swede

We have a new safety committee in our laboratory, and they are saying that we need to remove our saline from the 10L cube cardboard boxes and store the 10L bags in another plastic box that we relabel.  
They are using the "no shipping boxes" as the basis for this decision.  We've never heard of anyone in blood bank doing this.  Our arguement is that we are not a patient care area, so the cardboard shouldn't be a problem. 
The committee is saying since phlebotomists come in and out of the lab, it counts as patient care......they do not come and hang out in the blood bank storerooom.  
Having a hard time convincing the committee that we are not going to be taking saline out of the box.....HELP!

We have been doing second ABO/Rh types on transfusion candidates with no previous history since 2002! We use previously drawn hematology specimens whenever possible.  Since nursing does some of our draws, we send a small pink top tube to the floor to be used (we are the only department allowed to order and use these tubes) for the "confirm type".  We use parafilm around the cap so we can make it "tamper proof" to some extent.  Before we did this step, industrious people would draw two tubes at the same time and save one, waiting for our request of a second draw.  They would pour over the saved tube into our special tube....now they can't.  We do second types on all ABO types, we don't exclude type O.....they too can be WBIT.....which could affect other lab departments.....we let them know if we find mistypes.   We also don't exclude emergency transfusion......that is when the most errors happen because people seem to lose their minds in high stress situations.  We stick with type O until the confirm type has been drawn. 
We tried the two signatures on the tube route, but found they were just grabbing anyone and having them sign the tube whether they witnessed the draw or not.
Fun times in the blood bank! :)
 

We have been doing second ABO/Rh types on transfusion candidates with no previous history since 2002! We use previously drawn hematology specimens whenever possible.  Since nursing does some of our draws, we send a small pink top tube to the floor to be used (we are the only department allowed to order and use these tubes) for the "confirm type".  We use parafilm around the cap so we can make it "tamper proof" to some extent.  Before we did this step, industrious people would draw two tubes at the same time and save one, waiting for our request of a second draw.  They would pour over the saved tube into our special tube....now they can't.  We do second types on all ABO types, we don't exclude type O.....they too can be WBIT.....which could affect other lab departments.....we let them know if we find mistypes.   We also don't exclude emergency transfusion......that is when the most errors happen because people seem to lose their minds in high stress situations.  We stick with type O until the confirm type has been drawn. 
We tried the two signatures on the tube route, but found they were just grabbing anyone and having them sign the tube whether they witnessed the draw or not.
Fun times in the blood bank! :)
 

We have been doing second ABO/Rh types on transfusion candidates with no previous history since 2002! We use previously drawn hematology specimens whenever possible.  Since nursing does some of our draws, we send a small pink top tube to the floor to be used (we are the only department allowed to order and use these tubes) for the "confirm type".  We use parafilm around the cap so we can make it "tamper proof" to some extent.  Before we did this step, industrious people would draw two tubes at the same time and save one, waiting for our request of a second draw.  They would pour over the saved tube into our special tube....now they can't.  We do second types on all ABO types, we don't exclude type O.....they too can be WBIT.....which could affect other lab departments.....we let them know if we find mistypes.   We also don't exclude emergency transfusion......that is when the most errors happen because people seem to lose their minds in high stress situations.  We stick with type O until the confirm type has been drawn. 
We tried the two signatures on the tube route, but found they were just grabbing anyone and having them sign the tube whether they witnessed the draw or not.
Fun times in the blood bank! :)
 

We are using the NERL saline on our Vision.  We've been running for about 18 months with no problems.

We like to tease our inspectors and tell them that we have done 30 years of validation and decided we don't need to do QC because it always works!  It warms them up and we usually have a pretty good day after that!

