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Everything posted by bpkelly
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To have or have not a blood bank wristband
bpkelly replied to SantaFe Jane's topic in Transfusion Services
We have standardized the ABO second check procedure across our 7 hospital system. As a result, the two remining facilities using BB armbands dropped them this year. I think a BB armband give you a false sense of security. The second check of the ABO either by historical record or a second venipuncture is a much better way to go. -
We have been doing second blood type checks for over 3 years. When we began we had 2 facilities that used BB bracelets. They have decided to get rid of them since the second check policy is so effective. Just get rid of them and go with the second check. It's the best patient safety initiative out there.
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CMS will have yourhead if you bill for these products. Check with your coding people- the CMS/HCSPCS books are very clear on this.
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I am clinical specialist for a large system. The written order must be presented to us to pick up blood products. Theorder must include the correct verb-i.e.- give, infuse, transfuse- if it doesn't- no product. The order must have 2 patient identifiers on it- in our case full name and medical record number. One of our facilities just went paperless but we still require them to print the transfuse order and bring it to Transfusion Service. We then review the orderand identifying information with the tag, blood product and with the information we pull up on the Cerner dispense screen. There are no exceptions. We have the full backing of our Medical Director and our lab directors and VP.
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Mary, as far aas the labels go- We use Cerner classic still and they built a special program so the we generate barcoded labels from the computer. Before barcodes were required, we printed our own labels on a PC.
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We have been using Thawed plasma with a 5 day outdate for years. I don't know about you r blood supplier but ours doesn't make FFP any more, they make plasma frozen within 24 hours. Once thawed we take this right to a 5 day product and call it thawed plasma. We have a very aggressive prospective review policy and use the thawed plasma in situations where the INR is elevated. We ignore the PTT.
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CAP says to define your rare antisera. Even though the standard mentions anti-Jka and anti-Lea, CAP says rare should be antisera are not readily available from a supplier. Well any of them can be hard to get every now and then!! Just want to know how every one was responding to this CAP standard.
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Is your blood supplier making dry button cryos? If so, the volume in those should be so inconsequential that I don't see a problem. The other issue is that cryo is usually a one time thing so no matter what the volume will be small.
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We love the manual solid phase and hope to be moving to an instrument in the next year. We have a huge client workload on third shift and couldn't get through the shift without it.
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We dropped doing a full crossmatch on people with positive DATs unless you have tested the specimen you are currently using and it is positive. If you don't know and don't test- no full crossmatch required.
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We use both methods. We have kept our paper records because we had a 7 day unplanned downtime several years ago and would have never recovered without our paper records. The crash was so quick that there was no time to back up files.
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We are a level one trauma center and we have a standard protocol for preparations of products although not all of them wind up being issued. For every 10 LPRBCs, we thaw 2 FFP and hold one apheresis platelet. We are in the process of building factor 7 doses into the protocol as well.
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We are currently requiring a full crossmatch for neonate exchange transfusions and are wondering if everyone else is doing this. Per standards, the crossmatch can be omitted on a neonate as long as antigen negative units are used. The antibody screen can be performed on either the mom or baby. We routinely follow the antigen neg path for a routine neonatal transfusion and question why we are still doing a full crossmatch for the exchanges. Any comments??
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You will need to perform validations just like you did when the equipment was new. Whatever you did then will need to be repeated. All electrical checks and outlet checks will need to be performed as well.
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5 day plasma again and again and again.
bpkelly replied to John C. Staley's topic in Transfusion Services
We were just cited by AABB and CAP for not using a 2 step process for labeling our plasma. We use Plasma Frozen within 24 hours and take it directly to a 5 day out date. We use a very aggressive prospective review system and do not issue theis plasma for anyone with a factor VIII deficiency. Has anyone been cited for immediately labeling this plasma with a 5 day exp? If so - did you challenge it or change your process? Now of the literature is particularly supportive of either position.:mad: