[Retirement]

I will be retiring on August 9 and wanted to tell everyone that the forum has been a great source of information (and amusement at times).  I have spent time reading Malcolm's posts trying to imagine what he sounds like (just love a British accent).  Thanks for keeping the forum a place where we can all learn from each other

[Document Control]

We have a grid at the top of the page.  With it you know when the policy was originally adopted, the last revision and current revision.  All obsolete procedures are kept for 10 years.  This has been approved by TJC and AABB.

Title:
Department:	Transfusion Service
Manual:	Manual
Document #
Adopted:		Approvals: Signature/Date
Revised:		, Lab Med Dir:
Supersedes:		, Lab Adm Dir-Martinsville:
Effective date		, Transfusion Service Supervisor:
Pages:
Validated:		User’s Name and Title:
Author:
file:

[Blood Bank staff]

I am retiring in August and my replacement is concerned because there is no one with her level of experience to be her back up as she has been mine.  We have recently lost 1 tech that just completed her training as a generalist and another who was completing her clinicals and had given us her intention to work here.  Before that, the last 3 hires were fresh out of school and did their clinical rotations with us.  We have 2 other techs retiring by March with several others on their heels.  No one waiting in the wings.  Better pay and benefits can be found with in 1 to 2 hours of our location. For us, all techs work at least 2 departments (days).  There is no easy answer - training takes time.  It seems that thee training offered today is less comprehensive than what I received back in the dark ages.

[Blood Transportation to Floors]

We use a opaque purple bag.  I like to refer to it as the "party " gift bag.  My director asked that we do this.  It wasn't necessary to use a bio-hazard bag.

[Transfusion line flushed with saline]

At our facility, we attach a small bag of saline to the other "Y" of our tubing prior to transfusion.  This is used to flush the line at the conclusion of the process to make sure that all of the blood is given.  We are being asked to check on this as a good practice.  I would appreciate input from other facilities.

[Workflow for 2nd Blood Draws]

We have a history prompt that we answer with the patient's type/antibody status (AP/NAB/BN/PAB).  For a history of NONE, there is a reflex to the retype.  It is canceled if the patient is group "O".  IF the patient has a previous antibody(PAB) the user is prompted to enter the specific antibody, strength at last testing and the date of that testing.

[FDA 30 minute rule]

The ambient temperature is the key.  It is a matter of temperature not an absolute time period.  This was explained to me by an AABB inspector.  She did not cite us, but encouraged us to make a change.  We place temperature monitors on all RBC that leave the lab.  If they have not monitor, we will not accept them back.

[Meditech Unit Antigen Types]

The antigen types on our unit labels are not barcoded.  CMV negative attribute is, but we cannot read the barcode with Meditech.

[confirming blood types on products]

On ‎7‎/‎7‎/‎2013 at 9:21 AM, Brenda Hutson said:

Just one additional thought.....if you have the typing results in the computer; and if your computer system will not allow you to Test and/or Issue Products unless that confirmation testing has been done, you do not need to place stickers on the units indicating that they have been confirm typed (it is just an extra step....extra label supply...and more time).  And to eliminate finding out "later" in the process that a unit was not confirmed, would recommend you have a shelf where you place "Units in Progress" (or whatever title you want to put on the shelf; just so it is known to all what the status of those units are).  Should not be placed on an Available shelf unless they are truly "available."

 

Brenda Hutson

We stopped using the labels about 8 years ago.  We place the untested units in a designated shelf.  After testing they are moved with the available units.  We use Meditech and have a hard stop that prevents using untested units.

[AABB Std. 3.7 31st ed. Reagent Ref Alarm]

I am looking for an alarm to use with my reagent refrigerator.  This will be required as of 4/1/18.  Currently we just check the temp daily.  

[Quarterly Alarm Checks]

2 hours ago, AMcCord said:

I've been doing the ice water/warm water checks once a year and electronic check the other quarters for a long time. I've not had any concerns from CAP inspectors.

This is what we are doing.  An AABB assessor suggested we do the ice bath once a year.  We are TJC inspected.

[BloodBankTalk: Correct Blood Bank Nomenclature]

I just answered this question.

• My Score
  PASS

 

[Maintenance Frequency/Intervals]

We once had weekly maintenance scheduled for Thursday.  One of our inspectors didn't like the fact that wee were so specific and said that we weren't meeting our requirements if it varied.  Now we just call it weekly.

[Jehovah's Witness Transfusion Policy]

With the exception of emergencies, the patient must sign a consent form.  We have a place to decline blood products.

[Meditech Blood Product Wastage Report]

The report BBK Unit Disposition Statistics will give you all you need.  I print using all categories and get received, transfused as well as the different categories of  units not used (exp, dam, des, etc)  I print it monthly for my statistics.  The last page has all components listed.  Been in your position - Good Luck!!!!

[Final disposition for units transferred with a Patinet to another Hospital]

We complete a transfer form and include the information "Please call (phone #) when blood arrives - placing it in bold letters.  Most of the time our patient can be traced to a facility about 60 miles away and we can follow-up easily.  That being said, we encourage everyone to hang a unit immediately prior to transport.

[JOB OPENING FOR BLOOD BANK SENIOR TECHNOLOGIST]

Enjoy it.  I plan to follow you in August!!

[Transfusion reaction protocol]

The laboratory medical director has the final responsibility for these protocols.  Your medical staff should review the policy and discuss it with him/her.  We have emphasized that a fever can be the first indication of a hemolytic reactions and the transfusion must be discontinued and a workup performed.

[Unit History in Meditech 6.x]

We have had Meditech for 11 years and never had a problem looking up a unit history.  That is aslong as my fingers can type in the number correctly !

[Alarm for Reagent Refrigerator]

14 hours ago, pinktoptube said:

I am interested as well in a stand alone monitor. I really didn't like the proposed need for alarm checks on reagent refrigerators in the draft 31st Standards.

So I am not the only person reviewing the draft. 

[Alarm for Reagent Refrigerator]

Thanks, I am looking for a stand alone monitor with alarm.  We do not use a centralized system.

[Alarm for Reagent Refrigerator]

I am looking for an alarm that can be installed on my reagent refrigerator.  Any suggestions?

 

[Validating a new Freezer]

The chart on our freezer is in 2 C increments, so we use 2C difference.

[Meditech Product Build]

The associated patient tests (X, TS) must be entered for each product.  This is located on page 3 of the product dictionary.  Our physicians order RBC, PHP, FFP and add a comment if IRR or CMVN units are required.   It works as long as your product group is set up correctly.

[Fetal Screen/Fetal Maternal Hemorrhage]

Our Rhig workup includes a question "Fetal Bleed Required".  If the patient meets the requirements for the test (by gestation or post-delivery), we answer "Y" (yes) to the question and a Fetal Screen test is ordered on the same requisition.  It is also an indication that the tech performing the workup evaluated the need for the testing.