Please take a look at this before you make your indicator decisions. 
http://williamlabs.com/blood-banks/validating-temperature-indicators-the-return-to-refrigerator-challenge/
 

We just purchased the new Hemo-trac Blood Temp 6 indicators. This seems to be a new product from them.  I have not validated them yet, but the procedure does not indicate that they require activation as Scott has indicated.  These are different then the "flower" hemo-temp II indicators that people have used in the past.  They are stored at room temperature and are activated by pressing on a button on the indicator.  Then it is placed on the unit.  
I will let you know what I think of them after validation.  I am hoping these can replace our Safe-T-Vue 6's.
 

This would have been nice to know 2 weeks ago! We had our CAP inspection and got dinged because we weren't comparing Elu-kits (I'm pretty sure it was a "gottcha because someone got me" kind of deficiency!)   Couldn't get any backup calling CAP, so we took the hit and added that we will compare eluate results between kits.... (we'll have to make up a sample to elute when the time comes.....)
We were doing the fetal screen kit already.......
 

We currently have 2 patients on this drug.  One of them has only been transfused once in the past couple of months, and her screen was negative. The other has been transfused multiple times. She was negative for 3 rounds, then 1+ positive in GEL.  Currently she is negative again.......

We like to tease our inspectors and tell them that we have done 30 years of validation and decided we don't need to do QC because it always works!  It warms them up and we usually have a pretty good day after that!

We like to tease our inspectors and tell them that we have done 30 years of validation and decided we don't need to do QC because it always works!  It warms them up and we usually have a pretty good day after that!

We like to tease our inspectors and tell them that we have done 30 years of validation and decided we don't need to do QC because it always works!  It warms them up and we usually have a pretty good day after that!

We like to tease our inspectors and tell them that we have done 30 years of validation and decided we don't need to do QC because it always works!  It warms them up and we usually have a pretty good day after that!

We like to tease our inspectors and tell them that we have done 30 years of validation and decided we don't need to do QC because it always works!  It warms them up and we usually have a pretty good day after that!

We like to tease our inspectors and tell them that we have done 30 years of validation and decided we don't need to do QC because it always works!  It warms them up and we usually have a pretty good day after that!

We charge the first patient for the antigen typings. We do not charge the second patient. We also would not go back to credit the first patient. Blood was ordered for patient number 1 and we did what was required to provide that blood. It doens't matter if it was used or not....the order was there and the work was done.
Patient number 2 just got lucky this time!
We have a worksheet that we mark to make sure the typings have been charged.
If we grabbed 4 units to type for JKa and got lucky that all 4 were negative, we would charge the patient for all 4 typings.....even if they only needed one unit. We would not type our frig one unit at a time.....again, we are charging for what was required to provide blood at the time it was ordered.

We charge the first patient for the antigen typings. We do not charge the second patient. We also would not go back to credit the first patient. Blood was ordered for patient number 1 and we did what was required to provide that blood. It doens't matter if it was used or not....the order was there and the work was done.
Patient number 2 just got lucky this time!
We have a worksheet that we mark to make sure the typings have been charged.
If we grabbed 4 units to type for JKa and got lucky that all 4 were negative, we would charge the patient for all 4 typings.....even if they only needed one unit. We would not type our frig one unit at a time.....again, we are charging for what was required to provide blood at the time it was ordered.

We charge the first patient for the antigen typings. We do not charge the second patient. We also would not go back to credit the first patient. Blood was ordered for patient number 1 and we did what was required to provide that blood. It doens't matter if it was used or not....the order was there and the work was done.
Patient number 2 just got lucky this time!
We have a worksheet that we mark to make sure the typings have been charged.
If we grabbed 4 units to type for JKa and got lucky that all 4 were negative, we would charge the patient for all 4 typings.....even if they only needed one unit. We would not type our frig one unit at a time.....again, we are charging for what was required to provide blood at the time it was ordered.

We charge the first patient for the antigen typings. We do not charge the second patient. We also would not go back to credit the first patient. Blood was ordered for patient number 1 and we did what was required to provide that blood. It doens't matter if it was used or not....the order was there and the work was done.
Patient number 2 just got lucky this time!
We have a worksheet that we mark to make sure the typings have been charged.
If we grabbed 4 units to type for JKa and got lucky that all 4 were negative, we would charge the patient for all 4 typings.....even if they only needed one unit. We would not type our frig one unit at a time.....again, we are charging for what was required to provide blood at the time it was ordered.

