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John C. Staley

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Everything posted by John C. Staley

  1. Over my many years I have come to realize that inertia is the most powerful, driving force in the universe and the most difficult to over come!!!
  2. Personally, I would go for the all electronic documentation. Just have some form of backup procedure for down time. You may have to justify it to some inspector but you have a good case for it. If the inspector still insists on citing you then take it higher and contest the citation. It the only way to get things changed.
  3. Malcolm, my very 1st AABB inspection came about 2 months after taking the Blood Bank supervisor job. After it was over I contacted AABB and told them that I would never let that inspector in my facility again and if they tried to send her I would drop our AABB membership. YES, the inspection/inspector was really that bad and luckily I never had to carry through with my threats/promises.
  4. Personally, I never minded inspections/assessments. My blood bank and transfusion service were "visited" no less than twice every year by inspectors. Either FDA (we were licensed to ship blood interstate at one facility I supervised), AABB, CAP or JCHO. Being inspected that often meant we never had the opportunity to let things slip unlike other areas of the lab that were inspected less frequently. On the other hand it did become very expensive paying memberships as well as buying materials required to stay current on the requirements of each agency. When cost cutting measures were called for reducing in this area was always discussed but for some reason was never acted upon.
  5. A number of years ago in a meeting of the corporate transfusion service supervisors we discussed the possibility of dropping our AABB membership. After much discussion the corporate transfusion service medical director decided that we would not be dropping the AABB membership. Her reasoning, the prestige of being in charge of a group of facilities fully accredited by AABB was very important to her. She actually told us that!
  6. I'm curious, can those 25% that appear to be "order abuse" be linked to specific docs or is it random through out the ED? With current computer technology this should be discoverable. Over the years of my career I realized that not all ED docs are created equal and some have a much lower threshold for CYA than others. Just a random thought.
  7. What I was trying to get at is if the DAT is negative and the antibody screen is negative why would anyone consider it necessary to provide D negative red cells. Another thought/question just occurred to me (odd, I know), why are they transfusing the baby? Is it due to excessive blood draws or is the a hemolytic process going on? That would make a difference as well.
  8. Just curious but does the baby have a positive DAT due to the RhIG? Is the anti:D demonstrable in the baby?
  9. So, why, pray tell, does the alarm even sound at a nursing desk? This is quite unnecessary and obviously inconvenient for all involved. If the reason is, as usual, "that's the way be been as long as anyone remembers", it's time for a change. Hopefully you can get this easily rectified. Good luck.
  10. I'm curious on what you consider a 3rd party outside the lab. The engineering department within the hospital could be considered a 3rd party out side the lab but I personally would consider them acceptable because they could react immediately to the alarms. If you are referring to someone far outside the facility that would be considered a subcontractor I would be hesitant to consider this acceptable but that's just my opinion.
  11. I never considered keeping the opened segment used for the crossmatch. While I can understand the idea behind it I personally consider it over the top in our blood bank paranoia. Each segment in the line can be positively linked to the unit transfused and that should be all you need.
  12. Thanks Malcolm. It's sad to see the passing of another Blood Banking great.
  13. I'm going to be blunt. This is ridiculous!! You have the potential of causing far more problems by removing the cubes from their protective container.
  14. Just a thought but, might that not be a little problematic if there is an issue with the reagents? I know it's one of those "what if" questions that never happens but I couldn't help my self. To be honest, it's been long enough I don't remember what we did but something tickles the back of my brain making me think we did some form of on receipt QC but I'm certain it was not overly extensive or burdensome.
  15. Personally I always considered the human interaction to be part of the equation for performing QC. I don't recall anything that specifically stated that but I could not see where the human was not an integral part of the process. So in my lab the manual method would be QC'd as well. Your secondary methods only need to be QC'd on the day of use.
  16. I agree 100% for all the same reasons.
  17. I'm looking forward to hearing what you discover.
  18. I'm just curious, what makes you ask this? Did someone inadvertently put some platelets in a refrigerator?
  19. I must agree with exlimey. See if you can identify it if at all possible before assuming it is not a problem just because it is cold reacting. If the decision becomes transfuse or die before it can be identified then suggest running the blood through a warmer and hope for the best.
  20. When I first read this post yesterday I was tempted to answer but thought I would wait to see what Malcom had to say. Glad I waited. My thoughts were much the same but Malcolm presented it in a much more succinct and detailed manner. As expected I have nothing to add other than my agreement .
  21. John C. Staley

    Inspections

    I still remember my first AABB inspection and yes, they were called inspections way back then. I wish I had this info back then. The most difficult thing for me to learn was when to STOP talking.
  22. Ensis01 you expressed my thoughts far better than I ever could have. I've never been a fan of blood bank specific arm bands and fought against them most of my long and storied () career. Complicating a process never made it better and often made the problems far worse than the one folks are trying to address. My answer to glewis is that this is a perfect time to get rid of the blood bank specific armband. Let the computer and nurses do their jobs in the simplest most efficient way possible.
  23. If trained and documented there is no reason I know of saying phlebotomists can't perform therapeutic phlebotomies. At a previous facility there were all done by phlebotomists and the the techs were thrilled.
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