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Likewine99

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Everything posted by Likewine99

  1. We do not separate. I have seen 2 instances where the plasma pour off tubes were attached to the wrong tube containing the RBCs. In one instance one of the pts had a Kell, the other was an ABO discrepancy that was caught thankfully with an ISXM.
  2. I wouldn't be surprised in those rare instances where Pathologists do an interp on an ABID if they might be able to charge a professional fee for the interp? In my many, many, many, many years in Tx Medicine I've never had a Pathologist who knew or cared about an ABID workup.
  3. One of my previous jobs we did it just like tbostock. Just picked one tx at random, once a month. We tried to cover all nsg divisions and all shifts if the off shifts had time to follow a unit to the floor. Followed up with nsg director and if we noted any non-conformances we used these as "teachable" moments, tied to pt safety of course and had it outlined in our quality plan
  4. I can understand why you might want to get rid of your ProVue but before it becomes a boat anchor, think about any labor savings you may have with it there. The ability of having a generalist load it and not have to babysit with it while covering other depts, less chance of error labeling cards, those kind of things. Put ditching the PV lower on your priority list, and no I do not work for the vendor CAP regs are a great place to start. Work on this in small chunks, the whole thing is very overwhelming the first time out. Hit the easy stuff first, daily maint records, monthly PM stuff. Get your staff involved, they have a stake in this too. Keep posting here, lots of good information sharing happens here. Feel free to message me too, I have been where you are and you will make it!
  5. Still a manual paper process and the form has to come to the BB before blood is dispensed to the pt. Signed form is scanned into the EMR and we have a QA process to verify that the scan is truly attached to the correct pt.
  6. I agree with goodchild and Terri. It's time to send those cards to the great confidential recycle bin in the sky. Mabel has a great suggestion too. Back in 1994 when we converted to electronic BBIS we searched the SS death in and back entered the ones that were still alive. Good luck and welcome to "paperless" blood banking......
  7. Two words: patient safety. Having anyone working a bench who has not been through the usual training and staff competencies is a risk to patient safety. Just because you are a manager does not mean you are a competent worker bee. Would Nursing, Pharmacy, Radiology let a department director work in their depts w/o adequate training. Best of luck to you with this dilemma . When I was a manager I did competencies just like everyone else on staff. And as a PRN I am still expected to do my yearly mandatory training.
  8. In my experience, and this usually happens in smaller labs, the lab director works benches and turns out tests just like any other staff member. Yes, they always completed their competencies and yearly mandatory stuff just like the rest of us.
  9. Likewine99

