Dar
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Posts posted by Dar
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We are seeing more "gel crap" daily. You are right about the pregnant woman. I'm thinking it could be the pre-natal vitamins??? We are also seeing it on our trauma patients. Maybe it's the plasma expanders or whatever they are using to infuse these days. My concern is that it isn't always every cell, so it looks like it's something. After everything is ruled out, we go to PeG & it totally disappears.
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I just got off the phone from CAP. The panel QC is not required!
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No, we are on the same path. I'm just not making myself clear. What I am saying is that we are not required to check for the labile antigens on our antibody screening cells. Why should the panels be any different?
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Well, I don't believe my c option is the best; however, it's not wasting big money on antisera.
And really, do we care if we are not seeing the labile antigens, since our screening cells aren't checked for them. Evidently, we don't care if we can detect them. We only care that we can ID once we detect:)
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Well, funny you mentioned Duffy. Actually, my inspector was hit for the same item, so she dilutes Duffy a and runs it only when she receives the panel. I asked her why she chose Duffy, thinking along for your reasoning. She said: "that's just the one I picked". I'm sorry, but antisera costs too much for this stuff. Personally, I think running it only upon receipt is kind of silly. Remember, the CAP 31400 says follow manufacturer's directions.....which say to check "periodically with weak antibodies" and "may be checked periodically by testing the antigens likely to deteriorate, like Lea, with a weakly reacting antibody of the same specificity".
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My CAP inspector nailed me for no panel QC.
The last thread on this was a year ago, so I thought I'd start it again. I thought Id run one heterozygous little c cell (negative for D) with my diluted ortho confidence antibody each day of use to prove specificity and reactivity. What is everyone doing out there? Is anyone running a negative cell? Thanks! -
We have the ProVue & Soft. Retypes, with a bidirectional interface work beautifully! The only issue is with double red cell units. Only 1 can be done on the PV.
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We have the same type of problem; however, I feel better about our process. All trauma patients get a medical record number the starts with "800". A message prints on our printer once the patient is identified, if there is another MR#. Our computer system, SOFT, allows us to link the trauma patient with the old MR so that historical knowledge applies. The 800 MR# is not merged until discharge. Currently, the name does not change until they feel comfortable drawing a new sample. Of course, ICU wants the policy to change. My question is: Would you feel comfortable using the sample after the name has been changed, if you have the same MR# and a typenex number (2 identifiers that remain the same)? We do electronic XM, so most of the time, we are not even touching the sample once the T&S is complete.
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Would you care to share your SOP???
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We have recently went live with our ProVues, and we are having some difficulty getting our workflow established. We are trying our best to do without paper, but the ProVue only shows order numbers. Soft does not know what has been placed on the ProVue.
1. How do you know "what is running"
2. What is your "work flow"
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We print our labels & forms directly from SOFT. A SOFT programmer formatted our Transfusion Record and our compatibility label. When we XM or select, we print the label that gets put on the unit. When you issue the product, you print the Transfusion form.
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We only review exceptions. We only look at individual work when it comes to full XM, making sure weak D was performed on applicable newborns, etc. Just the unusual. We don't review routine work.
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We implemented the electronic crossmatch when we brought up the SoftBank system at our hospital. SoftBank interfaces with the Nursing SCM system.
How do others communicate blood product availability when there is essentially nothing for Nursing to see as "selected or compatible? Also, the way our system is currently, the various unit status changes keep "adding on" in SCM and not "overwriting" information. Patients receiving many blood products are impossible to follow. Is anyone having any better luck with Nursing being able to tell what is available for them to transfuse?
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Terri,
Do you require a new specimen when the name changes, or do you just use the typenex number & your Med Rec# as your identifiers??
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We are bringing up a ProVue & have the same issue. We have also just instituted a 2nd person ID check when the specimen is drawn; therefore, we also have 2 universal IDs (8 digits) on the tube. I would welcome any ideas also.
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Dingalls2,
So you have a unique trauma number that stays with the patient throughout the stay. What is your other identifier? Do they get a trauma name too? Does the name change? Thanks! Dar
Lcsmrz,
What other identifier stays the same on your specimen? You have your BB bracelet & what else? Is your specimen itself labeled with a pre-printed label? Thanks! Dar
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I need to know how other Trauma facilities deal with changing the patient's name. We use the Secureline band system The band says "Trauma, Joe". At some point when the patient hits ICU, the patient's name is changed. Our computer system (Soft) alerts us to the name change, and we accept it in the computer. At that time, we expect another specimen to be drawn to have the band reflect the current name. Trauma wants us to change this practice. Ideas???
Also, when you receive a trauma with a mixed field typing, and you can verify with another hospital that they did transfuse O cells, would you go ahead and call the patient the presumed blood type?
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I have 2 questions for those of you who have dropped the "weak D" test.
1. Do you require your techs to perform "weak D" as antigen typing if an anti-D is identified?
2. If you have a "weak D+" newborn, how is it reported? Do you report it as Rh negative to eliminate the confusion when it returns in later years?
Thanks!
Dar
The last thread on this was a year ago, so I thought I'd start it again. I thought Id run one heterozygous little c cell (negative for D) with my diluted ortho confidence antibody each day of use to prove specificity and reactivity. What is everyone doing out there? Is anyone running a negative cell? Thanks!
Rhogam screen
in All other topics
Posted
I have an additional question relating to this topic. Our ED physicians want to be able to give RHIG based on previous records. A few years back, we caught a case of identity fraud because we did repeat the type while the patient was in the ED. I am hesitant to drop it because of this. The current CAP checklist says there has to be a type on file by a "CLIA licensed facility" and the AABB is vague, so I'm afraid that if this really gets pushed, I won't have a leg to stand on.... Thoughts????