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AMcCord

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AMcCord last won the day on September 16

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About AMcCord

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  • Birthday May 8

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  • Location
    Nebraska
  • Occupation
    Blood Bank Section Supervisor

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  1. One of our neighboring facilities is inspected by Joint Commission and AABB. No CAP. We are CAP inspected and Joint Commission is perfectly happy with that. They look at a small number of very specific things in our lab - how we handle our bone/tissue implants and how pathology handles surgical specimens and biopsies.
  2. We've seen a patient like that. We ID'd a clear cut but weak anti-C w/ solid phase on one specimen, not there with the next specimen, back again w/ a 3rd specimen, We discovered that she had been transfused somewhere else between our visits. That lab used gel and they had not detected the anti-C. We suspect that she received C positive blood, which pushed her titer up again.
  3. Nursing policy for blood administration should include those type of guidelines, They have references available for infusion rate, etc. The medical director of blood bank should (ideally) then review all of those polices to make sure that what they have included is good practice. In other words, a collaborative procedure. We struggle with getting blood/blood product nursing policies reviewed when written. There is a constant rotation of new nursing admin staff writing policies who never seem to know that our medical director should review those new policies and they don't understand what the lab has to do with administration. I just tell them it's an FDA requirement and TJC expects those requirements to be followed. Our nursing policies are accessible on-line so I search periodically for blood related policies to see if anything has been added. I put all of those policies in my SOP manual under blood administration. When I do biannual review, I check to see if the policy has been revised so I can upload a new version if necessary. I usually check at least annually as well. The policy format used by my facility assigns 'ownership', which is the VP of nursing, 'authorship' and also includes a line which indicates people who must review the policy. TJC requires policy review every 3 years, so that's why I include those policies in my manuals - to make sure they are reviewed often enough for CAP requirements. If I find a policy that does not have the medical director's name on it as a required reviewer, I reach out to the 'author' or the 'owner' to see about getting it added. I've also made a point of knowing who is responsible for the facility policy manuals and who is responsible for the Joint Commission compliance book. I have those 2 ladies on speed dial and they are very helpful. It can be painfully slow to deal with all the committees/councils that direct nursing policy. I tell myself that persistence and patience is key (and patience is not necessarily one of my virtues!).
  4. Appreciate this information Mabel. We are not currently providing blood for our contracted air service except for transfers for our patients, but I can see the day coming where this might change. What you've described would work very well for us I think.
  5. Me too! And guess who always gets to come in during a blizzard - no snow days for me .
  6. We came up on SafeTrace Tx in May. Haemonetics offered validation with a 'partner' company, but we chose to have our system validated by BC Solutions. Using a totally independent company seemed like a better idea.
  7. Our Helmer CW cell washer does not make a beautiful tight button, but it does make a button that is consistent. As Scott says, I think that defining your acceptable button appearance is good enough.
  8. We also got push back on redrawing patients for a second specimen - reason...patient satisfaction. We do type one specimen twice, but use electronic patient identification and issue blood with a barrier (FinalCheck armband/lock system). I was questioned about the expense of the FinalCheck system by the hospital administrator when I proposed it, but when I told him that a second draw would be required w/o it and that the lock would be a good deterrent to hanging the wrong unit on the wrong patient IF we strongly policed the use of the system, he agreed to the expense. Is it possible to cheat the system and still have WBIT and mistransfusion? Yes, human nature being what it is, someone will always find a way around all rules, but I think it drastically reduces the possibility. I should note that we are all lab draw or lab observed draw w/ rare exceptions in the OR. That does make the armband use more effective. I think that the 2nd person verification for patient ID at time of draw is pretty open for potential abuse.
  9. I had a similar experience when a Family Practice Dr, who was chair of the OB committee at that time, brought back the Immune Anti-A, -B test. The only 'reference' he offered was his experience with his children. We wanted to ask if those tests affected how the infants were treated, but refrained....tongue biting was involved. The pediatricians say they don't need the test.
  10. This, plus Pre-admit patients are 14 days.
  11. I haven't done an eluate on a cord blood in many years. If mom has a clinically significant alloantibody, we antigen type. If we can explain the positive DAT with mom's antibody, her blood type (O), or her current dose of RhIG, we won't consider a routine elution. If the baby's bili is unexpectedly high or if we have some other reason to suspect that an alloantibody is causing a problem, we would perform an elution. Our cord blood panels are ABO/Rh and a DAT. If mom is type O and baby is type A or B, we perform an immune anti-A, or immune anti-B. This includes an auto control, an antibody screen and an AGT test with a reagent A1 or B cell against cord serum/plasma. I've tried to get rid of the immune anti-A, -B, but we have a couple of family practice docs who insist that it be included in cord blood workups. Heavy Sigh!
  12. CAP says you have to be able to detect complement when you perform a DAT (exception - cord blood). So you would need to do the automated IgG and tube for C3 to satisfy CAP.
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