Likewine99

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Could it be something stronger than coffee?? But coffee is good too!!

As everyone else said, document, document, document. This person is a huge risk to patient safety which should send up red flags to everyone and it's also a risk to your hospital to have someone of this caliber in your lab. Do you have an HR counseling policy, I've used it to document unsatisfactory technical performance or a violation of organizational values and mission. Start with a verbal warning/discussion. "No you may not do a DAT test without having your competency signed off". After the verbal (document this) then take it to a level I (or whatever your HR calls it), refusing to follow policy and procedure, unsafe patient care, tie this to something in the counseling framework. Get input from HR with this. At the time of the Level I, reiterate that if this behavior is observed again this will take the counseling to a Level II. At this point the tech may need to go on a "highly structured performance improvement plan" which I've seen done in conjunction with the employee. Goals are set, timeframe for touch base meetings set, feed back sessions on progress. You are giving them the benefit of the doubt and this is fair to the employee in question. Usually if the performance improvement goals aren't met, bye bye, adios, das veydanya. You can't do this alone, you need upper management and HR involvement because this could become quite unpleasant for everyone involved. Especially a patient.

Physician responsibility.

What is your site currently doing for the blood product transfusion tag? We are getting ready to change ours and are looking for suggestions to meet all accrediting agencies requirements. Thanks.

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Welcome, this is the best site!!! Ask as many questions as you need to, lots of great knowledge and expertise here.

Level II, 20 min from supplier, 2 plts for stock

Two cell screen for as long as I can remember. It saved the organization quite a bit of money and we keep 2 panels in stock. Have been on gel since 1994 and automated BB analyzer for almost 13 years.

When your lab goes to Beaker your BB system will be interfaced, regardless of which system you decide to go with. My organization has 16 labs on Beaker with HCLL Blood Bank. We sunsetted Meditech, Cerner, McKesson and Sunquest lab/BB systems and all of the labs are on Beaker and HCLL. Being downstream from Beaker you will want to become best friends with your Epic interface analyst as there is always some gymnastics that need to occur with any BB system to get it to talk to Epic and Beaker. After bringing up these 16 sites we learned quite a bit and with our last Epic 2015 upgrade and HCLL Maestro interface upgrade we are at a very steady state. Don't forget you will want to look at the Blood Product Administration workflow, again, regardless of the BB vendor you choose. If you have more specific questions PM or email me, Mary.Mendel@Mercy.Net

Dan87 do you get reimbursed for all of this "extra work"? I haven't done complete XMs since the early 1990s and have worked in a variety of places, large, small, adult, pediatric. Change is hard but it really is time to drop the "unnecessary" testing, imho!

I agree with jalomahe, why in the heck does your IT department care about a PC that is attached to an analyzer? I'm sure it is the fact that they don't understand it is part of the analyzer and will only transmit info to the LIS. And they may consider this part of the hospital network. It might be a tough sell to get IT to let you purchase this analyzer, network security, viruses, firewalls all that technical stuff is front and center in their minds, they are most likely technical and not clinical. What about other analyzers in your lab, what platform do they run on? Of course IT would probably say these were grandfathered in if they are not on Windows 7 and they are OK. You gotta wonder what Immucor is thinking since the Griffols, BioRad and Ortho analyzers are on W7. Sorry to hear this, it is always something isn't it????

Our BB system, HCLL, prints a single sheet, 8.5 x 11 transfusion slip which has a sticky label as part of the slip. We remove the sticky label, place it on a "toe tag" and use the plastic loop-tee-loo things to attach to the blood bag. The paper does not accompany the unit most of the time, we are on Epic and tx documentation occurs there. We only use the paper if we are in a downtime situation, or blood is going to an offsite location or the transfusionist is not able to document in Epic.

Pool before issue

Not doing this. Wow you must have a ton of time on your hands, just kidding!! And do you get paid for this "meaningless" work. If you can document pt had Rhogam administration you need to get your pathologist to stop this, it's crazy I tell you. What value does this add to the patient??