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kslaforce

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Everything posted by kslaforce

  1. Yes - we would use the pre-op sample for the crossmatch on the day of surgery, provided the antibody screen is negative. If the patient has an antibody requiring an AHG crossmatch, we do the crossmatch with the sampe while it is still fresh (less than 3 days) and hold the blood for the surgery. We then get a fresh sample on admit in case additional units are required beyond those crossmatched before the surgery.
  2. I do not currently subscribe to either as we send these tests to our donor center reference lab, but at my previous place of employment we subscribed to the anti-D titer and the eluate. We had been told by one inspector that eluate was a method but another one said we needed it. Last I heard, that institution dropped doing eluates to save cost and also there were only two techs who could do the procedure well and they were tired of always getting called in to do them!
  3. In every instution I have worked (7 of them) the clock starts when the blood is issued. At my current institution, we stamp the bag tag with the date and time so the nurses know when the clock started - both for the transfusion (4 hours) or to be able to return the unit unused (30 minutes).
  4. We use the name and medical record number as well as the Typenex band number. For outpatients, the physician office (mostly oncology) is required to call our patient placement/admissions office to get a medical record number. If the patient is not in the system, admitting will register them over the phone to get a medical record number.
  5. I received an e-mail inviting me to look at and join.
  6. We have several monitors, some directed at utilization review, some directed at patient safety, and some at service. Utilization review: we monitor C/T ratio (good old standby) with a threshhold of 1.5, product wasteage, and appropriateness of transfusion through the transfusion committee. Patient safety: we monitor the specimen rejections for inadequate labeling (patient ID) and the times nursing personnel present to blood bank to pick up product with inadequate patient ID information. We also review the transfusion record for complete documentation. Service: we monitor TAT on uncrossmatched request, TAT on STAT crossmatch from emergency room, and frequency of incomplete orders from our blood supplier. Hopefully you can find something that works for you.
  7. The Joint Commission is on the verge of adding quite a few metrics surrounding transfusion practice. This may impact how your tranfusion review is handled. Our transfusion committee is a subcommittee of P & T, reporting there once per year but meeting quarterly. Our Lab Medical Director is the Chair and we have representation from the major service lines and nursing on the committee as well. We are using it as a springboard to bring our transfusion practices in line with the latest available liturature. In the two years we have been activiely pursuing this, our red cell usage has decreased almost 10%. You might get more buy in from administration if they realize that monitoring and actively working to bring physician practice in line with the latest research regarding blood usage will bring down costs.
  8. You mentioned the patient is post partum. What is the baby type and status? Was there a large fetal maternal bleed? You could have a dual cell population causing this problem. If this is not the case and the patient is truly a weak A subgroup with anti-A1, I would document it as such in your records and transfuse O cells and A FFP. You could also flag the record to perform tube typing and not run on the ProVUE.
  9. I agree with Lcsmrs - if you don't do the albumin phase, there is no need to calibrate for it. We are like you - we do antibody screens and panels in gel and only use the centrifuge for types so we only calibrate for saline and wash/AHG for the occasional patient that has a history of gel dependent autoantibodies.
  10. We just started using Biotest anti-sera for our tube testing. It works just fine and is less expensive.
  11. We currently use 10 days for not pregnant or transfused in last 3 months and strictly enforce it. I have used as high as 14 days in the past. We also give our pre-op patients a band with their identifiers (name, DOB, medical record number) and they must be wearing it when they come back or they are redrawn. Any crossmatches performed on the pre-op sample at the time of the pre-op visit are charged to the pre-op number (crossmatch expiration is extended in the computer to 3 days after surgery or 10 days after specimen collection whichever comes first). If the units are transfused, they are charged to the new finiancial number. Additional crossmatches are charged to the new financial number.
  12. Puget Sound Blood Center in Seattle provides pools of 6 cryo. The supervisor of inventory management is Brian Danforth. You can find contact information as well as lots of other info at their website: psbc.org. We really like having pre-pooled cryo.
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