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AMcCord

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AMcCord last won the day on January 12

AMcCord had the most liked content!

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About AMcCord

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    Seasoned poster
  • Birthday May 8

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  • Gender
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  • Location
    Nebraska
  • Occupation
    Blood Bank Section Supervisor

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  1. AMcCord

    Elution on DAT positive Neonates

    Mable, if you can figure out a way to convince your providers to skip the O Pos moms, let me know! Our OB/Gyn practice is OK with not doing the O Pos moms (and they delivery 90+% of the babies here), the pediatricians are Ok with it. Our problem is one family practice provider and he's not budging. We offered to make it an optional order - he wants it, he can order it, but that didn't work either.
  2. AMcCord

    Elution on DAT positive Neonates

    No elutions here unless DAT is positive and we don't have mother's specimen or the DAT is positive w/ no apparent reason (no ABO incompatibility, mom's antibody screen is negative). In all the years I've worked here, we've never actually needed to do this.
  3. AMcCord

    Sample Age for 28 week antenatal RHIG injection

    When we still saw antibody screen orders prior to antenatal RhIG administration, the OB providers wanted the patients drawn within 7 days of their appointments. I always assumed that this was a recommendation of the American College of OB/Gyn. They stopped ordering those antibody screens several years ago, so I'm again assuming that there is no longer a recommendation for that testing. That particular practice very much follows guidelines.
  4. AMcCord

    Recent Joint Commission Survey?

    And you will fix what they cite - no worries. They expect to find things to cite you for, so don't plan on going through the inspection w/o getting nicked for something, Do the best you can, but don't be hard on yourself when you are cited. Look at it as a learning experience and an opportunity for improvement.
  5. AMcCord

    Patient identifiers on BB samples

    Exactly - patients should self identify, whenever possible, and that would be full name plus birth date. (We have had a few frequent flyers who would rattle off their MR#s when asked to identify themselves, but I think that was more about being a touch exasperated w/ our constant requests for them to tell us who they were rather than anything else.) And I agree that the birth date should be on the armband and the order for ID purposes. We do have it on the labels that go on our specimens, but it is not 'required' as an element of specimen ID. The CAP requirement for patient specimens is: "All blood samples used for compatibility testing are labeled in the presence of the patient with:1. Patient's first and last name2. Unique identification number3. Date of collection4. A method to identify the phlebotomist." AABB Stds say: "Requests: Requests for blood, blood components, tests, tissue, and derivatives and records accompanying samples from the patient shall contain sufficient information to uniquely identify the patient, including two independent identifiers. The transfusion service shall accept only complete, accurate, and legible requests." "Patient Samples: Patient samples shall be identified with an affixed label bearing sufficient information for unique identification of the patient, including two independent identifiers." They further say that the completed label has to be placed on the sample container at bedside; it has to identify the date/time of draw and the person(s) who collected the sample; that specimens have to be completely, accurately, and legibly labeled; and there should be a policy to reduce risk of misidentification of pretransfusion samples. I believe that Joint Commission recommends following AABB guidelines. So, as far as I know, the birth date is not 'required' on patient samples, but it is also not precluded from sample labeling. You can choose what your independent identifiers are and you can always have stricter requirements than standards in order to meet your needs. We choose to use full name, MR# and a separate armband ID for inpatients, giving us 3 independent identifiers - not required, but we've chosen that protocol to meet our needs.
  6. AMcCord

    Patient identifiers on BB samples

    Blood bank specimens here require 2 patient identifiers plus a sticker from a blood bank armband that is directly attached to a patient appendage. Our required identifiers for inpatients are full name and MR#. The labels that print at bedside include the birthdate, but birthdate is not a required identifier. We do, however, use birthdate as one possible patient identifier for outpatients. Specimens from outside clinics for reference work (prenatal panels) are acceptable with the name and a birthdate. We've stuck with our blood bank armbands because we've watched how some patients have gotten armbanded on the floor...staff member walks into room and slaps on band OR staff member walks into room, says 'Are you Fred?' and slaps on armband OR any other similar variation. That is definitely not policy, but it is human behavior. Blood bank specimens are lab draw, with some exceptions from the OR. We have a very strict policy about the removal of blood bank armbands - only we cut them off, or give permission for them to be cut off, unless the patient is being discharged. We've been doing that for long enough that we lose almost no bands. We have the full support of Quality to enforce the armband policy.
  7. AMcCord

    The moment when the glass broke

    They are just jealous that they can't play, too.
  8. I would rather deal with the unlikely event that my male trauma patient develops anti-D, then presents again as a trauma, than deal with having to give a young Rh negative woman Rh positive blood because I ran out of Rh negative units transfusing an adult male or a 50+ year old female. My stock of O neg red cells is 8 with full stock and my blood supplier is 150 miles away. A trauma situation could very quickly deplete that supply.
  9. AMcCord

    Training new employees

    Most of the techs I train are fresh out of school or MLTs whose blood bank experience is minimal at best (bench time at small facilities where almost no blood bank testing occurs). I expect to have them for a minimum of 3 months. We have a full test menu (automation + tube testing w/ mulitple enhancement media available, antibody ID, antigen testing, fetal bleed screens, crossmatching, emergency release/MTP, cord blood testing, etc.) that they are expected to be competent to perform. Our facility sees a wide range of patients. I want them to be comfortable with what they are required to do and I want to be comfortable with what they are required to do. Fortunately management sees things my way.
  10. AMcCord

    RHoGAM work up post partum Weak D

    Yes, a Kleihauer-Betke would be performed plus we would indicate in the patient record that Kleihauer-Betke is required for all future deliveries if the patient is weak D positive. We would not repeat the weak D testing. And as a side note, if the patient's baby was weak D positive, Kleihauer-Betke testing would be performed.
  11. AMcCord

    Fake blood products

    Great ideas for fake products using stuff that's easy to get your hands on. Thanks for sharing.
  12. AMcCord

    Fake blood products

    Where do you get your fake blood powder???
  13. AMcCord

    RHoGAM work up post partum Weak D

    We would do weak D on a post-partum patient only if the fetal screen is strongly positive.
  14. AMcCord

    IT'S DECEMBER ALREADY

    I've been looking forward to them...busted all of them already this morning. Just to get in practice .
  15. AMcCord

    IT'S DECEMBER ALREADY

    John - you can keep your silly snow. We've already had more than I want.
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