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mcgouc

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mcgouc last won the day on November 20 2019

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About mcgouc

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  • Birthday 02/28/1951

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  1. Having a readily available back-up for the ABO and any antibodies, ABO discrepancies and special needs (such as irradiated) is required. Ours was done to a PC in the transfusion service in the background at 0400 every morning. It was a hassle to get IT to make that program for us, but I kept giving them documentation that the info is required to be available when the computer goes down. Had we not had the back-up, we would have had to keep making cards to check during downtime.
  2. Many years ago, I was told by a consultant that if I modified a form, I needed a new revision number and a track of what was revised and when it went into effect. The form was an attachment in a policy so I did have the Medical Director sign off on the change. Something I considered minor might have been considered major by someone else. It would have been great to have a compliance review but I did not have that resource.
  3. QC-97-13 - procedure for issuing not performed or documented in accordance with specifications. If your policy states the form needed to be signed prior to issuing, this is a general code to cover that. As stated above, they will let you know if it isn’t necessary.
  4. Could the unit be a weak A or B? How was its ABO performed and confirmed? Try crossmatching with an A and B patient if you don’t have a lot of different reagents.
  5. I had in my policy that we would review the Changes to Standards document published by the AABB and document on each change whether it affected us or not. (We did not draw donors so we just reviewed and put those changes as not applicable.). If we were already in compliance with the change, we would document no change in policy required with the policy number. If a policy had to be updated, we documented when the updates, training, etc were completed. The Medical Director signed this review and we kept it with our policies.
  6. Our blood center could provide units with one or more bags attached. (We did not perform many neonatal transfusions and ordered these for the neonates). The empty bags had labels and our computer was set up for the aliquots. We were fortunate that this only took a few hours. If an urgent need, your process sounds acceptable.
  7. I am retired but volunteered several years as an AABB assessor. Both CAP and AABB send the deficiencies from the previous assessment to the assigned assessor with the submitted plan of action to correct the previous deficiency. Most plan of actions have a time frame documented to correct the issue. We were supposed to make checking completion of the plan of action a priority. My first question would be if this individual had completed any work before his training records were completed. Then, I would ask for his competencies that were completed during the allowed time frames. If I performed
  8. Before getting an ECHO and using the pHix recommended for that, I did buffer the saline using a powder. It was several years ago but I think I got it from Hemobioscience. I started because some (Immucor) manufacturer’s directions specified a saline pH around 7. Our unbuffered saline did not always meet that pH. We checked and documented pH daily and when we made a batch. We also had standards to check the pH paper daily. We QC’ed the saline daily as before. We continued the pH checks after switching to pHix.
  9. We also only tubed to certain floors. We sent a form with patient and unit stickers with the unit that the person who removed the unit was supposed to time, initial, and return. We called when tubing and they had 10 minutes for us to receive the form before we followed up. If we tubed to a floor, we had to have the form back before tubing for another patient. To validate and to do QA checks, we sent a tech to each location and tubed an expired unit to each location with a temperature monitor. When we tubed, we called that tech and documented transit time and unit temperature on arrival.
  10. I am retired but our corporation had set up a program and dashboard before I retired. We were using Cerner. We lowered the acceptable HGB level for transfusion in a non- bleeding patient to 7. We started physician blood ordering in computer and the physician had to select a reason to transfuse (as above). They could only order one unit at a time as they were required to do HGBs between units. At first, we pulled the dashboard and met monthly but, as we became more compliant, we met less often However, it took daily monitoring to become more compliant. Blood bank techs checked HGBs on
  11. We supposedly had physician order entry for transfusion orders. The order printed n Blood Bank and the nurse brought a copy to obtain the blood. We had instituted a blood management program with stricter reasons for transfusion. The reason was required on the order and we double checked the entry - if they marked HGB less than 7, not bleeding, and the HGB was 7 -9, we usually completed the order, but sent the transfusion for review. They could only order one unit at a time in a non-bleeding patients with HGBs between units. HGBs greater than 9 would require approval, if non-bleeding. We als
  12. We switched to using two samples drawn at a different time if there was no history several years ago. I had previously worked at a place that required two signatures, but we received a WBIT from ER with two signatures so I knew that had problems. There were different challenges in different areas of the hospital hen we added the second specimen type. We trained labor and delivery nurses to draw and label a tube when they started the IV. We were able to use previously collected (within 24 hours) Hematology tubes and most in-patients had those. When pre-admit patients needed a second type, w
  13. We had a log book and white board also. Each shift had to sign the book, but, I think, the most important aspect is overlap between shifts in the department. If the next shift doesn’t arrive on the bench until 15 minutes after the previous shift has ended, what was written in book 15 minutes ago may be out of date.
  14. Surprisingly, the change had little effect on our group O usage. We did not wash cells. We were allowed to use properly identified Hematology samples collected in the last 24 hours, at a different time from the BB sample, for the second type. We started a blood management program about the same time where Hgbs or Hcts had to be documented prior to issuing blood so Hematology samples were usually available, even on children. We did the second sample type on all type and screens so if they decided to transfuse we were ready. Different areas of the hospital had to be treated differently. For e
  15. I thought it would increase our group O usage, but it only increased it a couple of units a month. We had to work with different areas of the hospital. We could use properly labeled Hematology samples collected at a different time within last 24 hours for second type. That covered most in-patients. (We had a blood management program where reason for transfusion had to be documented and if the reason was anemia, we had to document the hemoglobin). We did the second type on all type and screens so if they decided to transfuse, we were ready. If a pre-admit patient needed a second type, we orde
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