Jump to content
May 2024 Challenge

KKidd

Members - Bounced Email
 View Profile  See their activity

  • Posts

    318

  • Joined

  • Last visited

  • Days Won

    3

  • Country

    United States

 Content Type 

Everything posted by KKidd

  1. KKidd
    I agree Malcolm. Thankfully, I have a great reference lab. We don't have the man power or reagents to perform some of the testing I would like and they are a fantastic resource. Back to the subject, Cold Agglutinins are like having a cold(kind of a nuisance).
  2. KKidd
    We currently have a patient with Cold Agglutinin Disease. We sent a sample to the reference lab because he had been transfused in the past. In addition to that very strong cold agglutinin, he has an Anti-K. You never know what lurks in the plasma/serum of patients.
  3. KKidd
    To meet Joint Commision requirements we have a competency documentation form that is used in each department. It includes direct observations, supervisory reviews of the tech's work ,Direct observation of PM, proficiency testing, and written test. Each year the techs get a written test that covers the Quality plan, computer operation, specimen /component handling, maintenance, patient testing and anything else I may have noticed. I am already working on 2013. When I notice a weakness, major change in protocol or we have an unusual situation, it is incorporated in the next year's competency. Of course, there may be specific competencies during the year. :sneeze: (the pollen is killing me!)
  4. KKidd
    We no longer split units. It was not worth the expense of the printer and the validation for 1-2 units per year. That was several years ago and we have not had any complaints. We tell the nursing staff that they have 4 hours to give as much of the unit as possible with the patient safety in mind for the rate of infusion. THey understand that this supercedes a physician order to transfuse over 6 hours.
  5. KKidd
    We had an AABB assessment last summer and the assessor approved of the fact that we had waited 24 hours once the temperature stabilized before moving the blood back. I also performed an alarm check.
  6. KKidd
    What kind of adhered label are you talking about? Do you know of a regulation or standard regarding this? My TJC and AABB inspectors have never commented on the ID labels we usre on the back of the bag.
  7. KKidd
    Our Red Cross reference lab provides education based on interesting cases that have come their way. Dealing with an Anti-G happened to be one of them.
  8. KKidd
    Sorry I cannot give you more specific info. We have started with the ED and have not moved to in-patients yet. If it is set up the same way, I think that the order is put into the nursing module along with any other orders for the day.
  9. KKidd
    We have Meditech and our ED physicians put their own orderd in the computer. Thed hardest thing to get across is they must order the blood(2 RBC, etec) ubn the BB before they order the transfusion in the nursing module. We have gotten quite a few calls from the ED asking is blood was ready on a patient and there was no order for us. Things are getting better. When we built the BB orders we kept it simple. They just order the component and number of units. If we have any questions, we'll call them. Unfortunately, I wasn't involved in the build. Good Luck!!!!!!!!!!! :eyepoppin
  10. KKidd
    We looked at maternal "Du" results microscopically until the first rosette test became available. That was many moons ago., but I guess I'm showing my age!
  11. KKidd
    We do not allow the return of a product unless it has a Hemotemp II temperature monitor and can confirm that the temperature did not exceed 10 C. Last week a nurse returned a unit after ten minutes. I placed in the refrigerator for a few monutes then decided to apply a monitor. The temp of the unit was between and 9. WHatever you decide to do, you must be able to monitor the temp.
  12. KKidd
    We do not perform a second type at the moment. I do have one question for those who do - how often do you need to get a new sample on the patient because a second sample from Hemo or Chem is not available?
  13. KKidd
    I am looking for an article on the potassium levels in stored units of red blood cells. I have read some articles regarding trasnfusion of "fresher" RBC to patients having cardiac surgery. However, I don't remember the sources. Thanks for your help! Merry Christmas to All ............
  14. KKidd
    What computer system are you using? We have physician EMR entry in the Ed and there is some confusion. They will put in an order to "transfuse2 units of RBC" but an order for T&S, and XM is not generated. That must be done seperately. In order to simplify things, we don't know if the order is for transfusion, have available or pre-op. I fear that when EMR goes live for in-patients it will be a mess.
  15. KKidd
    THanks, Denny I'm curious as to what computer system you are blessed with. We have Meditech.
  16. KKidd
    Within the next year our physicians will be entering their own orders into the computer system. Currently only the ED is doing it and they tend to order transfusions. We'll do a type and screen and the ED will call 1 hour later to ask if the blood is ready. Sorry, no order. I am interested in hearing from others that work at facilities where physicians put the orders in on in-patients. Are the correct? Do they get ordered too early if the patient is for surgery? What kind of queries must be answered?
  17. KKidd
    I calmly informed a doctor on Sunday that the blood would not be available the next day and I wanted him to be able to make an informed decision regarding the surgery date. He said that he didn't care if I had to crawl to the blood center (60 miles away), he wanted the blood on Monday. Don't you jjust love it!!
  18. KKidd
    We are a small facility and alternate sets of screening cells from one day to the next. I also only use one set for 2 weeks. At that point I open new sets of the same lot. This has helped in addition to keeping the reagent rack in a black file box to protect it from the light.
  19. KKidd
    My Ortho Resolve Panel A has 1 r'r cell and 1 r"r cell. I realize that they are not homozygous, but it helps differentiate along with selected cells in most cases. I agree that performing cell types for C and E will provide more information and ammunition.
  20. KKidd
    The JC standards that go into effect 1/1/12 state that the plasma must be labeled as "thawed plasma". Since the words are not capitalized, I don't think that it refers to Thawed Plasma (with the 5 day exp). It sounds like you need to label the plasma as thawed with the new exp. date/time. Of course, I have been known to be wrong on many occasions! :confuse:
  21. KKidd
    We tried to institute a form similar to Adiecast. Our Nurse Exec Committee shot it down before any physician even saw it. Congratulations!
  22. KKidd
    When a unit is issued, we place a segment in a tube labeled with the barcode label from the bag. The tube goes in a rack with diviisions for each day of the week. In total, the segs are saved for ten days in case subsequent testing is needed.
  23. KKidd
    By the way, before I started reviewing each transfusion form, our compliance was 30% in some units. It takes some work to get compliance and you need a strong CNO and NEC. One of the nurse managers prepared an in-service that took them step by step as they performed a transfusion. I participate in nursing orientation and skills fairs.
  24. KKidd
    I review all of our transfusion forms(approx. 225-250/month) and send a QA form to the nurse manager if nursing protocols were not followed. This includes vital times and proper completion of the form. It is up to the manager to review these with the staff involved. Our compliance rate is below 15% and sometimes below 10%. I also perform a transfusion monitor following a transfusion from pickup in the BB to thriygh the start of the transfusion and then ask questions regarding the rest of the procedure.
  25. KKidd
    We have not seen an autologous unit for over 5 years. I don't beleive the surgeons are pushing it.
×
×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.