    Hello

    Glad to have you here, this site rocks
  10. There are probably some CAHs out there using a BB system but I bet they are few and far between. AMcCord is correct, a BB system may be cheaper than a law suit. As a BBer and IT person I can tell you it is very expensive upfront and upgrades, maintenance and system validation are very time and labor intensive. If you have Horizon BB it would need to be thoroughly validated, a validation plan written and approved, lots of documentation generated during the process. I applaud you for wanting to use the system, you'd have to weigh the return on investment to decide if you really want to implement the system. Good luck!
  11. Wow, it's a shame to hear this. If you have actual system functionality questions I may be able to help, that is if it's allowed for you to reach out to other Mediware users. Someone needs access to the Mediware users group online. I've used Mediware for years, end user, builder etc. Is there any mechanism to get your "bosses" to strongly suggest to the contractors that if you are not allowed access to the Mediware supplied documents that your validation will be sub-par patients may be at risk when the system goes live? That may be a little extreme but proper system use and validation is almost impossible without some vendor supplied documentation and adequate training provided by someone. Feel free to private message me from this site.
  12. I agree with the others, most contracts do not allow you to discuss the prices you pay. You might suggest to the CFO that someone in your organization who actually knows how to negotiate contracts help you. That is unless you already possess this skill One of our previous blood suppliers cut the cost of blood products then tacked on shipping, it was a wash when it was all said and done. And as the price went down so did the service. Lots to think about, good luck!
  13. AMcCord hit the nail on the head. Hospitals are not reimbursed for the complex workups, we just eat the cost. And there are many places that no longer have dedicated Blood Bankers, especially on evenings and nights. Everyone is so focused on the bottom line, the turn around times, getting the work out the door faster many of us send WAAs to the reference labs simply because we lack the time and expertise to do it right. Sad but true, $$$ drive a lot of decisions in the labs now days.
  14. I agree with Dansket and Malcom, about 12-18 months. At my first job I was a generalist and not just dedicated to Blood Bank. It gave me good experience in seeing the overall impact of lab results on patient care. As a supervisor/manager it was every bit of 12-18 months to make the transition from bench tech to supervisor. That was much more of an adjustment as there were more responsibilities as a manager.
  15. Welcome, this is a great site!
  16. Like tricore, I am and IT person and my primary function is Blood Bank. I am a "corporate employee" and maintain the BB system for 8 and soon to be 11 separate BBs within our system. Everyone who has posted here is absolutely correct, your institution must have a highly structured, well defined change control process and a method to communicate changes to your end users. All changes need to be thoroughly tested and the appropriate documentation generated and maintained for your accrediting agencies. We do not have "standard" build but it is tailored to each site, our BBs do not have standard testing methodologies (yet). Would it be possible to talk to someone in your Corporate Compliance department. Your IT dept is violating all kinds of rules and regulations by just moving things into production w/o thorough validation and end user training? This presents a risk to pt safety which should get the ear of the compliance people. At the bare minimum you need to talk to the manager of the IT team. Being part of a corporation leads me to believe that there are other hospitals in your group and your IT people are probably making these changes w/o proper validation at other sites within your system. Yes, IT change control is long and involved and not always a quick process, but knowing that your testing results affect a patient should never be taken lightly, especially by someone working in lab IT.
  17. I retired an ancient cell washer about 10 years ago when it died and replacement cost was $8K. We use gel primarily with tube LISS as our backup. We do so few tube screens that yes, believe it or not, we use the old, antiquated, but extremely cost effective manual washing with a squirt bottle of saline. It works for us and not doing maintenance and calibration on a manual cell washer was a big hit with the staff. Good luck, have you tried Googling it?
  18. Blood_Banker, I too have used glass slides to do blood types (rural hosptial, late 1970s) but if you are in the US you may be subject to an OSHA inspection and glass slides most certainly present a sharps hazard to staff in your blood bank. If possible, please investigate the possibility of moving your testing to glass or plastic tubes. And by all means do not rewash these tubes, they are meant to be disposable. tricore, I've also used the "china markers" on tubes and slides. They came in 2 colors; orange and black. I preferred the black , Haven't seen them in the lab in YEARS.................... What few tubes we do mark these days use those new fangled Sharpie markers (not a product endorsement, I use this term generically).
  19. I've seen this done by taking the total number of billable tests (ABO, Rh, ABSC, XM, units of proucts transfused) divided by the # of tech hours billed to the department. We did not count things that are considered "regulatory" such as donor retypes or the 2nd blood type on file, or QC and daily temps, it was strictly billable lab tests out the door every 24 hours. This gives a productivity number that can be benchmarked as to how "productive" your blood bank is. It is tied to any test/procedure that has a CPT code or P code used when you charge your blood products. Don't try to do this alone, you need help from your lab director, finance people, etc. People higher up the food chain from you do this stuff on a regular basis, pull them in and pick their brains.
  20. I agree with all of the above posts. Most of ours are legitimate T&S and John is right: unwarranted testing isn't going to be paid for anyway. Good luck with this pbaker!
  21. We are almost identical to hillDi. Use Che/Hem samples when available, probably 90% of the time. No charge for the second type, it is considered "regulatory". Would use group O if we couldn't get a second type.
  22. I agree with Terri and in my pediatric days we only gave CMV= units to BMT candidates and recipients. Our neonatologists were good with CMV safe and it saved us something like $66,000 the first year we moved away from CMV tested units. Current adult world, do not use CMV= units for oncology patients. Again $$$ and docs say not necessary.
  23. Thanks for the pics, ours is very old and has the tube wells. Shame on Ortho for not thinking through how to take this temp easily. BTW, nice job on rigging a thermometer. You should patent this for use is US
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