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April 2024 Challenge

Michaele

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Everything posted by Michaele

  1. Michaele
    We do not do an IS XM when we have to do gel XM. Our computer system will stop us from issuing non compatible blood. Also, for the last 3 years I have been doing method comparisons between gel and IS XM showing that they correlate. Gel has picked up incompatibilities in ABO every time. My inspectors have been satisfied to this date. I'm due for another CAP any day, so I will let you know if they now have problems with it
  2. Michaele
    Question--what are you all using for your taget completion of transfusion vitals tag (since everyone seems to have this problem)? MRPalisades uses <2.0 target. Years ago, our powers that be decided that our target needs to be 100% completion on the transfusion tag. Nursing staff can rarely meet that target.
  3. Michaele
    Terri--I was just talking to someone about getting a BB disaster plan in place. Your ideas are wonderful. (Thanks yet again!!)
  4. Michaele
    When we have to give incompatible due to a warm auto, we have the medical director sign a deviation form on the patient and we keep the deviation form in a noticable spot until the specimen expires.
  5. Michaele
    Does anyone use this particular product for checking product temps at return? Interested in any information that you can give me. Thanks!
  6. Michaele
    We are currently having the same issues. Our IS department contracted out the PC swapouts. They just came in and started switching PCs. Our BB system locked up, all of our interfaces to instrumentation won't work--in every department. Our link to our reference lab wasn't working, so we couldn't send out those tests. The downtime snapshots for our BB patient histories weren't working. IS response? "You are going to have some growing pains, you're just going to have to deal with it". ??!!!!!?! That doesn't work for me. They have now come back in and given us our old PCs back until they figure out the compatibility issues with interfaces and systems. Grrr. OK, thanks for letting me vent there for a minute. I'm all better now.
  7. Michaele
    The nurses notify the physician and the Blood Bank. The doc can choose not to do a workup if he feels like it is due to the patient preexhisting condition. We do have authority to over-ride them though.
  8. Michaele
    During our last inspection, CAP was ok with our using QC materials to test between tube and gel IAT. We used patient samples for correlations with DAT and XM. I think it's a personal preference with CAP inspectors.
  9. Michaele
    Our 200 bed hospital (who is not part of a healthcare group, we are a stand alone hospital) has applied to be a level III trauma center. I have some questions on how the blood bank needs to be changed to accommodate the trauma needs. Currently, we do not keep platelets in house, and our supplier is an hour away. That is one thing that I need to address, I know. I would like to talk to other facilities who have went through this process that are similar to our facility. Would anyone who has went through this or have certification for a level II or III trauma be willing to talk to me? I can call your at your convenience... Thanks so much!
  10. Michaele
    We would start with 2 ONeg, then switch. Hopefully have a patient type by then.
  11. Michaele
    We aren't doing the complement DATs since we ran out of the complement control cells. I was told that our reagent was to be shipped on 2-3, never got it, called today and it was delayed again.
  12. Michaele
    So how many out there use Rh control during blood typing? We have always used it with every typing. Our anti-D reagent is monoclonal. I just got word that our Rh control is being discontinued, so wondering if we need to continue this practice. Any guidance is appreciated.
  13. Michaele
    Well, if this will make you feel any better:: our former cardiac surgeon requested 6 apheresis with EVERY case. Then wouldn't use them all. He wouldn't listen to me, our pathologist, our regional ARC medical director, NO ONE. All I can say I'm glad he's our former cardiac surgeon.
  14. Michaele
    Usually your patient will tolerate out of group platelets if you can't get group specific. We try to give group specific whenever possible, but can't always get them. We have never had a patient that had problems.
  15. Michaele
    We actually never had our own blood bank bracelet, we use the hospital arm band. On it lists the patient name, DOB, and Medical Record Number. We use those three identifiers. Has always worked well for us, but the lab is the only ones who draw blood bank samples (physicians in surgery are an exception). Until that changes, we will just use the hospital arm band.
  16. Michaele
    We use historical type as long as there is documentation of at least 2 ABO-Rh testing on file. Otherwise, we would get a new sample and retype them.
  17. Michaele
    We also do a QA on the completed blood tags. Each transfusion tag is reviewed for completion and to make sure no reactions were missed. Once we find an error, we notify the nursing unit, and the nurse making the error has to complete corrective action/education. I'd say we have about a 95% completion rate. So Liz, you see the same problem rates from nursing draws that Scott sees?
  18. Michaele
    Thank you all for replying, this is very helpful. Wish me luck on my fight.
  19. Michaele
    So, do you give type specific or O if you have no history on the patient?
  20. Michaele
    Hello, I'm sure this has been addressed somewhere before. I'm just not finding it... 1. Who collects your blood bank samples? 2. Do you use an armbanding system? 3. If nursing draws your samples, how do you handle patients who have no history? 4. Have you had instances of wrong patient drawn? We are a smaller transfusion service and the lab has always drawn the samples for blood bank, but one nursing department has decided that they want to change that--they want to begin drawing and sending type and screen specimens down to the blood bank to save time. We have enough instances of wrong samples collected /not labelled properly on other tests that we are a little leery of making this change. Any help or words of advice would be appreciated.
  21. Michaele
    Hi all, I am needing your expertise. Does anyone have a blood management policy that they would be willing to share? I'm really looking for information about indications where the patient needs transfused now, versus waiting until the next day. This is for our cancer program-they have tripled in patients in the last year, and the docs are wanting everyone to be transfused same day--it's taxing our nursing staff who never get to leave on time anymore, our blood supply (they will wipe out our stock and the regions stock of irradiated platelets in a day), and it's difficult for scheduling purposes. So rather than have a patient waiting hours (our supplier is an hour away) for the product to get here, we are hoping to come up with some criteria to discern if the patient can wait a day and be scheduled for the transfusion. We hope to take it to the docs and try and get them on board with this. Any help at all will be appreciated. Michaele
  22. Michaele
    Good morning, does anyone notify the patient if an atypical antibody is found? I am considering sending a card to patients, notifying them of atypical antibodies, in case they go to a different hospital. We just had a case of this last night. A patient who has a hx of Jka, with her last Antibody Screen Negative (3 mo ago). She came in last night, her antibody screen is now positive and the Jka is back. Come to find out, she had gone to another hospital for a transfusion and they didn't have the hx of Jka. If you do this, would you be willing to share your policy or letter, etc? Thanks-
  23. Michaele
    We do not issue without tags and paperwork as well.
  24. Michaele
    Our policy is if we have two blood types performed three days apart (or basically with two different specimens), then we do not have to retype the patient to give platelets.
  25. Michaele
    We use Safetrace and we have the techs enter a comment on the result screen that they have checked history/no record. When system is down, there is a backup program that we can access patient histories.
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