We charge the first patient for the antigen typings. We do not charge the second patient. We also would not go back to credit the first patient. Blood was ordered for patient number 1 and we did what was required to provide that blood. It doens't matter if it was used or not....the order was there and the work was done.
Patient number 2 just got lucky this time!
We have a worksheet that we mark to make sure the typings have been charged.
If we grabbed 4 units to type for JKa and got lucky that all 4 were negative, we would charge the patient for all 4 typings.....even if they only needed one unit. We would not type our frig one unit at a time.....again, we are charging for what was required to provide blood at the time it was ordered.

We charge the first patient for the antigen typings. We do not charge the second patient. We also would not go back to credit the first patient. Blood was ordered for patient number 1 and we did what was required to provide that blood. It doens't matter if it was used or not....the order was there and the work was done.
Patient number 2 just got lucky this time!
We have a worksheet that we mark to make sure the typings have been charged.
If we grabbed 4 units to type for JKa and got lucky that all 4 were negative, we would charge the patient for all 4 typings.....even if they only needed one unit. We would not type our frig one unit at a time.....again, we are charging for what was required to provide blood at the time it was ordered.

US standards require transfusion services to perform serological testing on red cells obtained from an integral donor tubing segment from cellular blood components to confirm the correctness of the ABO/Rh container label prior to transfusion. 
 
Units labeled Rh Negative must be tested with anti-D, but not Rh Positive units. Units labeled A, B or AB are tested with anti-A and anti-B and units labeled group O may be tested with anti-A,B only.
 
Meditech standardly allows for a single test to document the above serological test results.  This test is automatically ordered when a cellular blood component is logged into the system.  For example, when an OPOS unit is logged, user is presented with a test requiring results entry for anti-A, anti-B, anti-A,B and anti-D despite a serological testing protocol using anti-A,B only.  If an ABPOS unit is logged, again, 4 tests (anti-A, anti-B, anti-A,B and anti-D) must be resulted in some manner even though unit was tested with anti-A and anti-B only.
 
This has been bugging me for years, but I finally figured out a way to configure Meditech so that if an OPOS unit is logged, only anti-A,B is reflexed; if an ABPOS unit is logged, only anti-A and anti-B are reflexed.
 
To accomplish this requires creation of 3 different Order Groups, a T type test with Auto Result, a PRE type calculation using the keyword "bsp bt" and profile tests with T tests configured with anti-A, anti-B, anti-A,B and anti-D according to your testing protocols.
 
If you are an interested Meditech user (I'm currently using C/S ver 5.66), please private email me via PathLabTalk.

Yikes! In past years antigen typing sera could be used beyond expiration as long as there was a policy for QC. We consider them to be "rare" partially as an expense. Yes they are available from the manufacturer, but they are very expensive. Private Lear Jets are also readily available from a manufacturer, but they are rare because few people can afford them!
We will be eating some expense to get our rack in-date within the next few weeks. Our CAP window will be opening soon.
We also use expired panel cells for rule-outs.....in fact a recent CAP Survey we had to use expired panel cells to identify an anti-U....nothing in-date was helpful.
Sounds like another case of a non-technical person making rules they don't understand.

Yikes! In past years antigen typing sera could be used beyond expiration as long as there was a policy for QC. We consider them to be "rare" partially as an expense. Yes they are available from the manufacturer, but they are very expensive. Private Lear Jets are also readily available from a manufacturer, but they are rare because few people can afford them!
We will be eating some expense to get our rack in-date within the next few weeks. Our CAP window will be opening soon.
We also use expired panel cells for rule-outs.....in fact a recent CAP Survey we had to use expired panel cells to identify an anti-U....nothing in-date was helpful.
Sounds like another case of a non-technical person making rules they don't understand.