Dar
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Posts posted by Dar
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Thanks Terri, these will be useful. I was even thinking of adding things like responding for the flu vaccine. John, unfortunately, I think we are heading the same direction. If they make us do the bell curve thing, it will be very difficult, especially since we have been working on our HML performers for a couple of years now, and I also feel as if I have no low performers. Thanks everyone! Good Pouints!
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DOGLOVER, I am afraid that some of ours will be like yours. I've heard that the HCAP scores will play into everyone's score. Would you mind sharing what you do have. Scott, I have thought about the whole error thing, and I am afraid my staff will pick each other to death rather than work together as a team. Let's face it, if it ends up a bell curve, wouldn't you "rat out" a co-worker to ensure your raise? Terri, the staff has always recieved the same raise here, so this is uncharted territory for me. I do not want to be accused of "favoritism", so I am trying to think of ways to quantitate. Thanks for all responses.
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We are about to embark on raises based on high / middle / low performer performance reviews. I was wondering if anyone currently doing this would have a system of measurement for the Transfusion Service that would be impartial?
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Approimately 3 yrs ago, risk mgt asked the Transfusion Service to review physician transfusion orders prior to issuing the blood. Now, Transfusion Orders may or may not be placed into SCM directly by physicians. We in the Bank, are using SoftBank, so we do not see the transfusion orders. We have been reviewing a copy of the order if it was written & presented to us, but if they do not give us an order, we have not been questioning them. Now, risk mgt is back & wants us to monitor every order. I have refused to make the staff look into the other computer system for the transfuse order because our issue person is very busy. I am more concerned about matching labels, tickets, etc. Is anyone else monitoring the transfuse order? If so, how? I thought of building a "dummy" transfusion test where the transfusion order could come into SoftBank, but the logistics of keeping in all straight in big users is almost impossible. Has anyone else dealt with this?
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We face the same issues. We have been live for about 6 mos, and we are plagued with duplicate orders, red cell orders with no T&S, and orders to only transfuse, which we do not see:) Is anyone having "transfusion orders" flying into the Bank? We have SoftBank & SCM Order Entry
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We have ours pre-labeled with as much info as possible. The name actually gets placed on an internal log of what is included in our 8 pk. The blood goes out the door without a name sometimes; however, it is always pre-labeled as uncrossmatched.
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If I recall correctly, it used to be a part of either the AABB or the CAP checklist that a weak D test cannot be substituted for performing a fetal screen. I guess I'm showing my age:)
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I have seen this with MM patients. If you are seeing a lot, it could be attributed to being exposed to the severe cold in shipping??? Just a thought...
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I have to share our experience for those of you who need a laugh:) We are a 500+ bed hospital. On this particular day-shift, there were 3 Techs and the Supervisor (me). A specimen was sent to us via the tube system. Poof, a white powder was discharged when the tube carrier was opened. One call yielded a visit by the completely suited Hazmat Team. They placed each of us in tele-tubbie outfits and led us to the outside showers for decontamination. Thankfully, we are in Florida! The Blood Bank was totally in lock-down for 2.5 hrs, while we (squeaky clean in hospital gowns and no make-up)were placed in isolation with no phone or TV. Security stood outside our room, and we could not even communicate with our upper Management. Identification: Foot Powder. We were released with a bag of sopping wet clothes and shoes in our hospital gowns. That day, the hospital recognized the role that the Blood bank plays, and the Blood Bank staff bonded as never before!
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Get more specimen! Try enzyme, another enhancement media, or a reference lab. Too many positives to ignore, and not enough positives to be "crap":)
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I have the answer to my own question. ATW is now Polyfabmedical.com
office:770-787-8819
cell:770-842-3271
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We have an ATW "cooler" which we use to transport our blood products on our helicopter. This company appears to have dropped off the face of the earth. Have they been sold? What are other prople using? HELP:(
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I agree. Look at pre & post chems. Also, look at RBC morphology on the pre & post diffs. This patient might have something else going on.... Negative DAT may be because Duffy's are fickle. They don't always react beautifully. Then again, I've always heard that any antibody can cause a hemolytic reaction, given the right conditions. We are basically a group of gamblers, going for the odds.
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Thanks for your posting. We have been struggling with the same issue. It is much easier to release uncrossmatched massive transfusion packs. Once the specimen is type & screened, the process boggs down. We would like to be able to pre-tag, but we are afraid we might forget to issue. It would be so much easier if we could just hand out a cooler, which is the expectation.
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Good Luck to you. I've had a thread going on this subject, and you are pretty much validating what I have seen. Try explaining your typing results to an OB physician. LOL!
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If our immediate spin test is 1+ or less, we call them Rh negative and give them RHIG. We might put some sort of weak note in their history. If it is weak like this with Ortho, but was strong in our Immucor days, we do not change the blood type. We are now seeing 3 or 4+ reactions as immediate spins that have been called negative by the physician's reference lab. In that case, we leave it up to the physician to decide.
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Yes, we are using Ortho. We also used Immucor in the past. The staff have been advised not to change a blood type without supervisor approval, so that the physician can be alerted appropriately.
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Thanks for everyone's reply! We stopped performing weak D a few years ago without any issues. Let's face it, our industry has needed some healthy reagent competition for years. Now that we have it, the D antigen testing is a challenge. Not only is it the antisera, but the increase of methods / instrumentation that also feeds into this equation. I'm afraid that this issue will not be solved quickly, but at least I will be able to calm down my physicians...well, maybe....
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Malcolm, I love your verbiage! I am definitely plagiarizing it! Thanks!
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We have been recently having discrepant Rh typing results, especially from Moms whose pre-natal testing was performed in another Lab. I have been asked to send a memo to the Medical Staff explaining how this could happen. I was wondering if anyone has already had to deal with this issue. I began to quote Chapt 13 of the Technical Manual, but I realized that the physicians probably would not want to read anything in this detail. Any physician memos circulating out there regarding D antigen typing & clones from various vendors???
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Brenda, Our institution considers sex a identifer also??? Very strange! We have recently started using the typenex band that allows the pre-printed labels from our computer system. Of course, occasionally, names are cut off. We managed to get the typenex armband number on the corporate policy as a unique identifier for transfusion. While it is not the ideal situation, it does give me some comfort.
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Ortho's Nancy Mann always recomended mixing the tube well & re-spinning prior to testing. It works for us.
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If a patient qualifies for an electronic crossmatch, we do not set it up unless we know they are coming for it. We do set up outpatients, open hearts, & auto units. The process works very well; however, it is very difficult explaining blood availability to Nursing. That is usually how we know they are coming because they call 1st
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Thanks! It's nice to know I'm not the only one that has an issue with this.
Rated Performance Reviews Linked To Raises
in Transfusion Services
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Thanks Kate! We did come up with timely SOP, etc review. Maybe now we will not have to beg! We had manditory flu shots this year with a deadline that ended in job termination, and yes, there were those who waited to the last minute, knowing that if they got sick at the last minute and could not get the shot, they would be terminated.....so, yes we are looking a flu shot, etc...Thanks for your feedback!