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mcgouc

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mcgouc last won the day on August 9

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About mcgouc

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  • Birthday 02/28/1951

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  1. mcgouc

    Frequency of vital signs

    We used to do pre-transfusion, 15 minutes, every hour, at end, and one hour post transfusion. Then the lab was inspected and the Blood Bank was cited because the nurses were not documenting close enough to the specified times. They noted one hour vitals at 45 and 75 minutes on a transfusion and said that was not acceptable for one hour. It got too complicated with so many vitals to specify a tight time frame for one hour. We researched and dropped the every hour and one hour post transfusion and added checking the vitals documentation as a QA monitor. Whatever you do, just make sure the times are specific and being followed.
  2. I only used the cryo pooled by the blood center for the last several years and agree it is marvelous although it may be cost prohibitive if you give a lot of cryo. In the past, blood centers could make what we called "dry" cryo or "wet" cryo. If your blood center only makes the "dry" cryo, there is a very small volume in the bag and it is necessary to add sterile saline to the first bag and pool as you described. "Wet" cryo did not need additional saline added. Years ago, our local blood center switched to "dry" cryo for a while and the hospitals had them switch back to "wet" cryo because of the additional documentation, time, and expense required with obtaining and adding the saline to the bag.
  3. It was so hard when teaching students not to reach over and flip open that lid. Remember changing broken clips on the immufuges? Or the Dade Cell Washer that added the antiglobulin? I think that is why manufacturers started makng green antiglobulin.
  4. mcgouc

    References

    AABB recommends that so you don’t have to rewrite the references on every policy when they are updated. Like above, you can have a cover sheet with current edition info. Also, when AABB issues a new edition of standards, they publish a document detailing the changes. Before the new Standards implementation date, I would go through that and document on all the changes any policy affected, action required, and date completed. I had the Medical Director sign off on that when done. Most were “not applicable”, as we were not a donor center, or “no change required to policy XYZ”.
  5. We had a policy and form where we could issue on a RN’s signature with a place for the ordering pysician’s name. The RN was responsible for obtaining the ohysician’s signature once things got calmer. The Blood Bank did follow up if we didn’t get the signed form in a couple of hours. (Due to ER physician groups covering multiple hospitals, a particular physician might not return for weeks.)
  6. mcgouc

    Retirement

    Congratulations! You made it and will love retirement - once you get used to getting some uninterrupted sleep! It is so interesting to read what Malcolm says. My SBB program (in Texas) many years ago was headed by an Englishman and when he would say something we didn’t understand, we would just look at each other until someone realized what it was and would mouth it to the rest of us. The old days when we had a human instead of a computer in front of us.
  7. mcgouc

    Gold Medal.

    Congratulations! You deserve it!
  8. mcgouc

    ARC Packing Slips? Keep? Trash? HELP!

    It depends on your policies and how you handle the documentation. You need documentation for each part of the process. If one tech can sign the form and document the inspection and another tech enters into the computer under his or her name, you don’t have a complete tracking of the unit. Also, if you are busy, there could be a delay in entering the units in the computer. If your policy states the one receiving and inspecting units enters them in computer on receipt, you don’t need the paperwork. There could be some other form for that documentation. The Blood Center is keeping a copy of that form and if you sign for it at 0530, you need to document what you did with the blood until you put it in computer at 0730.
  9. mcgouc

    Blood Product Transfusion Form/Labels

    Check and see if your hospital uses a printing company so you can design your own forms.
  10. mcgouc

    Platelets for CABG

    We also set up a rotation with our blood supplier. However, some suppliers will not do a platelet rotation.
  11. mcgouc

    FDA reportable events

    I have to second that my experience with the FDA employees handling BPD reporting was very positive. They do review, delete, and explain if they don’t find it to be a deviation. However, I am not sure how many facilities report them. In 2014, a new Lab Director who had been a director at several hospitals in the area told me to stop reporting BPDs because a QA tech at one of her hospitals said they are not required in transfusion services. I showed her it had been required since 2000.
  12. mcgouc

    Competency on Couriers

    I was advised by one assessor to have an information sheet like the one mentioned above for the couriers (nurses, patient care techs, anyone who pick up blood) to read and sign. We gave them a sticky dot for the name badge and if they didn't have that, they had to read and sign the form. We required the form to be read yearly and they got a different colored sticky dot each time. It would be difficult to perform true competencies without following the courier to the floor to make sure they delivered the blood properly.
  13. mcgouc

    CAP EXM J SURVEY

    Our IT department created a new blood supplier (we just called it CAP) for the unit so we could scan all the information on the CAP unit label. Just follow your policies. Pay a lot of attention when completing the CAP paperwork as that can get confusing.
  14. We didn't have the medical director sign. The patient's physician signed. The Medical Director was not always available and felt the patient's physician should be held responsible. Since the work-up takes a while, we started discussions and getting signatures on an " Incompatible Blood Release" form early so there wouldn't be an additional delay once we had appropriate blood. Just a few comments about sharing Blood Bank computers with other facilities. I am now retired, but a couple of years before leaving , I added a section to my validation policy titled "post-implementation validation". I wanted an assessor to see it and ask why I needed that section. I wasted so much time and energy trying to explain to corporate and local management that all affected facilities needed input and knowledge of changes prior to the changes being placed in the live system.
  15. I agree "least incompatible" is not an appropriate term to use. We had stopped using it until we got a new computer shared with other facilities and the only way to issue these units in the computer was to interpret as Least Incompatible. We kept the same paperwork for signatures stating "Incompatible", but had no choice in the computer. Personally, I think interpreting as Least Incompatible gives a false sense of security.
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