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Posts posted by BUGGIE
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My hospital is going to change from using MediTech (main hospital)/Athena (clinics)/T System (ER) computer LIS to Thriver EHR/CPSI. Have any of you experience with this? I am particularly concerned with how the Blood Bank module is presented and what it offers. Thanks
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Go to www.packmasq.com, or SALES@FLYMAX.COM. They have many different sizes and applications. The cooler is reusable and can be disinfected so they are acceptable to the OR. We bought the Max+Blood Shipper--Refrigerated storage (1-6C), SKU # R12MB (5). It can hold up to 8 PRBCs at 6C for 24 hours. We use this and a smaller (4 unit) Igloo cooler with ice blocks and refrigerated gell packs for our OR needs.
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Thanks! How did you pack the units inside?
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Hi, I need help. For years we sent blood to our OR in our blood supplier boxes to be stored there in case it was needed. The boxes would hold temperature 1-6 for at least 4 hours and were great. But now I have learned it is an infection control problem to use cardboard from outside the hospital. The box can be nowhere near the OR. So what kind of coolers do you use. I have been on line researching possible coolers. Any recommendations would be great. Thanks
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Blood Bank Lead Tech position opening September 30th, 2017, soon to be posted, old tech retiring.
Send resumes to Human Resources at
Rehoboth McKinley Christian Healthcare Services (small, rural, 60 bed hospital with 2 clinics, behavioral health services, dialysis and cancer center near by)
1901 Red Rock Dr.
Gallup, NM 87301
Fax: 505-726-6714
Or go http://www.rmch.org/
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Hi, I need help. Our pharmacy about a year and a half ago said we could no long stock RhoPhylac in the Blood Bank as it was a drug. So they now buy and stock it. We do the testing, tell the floor how much to give then Pharmacy said they should bring it down to the lab to be issued and charged to the patient. We issue it as a product with a billing code and charge. Same set up as at our OB clinic, except there it is built as a test and charged that way. Now pharmacy says we need to associate that with a NDC code as it is a drug, which I thought they were doing.
We have MediTech 5.65 what do you charge and how do you set it up in blood bank for RhoPhylac. I would prefer Phamacey do this. Thanks
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I am really glad this post started. We have been working on this issue since we were inspected by CAP in July. I have an extensive new employee training system, an annual computer review called "HealthStream" that includes a blood bank module for lab and RNs, CAP and United Blood Services competencie articles on line, CAP proficiency samples used as competencies, and of course the usual review of all QC and work done on bench with cards and computer enteries but we need to add more direct observations I guess.
As I understand it, as far as CMs is concerned, this 6 point review is for every "test" we do every year.
(i.e. ABO/Rh, DAT, FHB, ABSC, XM, ABID, etcCOMPETENC-BB YEARLY ASSESSMENT.docx
I have attached a template that was sent to us from our CAP inspectors. Any ideas would help.
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How would I set this up for a retype in MediTech 5.65 going to 5.66? We use a seperate BB band and have barcoded Hospital ID bands and would like to go to barcodded BB bands and use the TAR system in MediTech but that will take some time and money to set up.
So in the mean time I want to test out a double draw/double type system. We do a lot of prenatal type and screens that will not have the opportunity for redraws. Also alot of Baby Types. So if I set up a "Previous History?" question and the answer "No" reflexes an "ABO/Rh Retype" I get a lot of unwanted test orders.
Could I tie the refex order in to the XM order? But that would not help if the patient just got FFP.
So how are other Meditech 5.65 lab handling this? Thanks
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Innovance reagents are good for 4 weeks refrigerated in their original vials. Is it acceptable to run tests using the original container and put them back in the fridge after running tests, in that way we will not waste reagents when reagents are just left in the machine? We really get low volume of D-Dimer request.
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We are a small rural lab and for years have sent all Poly AHG Testing out to our United Blood Services reference lab for Anti C3d confirmation as we can't afford compliment coated check cells. We report the initial results and say we have sent the C3d out for confirmation, we only request the C3d and that is all that is done. For all the non-neonatal DATs we do it is much less expensive than ordering Compliment coated check cells. It has always been an EDTA sample as well.
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We have validated the new kit and all my techs have run the + and - QC as training, none have had a problem. The new CAP survey was done on the old and new kit and all went well. The new kit is inuse and I do not expect any problems. We are still using NERL saline. The positive and negative controls are well defined.
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We had a visit from a QUOTIENT Biodiagnostic sales rep selling ALBA Blood Bank reagents, have any of you used these? She said they make several of Ortho's products but are developing a line of Blood Bank reagents of there own. One interesting product is a do it yourself compliment control check cell kit. Thanks
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Does anyone know how to contact Clay Adams, I can't seem to find a company listing. Were they bought by someone else?
Thanks SB
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The Medical/Surgical department is revising their policies and procedures for using the Stryker Constavac Blood Conservation System. These will be reviewed and approved by the Transfusion Medicine Medical Director but all other responsibility for training, instalation, labeling, transfusing, monitoring, and reporting to the Transfuion Committee is with this department. They are wondering how to handle autotransfusion transfusion reactions. If there is a reaction should lab be notified to do a work up as with regular transfusions. What are your thoughts?
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Ah the RhoGam debate again. I started a thread earlier about where RhoGam was to held Blood Bank or pharmacy. The latest JC rule, and they are at my lab today, is that RhoGam must be treated as a drug. So we gave it all to pharmacy. We put a message on each box to say go to lab and confrim all testing has been done so lot numbers can be recorded and the product issued and charged to the patient. We are to buy the RhoGam from the pharmacy but we can not touch it, or apparently know what lot numbers have been received (working on that). We do not have the pathologist review the order, our techs do that, and tell the doctor how much to order.
