THintz

Hi~ I am revising some procedures and wonder if anyone has a fabulous process/procedure (and, if possible, a related form for documenting the work-up) for the investigation of a positive DAT. If you are willing to share your creation with me I would very much appreciate it! If you prefer not to put it on the site, you can instead email me directly at thintz@altru.org. Thanks a bunch!!

Here is the procedure and form we use for the calibration of all of our centrifuges (Hettich EBA 21 and Sorvall Cellwasher 2). This works well for us, hope you find it useful. Terri TS 002404 Calibration of Serologic Centrifuges.doc TS 009002 Serologic Centrifuge Calibration Worksheet.doc

Hello! Our facility (Hospital Lab with a FDA Licensed Donor Center) has been approved for a new position of Compliance/Safety Officer. We've always had someone in this role but was combined with LIS too (I know what you are thinking!). Anyway~ because the LIS portion of the job monopolized this positions time we are splitting things out. I've been asked to give input on the rough draft of the job description and would like to compare it to what others use. If you have a Compliance Officer position in your lab/blood center and you'd be willing to share the job description with me I would be so appreciative! One catch~ I'd need it by Monday March 28 as we were only given a few days to give input. If you prefer to send privately rather than post here email to thintz@altru.org or fax to 701-780-1897, ATTN: Terri. Thank You in advance!!

At our facility we use Epic for our HIS and Sunquest for our LIS. Our Hospital Info Service area is rolling out Epic to a small area hospital (not a part of our company-somehow we have an agreement with Epic to be able to do this). The lab in this small area hospital does not currently have an LIS so as part of the "total Epic package" they are getting with our help they want to install Beaker, the Epic lab software. Beaker does not have a blood bank module that is 510K cleared for use. However this small lab does do some blood banking and were told by someone (unsure who) that it would be "ok" for them to enter blood bank results in Beaker as the process used to result other lab work like heme or coag could be "tweaked" to allow BB results too. By this I assume they mean the interpretation of blood bank testing documented on the current paper system, not actual reaction results as there is no logic in the system for QA checks, etc. The statement was qualified with "but if they do more than a little blood bank work (define little...) then this small lab would need to get a separate BB software to interface with Beaker. Thoughts on this? If they enter BB test interpretations into Beaker is this ok to do in a system not specifically cleared for BB? What about if they did enter some reaction results for types and screens or DAT's? This I am really uncomfortable about. I've been asked to give my opinion on this by our LIS staff who are working with the small lab on the Beaker implementation. Something about the whole thing makes me a bit uneasy. For reference, the lab implementing Beaker is accredited by Joint Commission. Thanks for your input!

@clmergen: Thanks for the reply. I too have a general plan template but was looking for what someone has done specific to the EBA 21. I appreciate the offer though!

We just purchased two new Hettich EBA 21 serofuges and I'm wondering if anyone is willing to share your Implementation/Validation Plan with me so I don't have to re-invent the wheel. I'd really appreciate anything I could get my hands on. If you're willing to share, please e-mail to me at thintz@altru.org or fax to 701.780.1897. Thanks in advance.

bduff, While in the design phases of the system be sure to insert yourself in discussions that pertain to blood banking, including the design of the armband and even more important the blood administration flowsheet (if you plan to use it), and billing. Make sure you have a barcode readable Medical Record Number. Our site (specifically the pharmacy) wanted the CSN (an account number) barcode readable. So on our armbands the CSN is barcoded and the medical record number is only in eye readable format. As a blood banker this makes no sense to me. Since we didn't have funds for our transfusion verification software right now we let it go saying that eventually we'd need the MRN barcode readable. We use Sunquest for our LIS, including blood bank. In all, I like Epic a lot, it's a great product and very powerful tool for us but the build and go-live (including post go-live) are very painful. I hope Epic serves us well for many years to come because I don't ever want to have to implement an HIS again.

We just went live with Epic on 04/01/10. During the design phases of our system (which took place in summer 2009) the Epic team kept proudly telling me that you can "barcode your unit number into Epic and it reads ISBT". Trying to better understand the functionality of the sytem I asked, "What is the system checking the barcode against?" After much discussion and confusion surrounding my question, the answer was--nothing. The barcode functionality is simply to avoid clerical error in typing the unit number when documenting blood administration using the blood admin flowsheet. The system is not capable of an electronic verification that the unit about to be transfused was released from the transfusion service for the intended recipient.

