable situation will not provide direction for care, per the exec's thinking. TJC will only hold you accountable to your own policy on this until further evidence-based best practice is established. Likely never.
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