BBMT

I don't think there is a requirement to share between hospitals, only that a search of previous records was performed for ABO/Rh and antibody screen. The lab needs to define how they will perform the search. The reasoning that labs use 2 types is a. to limit mistransfusion events and b. to use electronic crossmatch. You don't need 2 types is you aren't using electronic crossmatch and if you use other ways to reduce mistransfusion risks- you can always use immediate spin to allocate type specific blood. To use a type from another hospital, personally, I would want the testing/results to show up in my LIS automatically, and know that my lab and the other lab follow the same policies for patient ID, labeling, testing, etc. TRM.40300 Historical Record Check TRM.40670 ABO Group and Rh(D) Type Verification TRM.30550 Misidentification and Mistransfusion Risk Monitoring TRM.30575 Mistransfusion Risk Reduction

I am retired now and will never forget the sound they make when they are dropped on the floor.

It is required per CFR 493.1271 Standard: Immunohematology, see below. IMO, how the lab wants to do this would be up to them and the manufacturer's specifications Per CAP regs, if the manufacturer does not have a specification for frequency then the alarms must be testing quarterly. (c) Blood and blood products storage. Blood and blood products must be stored under appropriate conditions that include an adequate temperature alarm system that is regularly inspected. (1) An audible alarm system must monitor proper blood and blood product storage temperature over a 24-hour period. (2) Inspections of the alarm system must be documented.

This is the requirement for element 5 from the CFR493.1451 "Assessment of test performance through testing previously analyzed specimens, internal blind testing samples or external proficiency testing samples; "

If u go this route, make sure the plan is compliant with CLIA requirements for verification/validation. I have come across a few vendor plans that were missing some elements of verification.

Perhaps the physician is worried about residual plasma in the packed red blood cells causing hemolysis? This used to be a problem decades ago when BBs were using CPDA1 units and many units were transfused. I have not seen this issue since using ACD units. Or what Dr. Blumberg said.

I just answered this question. My Score FAIL  

There is no requirement that the blind sample for element 5 of competency assessment must be a positive sample. It is perfectly fine to use a normal sample, ie, negative antibody screen, negative FMH, etc.

Some CLIA roles do require lab experience. For example, someone hired for the a BB supervisor may be expected to fulfill the the CLIA role of General Supervisor, which requires 1 -2 years of high complexity testing training and /or experience, depending on if the education of the individual. IMO, the training received in med tech school can be used to satisfy some of this training/experience. So if someone's BB rotation was 3 months, that can be used for some of the training/experience for the General Supervisor. I would not consider 1 day a month full-time.

The lab I worked at was CAP accredited and CAP does not require initial competency. Our organization was standardized with the assessment documents and some training documents.

If u are performing patient testing, then u need to have your competency assessed. No way around that requirement.

As some one mentioned before, the annual assessment can be completed throughout the year. Make sure your policy reflects your process.

most of blood bank testing is high complexity so someone with an associate degree would qualify as an assessor.

2 people at sign out or issue is not required.