Thanks-I was hoping they wouldn't need to use a barcode. I know that all of the units collected here stay with the patient and are not stored for future use.

Would anyone please share how they label blood collected with the cell saver? In looking at the AABB Standards for Perioperative Autologous Blood Collection and Administration (I have the 3rd edition, I know the 4th is the current one)--standard 5.1.6.2.3 "Labeling should conform to all FDA regulations, including bar code labeling as applicable. Each unit should be labeled "For Autologous Use Only" and "Donor Untested, " if applicable...." I'm asking on behalf of the person in our surgery area that works with our program which is not currently, nor seeking AABB Accreditation, but simply using the standards as a good-practice guideline. I know they currently hand-write a label. Should they be using barcoded labels instead? What information is on your label? Is it hand-written or barcoded? Thank You! Terri

We are wondering what various institutions have for a policy on collection of pre-transfusion specimens on trauma patients by paramedics. Do you allow paramedics to collect a pre-transfusion specimen? If so, what do they use for labeling it? If collected in the field or ambulance en route to the hospital do you have the expectation that they will label it immediately using a trauma band, handwritten information, or something else? Are the paramedics included in any training that your facility might have on specimen identification/collection? We'd just like to hear what others are doing. Thanks much!

We use Sunquest (v6.2) and will interface to EPIC. I've been told that Sunquest and EPIC work well together. Our IS dept. keeps tossing around the idea of "someday" having us switch to EPIC Lab, but until they would have an FDA cleared BB module, it won't happen for us. I'm excited for the switch to EPIC it will be a lot of work, but a favorable change in the end. Currently, I find it a bit difficult to understand and I tend to get a bit frustrated with the fact that I haven't seen enough of an overview of the system, yet I need to determine how these order sets should work and what components they need to have.

We are in the process of implementing EPIC as our HIS and would like to build an order set for ordering blood products. We do not currently have a "pre-printed" order form that providers use to order blood products. I would appreciate obtaining examples of order sets that others use (either built in EPIC or as a paper form). If you are willing to share, please fax a copy to 701-780-1897, ATTN: Terri. Thank You in advance! Terri

For those of you still using whole blood platlets...a few questions: 1. Pool size--what do you do? a. Physician order number of units to be pooled. b. Have standard pool size (adult dose). If so, how many WB platelets per pool? c. Based on weight of patient. d. Something else. 2. For option (a) in question #1: What is the average (typical) pool size ordered? For option ( in question #1: How was the standardized pool size determined (calculation--if so, what; literature, etc.)? For option © in question #1: Is the transfusion service provided the weight and then subsequently provides the product? or-- does the physician calculate dose based on weight and order that amount of product? For option (d) in question #1: What do you do? Thanks in advance for your reply! We currently let the physician decide the number of units to order and I find they still are ordering 8-10 per pool rather than the desired 4-6 units/pool and I'd like to make a change.

Mini Me, I would never say that online study is easy. It takes a lot of discipline and commitment. But, without the option of online study, I would have ended up studying for the exam on my own and possibly finding myself retaking it instead of passing the first time. My goal in becoming an SBB was never to just pass the exam, but in the end to be a better blood banker than I was when I started. I personally felt that by going through an online program I was able to achieve that goal (and pass the test!). It is a challenge to arrange the necessary clinical sites. My clinical rotation sites were not all local. I did my reference lab and some of the donor center checklists at a blood center in St. Paul, MN, 4 hours from where I live. I was lucky to have family in Minneapolis so I had a free place to stay! If you’ll need to travel to clinical sites, do not forget to plan for these expenses when estimating the cost of your education. If you are interested in an online program, I would make a list of the ones that appeal to you and call the program directors to inquire about some of the specifics of the program. They all vary slightly and maybe you’ll find one is a better fit for your situation. Lastly, if you do apply, make sure your application is very descriptive of your abilities and desire to be an SBB. Some programs have three or four times the applicants than openings. Your application will need to shine! If you do choose to take an online course it will be really, really tough, but I don’t think you’ll ever regret it.