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melvolny

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Everything posted by melvolny

  1. We will be using Epic/Beaker/Soft by Feb. 2020. I would love to be a part of any discussions.
  2. We just switched over to using thawed plasma - 5 day exp. I changed my outdate to 120H - but it expires them at midnight - which brings it past the thaw time by several hours, so technically it is 5 days + some hours expired. Is there a way to make it reflect the time of thaw as expiration and not midnight? Does it matter?? Am I being too literal?? lol thanks for any insight
  3. Which standard or regulation states blood products have to be transfused within 4 hours and started within 30 min.? I've begun the process of going electronic and want to make sure I will have access to the all the information required. I looked in Standards 30th edition. I looked at JC requirements. I couldn't find anything that specifically laid out what was required when reviewing for completion. I know I have read it somewhere, but I sure can't remember where. Thank you in advance for any help with this.
  4. This topic just came up today. The Nursing Council has decided they want the respiration rate documented for each transfusion. I have looked for some reference that states specifically what is to be documented. Everything just says "vitals". My thinking is respiration is a part of vitals, so they should be documented. We have not in the past. We have only done BP, temp and pulse. My concern with this is they (RN's) have trouble completed these forms now, adding this one more piece will equal many more Midas reports for me. I would like some references or articles or something, just for my own knowledge as well as for sharing with the powers that be. Thanks for being there.
  5. Hi all, Just got a phone call today from our local nursing home. She wants us to be their "supplier" so they can do the blood transfusions right there in their facility. This will save the patient a ton of discomfort. This will help reduce the number of non-emergency admissions. My problem is I do not know where to start to do some research for my manager. My manager did mention something about having a different designation because we would technically be a supplier. I didn't see anything in the Standards. So I figure I am just not looking in the right place. Any suggestions on how, or if , we can accomodate them? Anyone have any procedures they wouldn't mind sharing with me? Thanks in advance for any and all ideas. Melissa
  6. Thanks for all your replies! Right after I posted this - my brain did the old "Of course - prozone!" I thought I would titer it in the tube next - just to see what it does. I, too, was very surprised it wasn't a higher titer than that. We'll see what happens as the pregnancy progresses. Thanks again!
  7. We have an OB patient with an anti-E. This morning when I titered it, it gave me some very odd reactions, something I have never seen an antibody do before. The repeat was the same. I performed the titer in gel. The first (raw) tube was weak, the second tube was 1+ and the third tube was a strong 2+, the rest were negative. I repeated it thinking I set up the tubes incorrectly. The repeat was the exact same with tube 4 being weakly positive. The rest were negative. Anybody else ever see anything like this? And what's up with the antibody that would cause this? Thanks in advance for any and all responses. Melissa
  8. Hi all, We have recently moved into our new lab. (Loving the space and the beauty of it!!) Blood bank is now in its own room, free from distractions (YES!). The break room is clear across the lab, very far to walk for that sip of water that is needed during a hectic workday. I wanted to designate a little area around my desk as "clean" but my manager was concerned it was too close to our secondary work station. I have hunted for any guidelines or regulations regarding setting up a clean area but I am not finding anything very specific. Anyone have any ideas where I can look or what I can say to my manager to "persuade" her. Thanks for your ever-valuable input. It's awesome to have this forum to run to when there is an issue. Melissa
  9. Deny, did you do any validation or comparison testing before implementing? Would I have to? Is plastic less costly than glass? Thanks for your insight Melissa
  10. Thank You Malcolm - I knew I could count on you for a reply. Melissa
  11. I've seen alot of information about going to plastic vaccutainer tubes for specimens. But I find nothing about the testing in glass test tubes. Why do we use them? Can we use plastic? Do we want to use plastic? These are questions that have been brought to me. My gut reaction was "we've always used glass tubes" - but I realized that is not the appropriate response. One of our techs cut herself on a glass tube the other day, so now the Risk dept wants to know why we aren't using plastic. We use gel for everything we can, but the tube is our backup right now. Does anyone have any appropriate responses to the above questions? Thanks for being there. Melissa
