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Everything posted by vam3401
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eluation competency evaluation
vam3401 replied to jerriemc's topic in Immunohematology Reference Laboratories
Are you talking about Comptency of the staff OR Proficiency testing? -
We enter the QC into our computer system from the printouts, but do not keep the printouts long-term. The ProVue keeps all testing records electronically and these can be retrieved at any time if you need to see them again.
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ProVue: Ortho Reverse Typing Cells
vam3401 replied to Brenda K Hutson's topic in Transfusion Services
We have seen the same thing on both of our ProVues. It's very frustrating. We have tried all the same troubleshooting ideas that you have. Ortho is telling us "others" are seeing the same issue. We have had our ProVues for almost four years and are just now having this issue. It has to be something in the A1 cells or perhaps the software. We are not repeating testing at the bench, but are just reviewing the card from the ProVue. There doesn't appear to be anything wrong with the reaction! I hope Ortho figures this out soon. -
Thanks for the explaination of FBC! Our hematology samples aren't necessarily labeled the same as our blood bank specimens either, but we are only performing the ABO/Rh confirmation testing so it's ok with us. With this specimen, we are at least sure it is from a different patient identification and specimen collection time. We do not use that sample for compatibility testing, only the second ABO/Rh.
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Great question! This is something I'm trying to work on right now too. I would love to hear suggestions.
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I'm sorry, but what is an "FBC sample"?
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We do require a second specimen from a different draw to perform a second ABO/Rh when no type is on record. We will first try to use a specimen from Hematology, if available, to do the retype testing instead of having the patient drawn again. Facility is Missouri Baptist Medical Center.
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We saved some to use before Ortho changed the packaging! The smaller plastic holders are so much better to use at the bench. I don't know where you can get them now. I've also heard that some people cut the cardboard packaging in half to use.
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We allow patients to have a pre-surgical specimen drawn up to 30 days ahead of surgery. The question about transfusions and pregnancy is asked and documented. This has been a great patient and physician satisfier.
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We do not type our OB patients for K, nor do we transfuse K negative units to them. I have not heard of any cases of HDN caused by anti-K at our hospital.
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I agree with Heather. We did this exact process before moving into our new laboratory 3 1/2 years ago. Planning the new lab's layout and design was the best spent time you can have. We involved our techs and they designed everything - down to the placement of each centrifuge, rack, lamp, computer, etc. And it has all remained in the same place on our countertops since we've moved!
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If we do not have an historical ABO/Rh on file, we collect a second sample and perform both forward and reverse typing. We will also use a sample from elsewhere in the lab to use as our second ABO/Rh sample, if available; example the lavender top CBC tube from Hematology, thus saving the patient the phlebotomy. Our lab also uses a phlebotomy hand held device that reads the patient's barcode on the armband and prints a specimen label at bedside.
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When each unit is processed into the blood bank computer system upon receipt from our blood supplier, we pull one segment that is re-typed and two other segments that are saved. We use a unit number label from each unit to label a test tube and we store the two segments in this tube. These test tubes are stored in a test tube rack. We use several racks per week. Each week we discard the oldest segments (we keep the segments for 8 weeks). We write a discard date on the racks of segments using a piece of masking tape (high tech).
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We verify each pipette quarterly.
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We use an 8.5 X 11 requisition that prints on a laser printer. It is a pre-printed form that we place in the printer paper tray. We have it set up so that HCLL will print the patient and unit information on the form at crossmatch. The form also has a label/sticker that is printed with information and we use this label on the blood product itself. The paper requisition is then rubber banded to the product. The two signatures, vital signs, etc are documented on this form and placed in the patient's medical record chart. I will be glad to fax you a copy to look at.
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We allow pre-surgical specimens to be collected up to 30 days prior to the surgery. History of pregnancy and/or transfusion in the past 3 months is documented at that time. Units would be crossmatched day of surgery, if needed. We do not use a specific blood bank armband, so no armband requirments for us. On day of surgery, the transfusion history is asked by the RN and a pregnancy test is performed per surgery policy. If the transfusion or pregnancy history has changed since the specimen was collected, a new Type and Screen specimen would be collected.
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I understand that there are lots of variables to consider. Do you know if your information of 1.5-2 week level supply is published somewhere? It makes sense to me; I just would like to be able to see information or data in writing. Thank you for your help!
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Does anyone have a quick or easy calculation to determine the number of units of red blood cells that should be kept in inventory in the hospital blood bank? We have delivery from our blood supplier every day Monday through Friday. Supplier is about one hour away from our hospital.
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We also just report out the Cord Blood's DAT as positive. If requested by the physician, we will do further testing.
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I am investigating the Blood Safe product from Mediware. It is a storage unit that interfaces with my information system. I hope it will be able to do all of the things you mention. I would love to hear what anyone knows about this.
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We do not worry about typing for Lu(a) antigen. We would just go for an IgG crossmatch compatible unit.
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We also used to do this audit more often, but found no problems, so discontinued the continuous type of audit. Now we just perform this type of audit once or twice per year to continue to monitor the process.
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Is there a quick way to tell if it is Rhogam
vam3401 replied to LaraT23's topic in Immunohematology Reference Laboratories
We ask for RhIg injection date and prenatal antibody screen results (if we didn't perform testing). If screen was negative and RhIg was given, we call it a passive anti-D. If this information is not available, we call it anti-D (the real thing!). -
We require an ABO/Rh per admission.