Intrestingly enough the first RhoGam order came from Medical/Surgical for a 80 year old man who received Rh positve platelets about 700 mls. I was not really worried about sensitization to Anti-D as much as we were giving an A neg, O pos. What do you think?
My manager wants to know how labs who do not keep RhoGam in the Blood Bank handle tracking the product. My pharmacy says they do not track lot numbers to patients,nor do they review the orders.
Why does this bother me so much?
Also- my manager wants to know where do you store your blood boxes from your supplier, the JC says we can not keep cardboard boxes witch have been used as shipping boxes in the lab. It gets so complicated.
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In a recent Joint Commission (JC) review we were told that it is now mandated that RhoGam and RhoPhylac must be under the control of pharmacy as RhoGam/RhoPhylac is a blood derivative not a blood component such as blood, FFP, etc and as such is defined as a medication per the JC definition. Pharmacy will review orders and store product.
Is this something new? I remember a thread/poll about how labs deal with RhoGam and derivatives as to whether they were stored in Blood Bank or Pharmacy, but nothing that mandated one or the other.
I don't mind pharmacy dealing with this, but I worry about patients getting the appropritate testing (RH type/Fetal Bleed Screen, etc) before RhoGam is issued.
Too many times ER or OR has just called our Blood Bank for RhoGam without being aware of what test were needed.
I would like the order to go to pharmacey, and the product then be delivered to lab to dispence so we can assure proper testing and amount.
Any comments would be appreciated as this seems to be a done deal with pharmacey and the JC.
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Our hospital supports three clinics close to us. In one we transfuse out-patients. The staff is employed by our facility, the nurses and doctors are trained in transfusion policies and procedures, and follow all the main hospitals guidelines. For this reason we allow transfusions to be done there.
Is there a regulation that states what the actual rules are for off site transfusions?
A question has come up as to wether it is legal and if we can transfuse there why not at the local cancer center (which is not at all affiliated with us.)
Thanks for yor help.
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Hi, I agree that this question is for the transfusionists. We have a computer inservice for Blood Banking that all lab and nursing staff take each year. Plus we have a Blood Bank In-Lab orientation for all new nursing hires. But even with both of these we have found they are not aware of basic reactions.
We recently were inspected by CLIA and she found several transfusion records with temperature spikes >2F that were not investigated.
So now we are planning to add an annual Transfusionists/Transporter inservice at out National Patient Safety Goal Fair.
I would really appreciate any ideas you have if you do this too. Apparently this will be the Blood Bank Lead Tech's responsibility. So any power points, handouts, ideas for quick easy reviews would be welcome. Thank you so much if you do!
Please email me at sbuggie@rmchcs.org.
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We do the same basic transfusion reaction workup on all blood products, including a blood culture on the patient and unit if there is evidence of a 2F/1C increase in temperature above baseline (initial temp reading). We recently had a CLIA/CMS inspection after our CAP inspection where the inspector found 2/9 transfused patient's charts with a > 2F increase in temperature and no transfusion reaction work up was done. This has caused a thorough investigation of transfusion reactions. We do have a Blood Bank new employee orientation and a Yearly blood bank Healthstream review for transfusing nurses and lab but this obviously was not enough as many nurses said they had never herd that a >2F increase in temperature could indicate a reaction. We now will have a Blood administration and reaction review at our anual manditory National Patient Saftey Goals fair that will be attented by all nursing and doctors giving blood. That should help a lot.
Is this common practice in other facilities to do work ups on all products and to do workups on temperature increases? Our blood bank seems to be the main inspectors for the transfusion records. We have a paper system that is reivewed for all times, dates, signatures, length of transfusion and now particularly temperature increases.
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Thank yoy all for your responses. I called CAP today to clarify the issue. Susan at CAP Accreditdation said the is was up to the Transfusion Director to decide what consituted informed consent and what form this would take based on good medicall practices and patient saftey. I would think all your responces would be OK.
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In the revised CAP checklist dated 06/15/09, TRM42300 on Therapuetic Phlebotomy requirements, there is now listed the need for informed consent. We are trying to develop a specific consent form for this procedure as we are a small rural hospital and this is the only donation procedure we do in our phlebotomy department. Would any of you have Consent Forms you could share to give me some ideas to go on? Thank you
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We get pooled CRYO from our blood supplier, United Blood Services, as we are unable to relabel onsite pooled products. My question is, how do you charge for it? We have a P code of P9012 for one unit of cryo. Is there a P code for 5, or a CPT code? Our blood suplier doesn't charge to Medicare so they could not help. Any help will be appreciated.
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We have run into a problem. Our anesthesiologists insits that they can inject drugs/medications into an IV line (in the OR) that is running only blood or blood products. We (the lab) tell them this is strickly forbidden: that only normal saline can be infused into a blood line. They claim they have never heard of this rule, they do it "all the time", and that this practice is OK'd by the American College of Anesthesiologists!
We have shown them the AABB regulations to no avail. Isn't this an FDA and JACHO rule as well?
I know if you have only one line it is allowed to flush, give meds, and then flush again but they are injecting right into the blood line during transfusions.
My pathologist has emailed the AABB for clarification. Any comments or suggestions? Are there approved drugs other than injectable saline allowed?
Meditech Orders Inpatient vs Outpatient
in Transfusion Services
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We use MediTech 5.67, and when we have an out patient we use his Medical Record number that is the same with every visit as our Hospital number on the blood bank band, and then make sure the blood bank orders are entered on a separate requisition number under the fist H number (account number) and then just use the Move To Another Account feature in requisitions to move the blood bank test results to the H number for the day of transfusion.