  12. Good Luck - You will do fine. Just study the Technical Manual and you won't have a problem!
  13. Good Morning, In every transfusion service I have worked in, we have always filled out an emergency release form for the doctor to sign and manually completed transfusion report forms for the documentation of vitals, times, etc. As I am looking at my current emergency release procedure, it does not specify the manual complete of transfusion report forms. So, of course then I started investigating what others do. Standards only states a doctor's signature is required. Others, rely on the flow charts, and some manually complete transfusion report forms. So - I put the question to you folks: what is your practice? it seems unreasonable to make the RN's document the vitals in the patient's chart and then again on our form in an emergency, but then it seems these should be part of the patient's history in the blood bank. Thanks in advance for your thoughts - it's so nice to have somewhere to bounce these questions around. Melissa
  14. donna, Is it too late to get a copy of your checklists? Thanks in advance mvolny@centegra.com
  15. I think that's what threw me - the computer gave it a 24 hour expiration - and I wondered why? why didn't it know to change it? apparently I am expecting way too much! Thank you for affirming my thought process.
  16. Your frozen plasma has an expiration less than 24 hours. When you thaw it is the expiration 24 hours from time of thaw, thus pushing it past the original exp date/time? or wouldn't the thawed product have the same expiration as the original frozen product??? It's been a long holdiay season....
  17. I need your help! I had a distributor call me a couple months ago offering Rhophylac at a much cheaper price (than Ortho Rhogam) and a promise of better insurance reimbursement. From what I can tell it looks like exactly the same as Orhto's Rhogam. I had never heard of Rhophylac so I started calling around (actually I delegated that part) and found only one area hospital using it. Can you let me know what you use and where you are from? Happy with it or not or no feeling one way or the other?? I want to present something to my medical director. Thanks for being there. Melissa McHenry, Il
  18. Hope you guys don't mind - I am posting these rules in our blood banks. They are right on target - and made me laugh. Thanks!!! Melissa
  19. I suppose my thinking is: when the blood comes back from OR/ER or the floor we take the temp, using a Temp-Check - why would we need the indicators? I can see using them for our FFL blood - but even then when the units come back we take the temp. So I'm not sure they are even necessary then, but it feels safer to have them on those units, due to the fact we really do not know what they are doing with the blood. I have seen many turn red in the frig. The first time it happened, I thought for sure the tech put the blood back into the frig with a red indicator!!! But it has happened too many times for that to be true. With the validated coolers, the monitored frig's, the Temp-check - I think I have pretty much decided to forego the use the indicators. Plus, there is nothing in the Standards or Cap. Thank you all again for your wonderful insights. Melissa
  20. Thank you for all your input! It has given me a wider perspective to ponder. Melissa
  21. Hi All, We have been looking at ways to cut costs (who hasn't!) and we all have been wondering if indicators are necessary. We have validated coolers. We have the 30 min rule in place. We have a temp check to take the temp when the product is returned. OR has a monitored frig. It seems to me we have everything covered, but I wonder what am I missing?? Thanks for your input, in advance. Melissa
  22. Hi Everyone - Happy Lab Week! I have been wanting to update and revise our reagent QC form - but what a daunting undertaking. I looked online for a template or something I could get ideas from but there is nothing out there. Does anyone have a form they would be willing to share? I love this site - anytime I have a question or concern I come here first and can usually find a solution. Thanks for being there. Melissa
  23. Hi Lara, I studied the Technical Manual - inside and out. I slept with it, ate with it, went shopping with it. It was my best friend. It worked. I passed on the first try. Good Luck! Melissa I also went to the Last Chance Review. (I had forgotten I'd done that!) It was very helpful because it showed me I had been studying the right things.
  24. mvolny@centegra.com thank you so much, Lara
  25. TRM.20000 - has to do with a documented QC/QM program specific for Transfusion Medicine. We just had our CAP inspection and were cited for not having a QM program specific for the tranfusion service. The General Lab QM program was not enough. I shudder to think of writing one from scratch. Does anyone have an outline you would be willing to share? It would be greatly appreciated and extremely time saving. Melissa
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