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AMcCord

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AMcCord last won the day on July 17

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About AMcCord

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    Seasoned poster
  • Birthday May 8

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  • Location
    Nebraska
  • Occupation
    Blood Bank Section Supervisor

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  1. Transfusion reaction workup is a whole 'nother animal. If I get a post-transfusion specimen that is hemolyzed, the first thing I do is ask the phleb if the draw was difficult. If it was, I send up someone else to obtain a new specimen. If we can't get a clean specimen, then that information is part of the documentation and taken into consideration with the interpretation of results.
  2. We also use Epic BPAM for administration, so if provider orders are not in the system correctly and nursing doesn't release those orders, BPAM won't work. They've been learning that the hard way. Some nurses still like to point the finger at Blood Bank, but their IT folks can see when the problem is user error rather than a lab issue. They educate nursing staff accordingly. There are still problems, but at least nursing management knows where the problems originate and some of the front line nursing staff is getting pretty tuned in to BPAM. When blood products are in a 'completed' status in Epic at my facility, a little red blood drop shows up at the top of the nurse's screen in Epic, something like the 'new test results available' notification works. They still call sometimes, but that little drop has helped tremendously. We do communicate by phone if the patient has antibodies or there is some other reason for delay. We might also notify surgery or the ED that blood products are available in some situations, but not routinely. When the provider signs the Transfuse order in Epic, a copy of that order prints in Blood Bank. When the transfusionist releases the Transfuse order, a copy prints on the floor and in Blood Bank, so we know that they are ready to start the transfusion. The nurse who comes to check out a blood product brings the Transfuse order that printed on the floor when the order was 'released', which serves as positive patient ID for us. Works well for us even if it does kill trees.
  3. The Echo won't like a specimen w/ hemolysis at 3-4+ when graded. That's actually quite a lot of hemolysis, so the specimens we reject for hemolysis are few and far between. The majority of our hemolyzed specimens tend to come from IV starts collected by nurses - they are 'supposed' to be saving us time by collecting specimens that way.
  4. Mabel - our patient is wearing a medical alert bracelet which says that she has the antibody. Not sure exactly what it says about transfusions as her provider dealt with the details. The patient (former nurse) and her husband are both very aware of what her problem is so are able to communicate effectively about her situation, which is very helpful. We were contacted by another facility not too long ago w/ questions about her as they were making plans for a surgical procedure - did we actually test for the antibody? (we did), symptoms of her reaction, etc. She is now, understandably, very reluctant to consent to transfusions.
  5. Dr Blumberg - appreciate your input.
  6. We've seen one of those patients with the antibody who had the severe anaphylactic reaction - impending sense of doom, etc., just like the books say. Fortunately the nurse was very attentive when the transfusion was started and caught it immediately. My advice is to instruct the nurses to watch very closely if she is transfused and make sure they know how to recognize a reaction if it occurs.
  7. AMcCord

    Unit Labels

    We use hang tags that we have printed for us. They have a header with our facility logo and name/address and a big blank spot on the front to receive a 4 x 4 label printed from our BBIS. The back of the tag has info for recognition of transfusion reactions, response to transfusion reactions (in a nutshell), and blood product handling instructions. Works well and no stickers on unit face to cause problems.
  8. This is what we do. We are a smaller facility with an active Oncology treatment unit. We transfuse platelets and plasma with a type from the current admission.
  9. I also had an elderly male like this. The first time he was transfused was the first time he had ever even been in the hospital.
  10. I have my centrifuges set for a very soft brake - makes a big difference.
  11. Keep it simple. Let them order red cells, just red cells. If they need irradiated or CMV neg or leukoreduced (assuming there is a choice at your facility) or whatever, let them select that option. In Epic they can be required to select a reason why they are ordering irradiated or CMV or whatever - the reasons should come out of institution policy. That way they are less likely to order inappropriate special attributes. Ditto for platelets and plasma products.
  12. Epic/Orchard Harvest/SafeTrace Tx It has been challenging to get everything communicating, but once past that everything seems to be working well. We went live with SafeTrace in May, so stilling working on some bumps with billing and workflow.
  13. We have also used the small Helmer incubator. It was very dependable over a lot of years. We have since upgraded to the next larger size.
  14. We are Epic/Harvest/SafeTrace. Our cord blood specimen labels include the mother's name and MR# as well as baby name and MR#. Our facility is also using a naming convention for babies that includes mother's first name (Last Name, Mother'sFirstNameBaby's Sex - example: Jones, BeckyBoy). The names are awkward to look at, but do help connect mother/baby.
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