Likewine99

Welcome back to BBT and congratulations on your return to the Blood Bank

My organization is beginning an implementation for HCLL donor module and I am on the build team. I've done HCLL transfusion side but know nothing about the donor side. If you have any suggestions I'd appreciate it. We are looking at a go live for both Tx Med and donor side in early 2015. Thanks for your help.

Our organization was extremely successful with a blood conservation project but we did it ourselves. We had buy in from the CMO which is of the utmost importance. Docs will listen to other docs. We had input from the financial side, the Blood Bank sups, lab directors, pathologists and representatives from our blood supplier, people from the quality and risk dept. If you have a strong physician leader internally you may be better off w/o the consultants. Mabel is absolutely correct, get references, talk to their clients, make sure that the dollars that were saved were "real dollars" and not just some smoke and mirror financial mumbo jumbo.

Congratulations! Great job!

Congratulations Melissa and best of luck to you Emily. Lots of fingers crossed for you here on BBT

Thank you Cliff, took away some stress from a very stressful day:D

We are just like Terri's lab, switched to 2 cell screen 4.5 yrs ago to standardize practices across our blood banks. No major problems, no compromise in pt care. Some techs missed having the 3rd cell but got over it fairly quickly. And we save the organization a lot of $$ by eliminating the 3rd cell. Good luck and happy validating:)

Helmer. Easy alarm testing, shelves slide easily. Our old one was 35 years old (no kidding), we just replaced it 4 years ago. They rarely need service.

Yes we use buffered gel cards on the ProVue for ISXM and have for about 6 years. Use tube ISXM for traumas and massive bleeders. SSM Healthcare, St. Louis, MO, DePaul Health Center, 350 bed Level II trauma center.

We give O cells like everyone else. Keeping the BB system and especially the techs happy is always a good idea in my book:D

We do the same as Terri and have our computer system set up to require an IS and a gel xm. I agree with rmblack about doing a tube screen and if neg calling the absc neg.

I agree with Dr. Pepper and we add attributes to the patient in the BB computer system. aakupaku also has a great point, prior to going live with your BB computer system you will validate it extensively (believe me!). If your hospital has and EMR you can test and see if "special attributes" make it to your blood bank printer. And as you move away from your manual cards you will have the opportunity to add patient special attributes into your BB computer system so at least you will have some control. Lots of opportunities for mistakes here due to the number of people who enter orders and their level of expertise in transfusion medicine. You do the best you can do and make the transfusion as safe as a Blood Banker possibly can. Good luck!

Love it and the lights too! Merry Christmas to everyone!

Congratulations. Good job! The next inspections won't be nearly as stressful. Note I said "nearly"

I highly recommend this site. I look forward to the questions every M-W-F. Top notch work.

I agree with the rest of the group. Cliff, do whatever you need to do to make the site run better and make life easier for you. Thank you very much for your time and talent. This is the best site ever.

I (the Blood Banker) worked on the EHR team in a very large trauma center and we were moving towards having an electronic signed "order" be part of the physician order set in the ED. The idea being that this electronic order was mirrored after the AABB and CAP standards for emergency release. The Bld Bk would receive a printed copy of the order in the BB and write the SOP to state that upon receipt of the order it was the documentation that an order had been signed. We tried it several times, never could get it to print or the order never was placed in the first place. Compliance was dismal at best and the poor BB sup ran all over the place to try and get the proper paper documentation. The saga continues.

I think JPCroke has some good points. If you make a recommendation on the transfusion slip it now becomes part of the legal medical record. In the unlikely event that there would be a problem with the transfusion (not that I think there would be) and your notation is not in the SOP, the legal profession could have a field day with this. It is great that you are keeping the patient in mind. As a former supervisor I saw way too many techs just going through the motions and some of them would never even have though of using a blood warmer. And I've also had supervisors that I felt were "picking on me". That's unprofessional behavior but you can't control that!

Agree with mhc, 24 hours or original expiration date, which in this case is shorter

Change is hard but you might mention that this has been standard BB practice across the industry for in the neighborhood of 20 years in hospitals both large and small. How about some buy in from your Medical Director? Going to ISXM is going to decrease the amount of time it takes you to get an ABO compatible unit of blood ready for transfusion which your ED will love I'm sure. Maybe give them a chance to "parallel test" for a couple of days, just to help them make the transition from the "old AHG" method to the "new, streamlined IS method". Once they do it a couple of times I bet they will be hooked.

Same as SMILLER. We have also taken both specimens and done a quick ABO/Rh and if they were different, notified the collector of the second specimen that we "have reason to believe" that the second specimen may be mislabeled.

This thing is great, thanks so much

You will be fine and after the intros are over and you actually get into the lab your anxiety level will come down, I guarantee it. A wise friend of mine once said that when an inspector asked her a question and it either appeared that she was going to be cited or that she didn't know the answer she asked the inspector, "how do you do this in your lab" knowing that she was probably doing it fine in hers but was sort of trying to find out where the inspector was going with the question. And another wise friend of mine said, "answer the question (and shut up!)" Don't overthink it, just answer the question the best you can. I agree with the others, organization is the best advice. If you look prepared they will know that you are. If your policies and procedures are neat, look nice, etc that will also go a long way on the first impression. If you do get a deficiency you can always contest it if you feel that it is not appropriate. I've participated in inspections on both the receiving and performing side and in the true spirit of the inspection process, try and learn as much as you can on inspection day. Good luck, go get 'em and keep us posted.

Count me in with you nerds, please. I was a nerd back when being a nerd was NOT a cool thing. I too check this site daily. Don't want to miss anything nerdy!

If it's a one time occurrence have a non-threatening conversation with the tech, explaining the problems with this deviation from procedure. Document this conversation. Also look at the why? Massive bleeder, working multiple depts, staffing, that kind of stuff. If this is a "repeat offender" take the "conversation" to the next level and tie it to a patient safety issue. I agree with David, look at retraining (document this) and if the problem persists maybe this tech is "not a good fit" for the Blood Bank or your organization. Did I mention documentation?