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Everything posted by swede
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Switch from gel ABO/Rh to tubes for cost savings?
swede replied to Kathy's topic in Transfusion Services
We will stick with gel/Provue for the majority of our typing. The Provue serves as a tech and frees up our techs to do all the other jobs that must be done on a daily basis. PMs and Nights are much more confident and happy working in blood bank since we went with gel and the provue. Peace of mind does not have a price! -
We put temperature indicators on our cooler units because we don't trust anybody.....in the past, "they" were known to take units out of the cooler, line them up on the bed, and then place them back in the cooler when the patient stopped bleeding. After a lot of education over many years, this no longer occurs, but we still use the indicators....
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We would definitely stay with type O until a specimen is received. Never ever go with an historical record.
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We set our set point to 35.5 and our high alarm at 36.9. Daily temp is typically 35.6. Yes, you are right, whatever Helmers set point is, is too high. I don't remember off-hand what it is. The set up manual is very user friendly.
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The book will talk you through set-up, which is basically setting a set point for temperature, calibrating the temperature control, setting alarm high activation and low activation. After we did that, we followed the temperature readings for a week and then we put it in service.
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Yes, Mabel, we know that ! We try to keep educating and are hoping for the best, its all we can do.
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When we first started doing confirmatory types, we had trouble with work-arounds, but after years of trying to out think them, we have a system that is working. We now send the tube to the floor (mostly ED and Labor) and they must use our "special" tube for the confirm type. We send a 5ml pink top; we use the 7ml for the type and cross. Blood bank is the only department that is allowed to order the 5ml pink top. We used to catch them taking caps off and using "saved" blood for the test. We now wrap a small strip of parafilm around the cap (making it tamper evident). Nurse managers are behind us, so anyone caught circumventing the protocol is disciplined. We don't have to have many confirm types drawn, we do look for a previously drawn cbc first. ED and Labor are our most frequent draws.
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We retype all patients without a history; we figure if we are catching misdraws, Type O people can be misdrawn too and other lab work may be involved with same "stick"
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Mom D neg, Baby DAT Pos
swede replied to californiacls's topic in Immunohematology Reference Laboratories
Our docs like to have a heelstick done on the baby so we can do another type. They typically resolve to being Rh negative. -
I would love a copy, jcoe@swedishamerican.org. Thank you!
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We verify ours quarterly. We figure that way we are covered no matter who wanders in to inspect!
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Does anyone have any helpful hints for the Meditech 5.64/ ProVue interface? We finally have it uploading and calculating blood types and antibody screens. However, I am unable to get it to "download" the tests so I can use the fancy HOST button on the sheet tab. I can only get it to work for Type only. I cannot get it to mark the type/antibody screen combo on the sheet tab. Downloads the combo as just a Type also. Very frustrating and Ortho is not much help. Thanks for any help provided!
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Barbara, if you are still emailing this, I would greatly appreciate a copy. Thank you! jcoe@swedishamerican.org
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We finally gave the factors to pharmacy about 6 years ago, and we haven't looked back. They have always handled the albumin, and we still have Rhogam in the blood bank (pharmacy doesn't want the responsibility!).
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Actually they work quite nicely, even for us folks with "old" eyes. Our tape is 1/2" wide. We use all caps on the letters. Our drawers have a lip that is angled out a little bit, so the labels are very prominent. I hope you find something that works for you.
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I have been having good luck with the P-touch label maker. I think it is by Brother, and I bought mine at Target. The labels are white with black printing. I have added the labels after the refrigerator has been in use (Helmer). Good luck!
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Type and Screen only vs. Type and Screen and Crossmatch
swede replied to Brenda K Hutson's topic in Transfusion Services
We do the same as Joanbalone. Our C/T ratio has been slightly over 1 for years. -
We do our antigen typing in manual Gel, but if we did use our ProVue for typing, I would go the easiest route and use reagent RBCs. We use reagent rbc's for qc manually, so it would be easiest for the generalists to keep with the same idea.
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We also have a Helmer i series freezer. We keep about 15 O, 15 A, 15 B, and 15 AB units of FFP, 6 prepooled bags of cryo and 15 cryo-reduced plasma in ours. We have room for the ice bottles for coolers and some frozen hematology specimens! It is a great freezer.
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We have the DH8 and our thaw times are about 10 minutes for 200ml and 16 minutes for 300ml. I can't remember the last time we had to use 18 minutes for a bag of FFP. Cryoprecipitate thaws very quickly. We love our DH8 and are hoping for a second one this budget year!
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We use the ortho poly cards, and we no longer order the tube reagent. We only use them for our DAT testing, which we only perform when doing an antibody workup or if a doctor specifically orders the test. We QC them on the day of use by running a positive IgG coated cell, a negative cell and a complement coated cell (we purchase these from Immucor and dilute them to 0.8%).
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We do the same as Autumn and it works great for us.
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We have been using the BioHit electronic pipette for years, and we love them! Once you use them consistently, they become second nature. We still have a couple of Tipmaster pipettes around, but I believe only one or two techs use them. When we switched to ABO/Rh gel cards, the last hold-outs on the BioHit came around!
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I would try Wescottlabs. We get our pipet tips for the Biohit pipets. They are a lot less expensive than Ortho.
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Nothing is returned to our blood bank. We send one laser copy of the transfusion form with the unit of blood, and it is placed on the patient's chart. This has been done since the early '90's and we have had no problem with inspectors. We do follow units to the floors several times/week and follow the whole process. Those transfusion sheets are observed for completeness at that time.