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jalomahe last won the day on October 17 2017

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About jalomahe

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    Are you trying to make 3% from 0.8% screening cells?
  2. Anyone using Sunquest v8.0 and have a implemented a Group O Policy at your facility. We recently implemented a Group O Policy which states that until such time that the patient has 2 ABRH types on file in SQ that they are to receive Group O RBCs. We have had several instances where the techs failed to follow this policy. It usually occurs with patients who do not qualify for EXM due to no 2nd blood type. The techs forget and grab group specific units for the immediate spin crossmatch. Have you found a way for Sunquest to give a QA failure of some sort when a patient should receive Group O RBCs but the tech allocates Group Specific units instead?
  3. Reference Lab Testing

    Luckily our Reference Lab allows us to choose only the testing we want them to perform so for Antibody Identification order just that. We send them our results as part of the order and then if they choose to perform a Type & Screen they don't charge for it. If they did charge me for it then I would call to investigate if there was a good reason for them to have done the TYSC. If yes then I'll pass the cost to the patient, if not then I request them to remove it from the bill.
  4. Reference Lab Testing

    We have a "Special Test B Bank" built in our system (Sunquest) that is solely for billing Reference charges. The test has no CPT code or price assigned. When we receive the bill from the Reference Lab, we order this test and then manually enter the appropriate CPT codes (the test is built to accept multiple codes) for the testing that was performed and the total dollar amount to be billed to the patient. The reference lab we use is very good at getting at faxing us the bill within 24 hours of the workup so the patient billing can be accomplished in a timely fashion.
  5. We would report the gram stain as negative and the culture as positive with the identified organism. Actually blood bank wouldn't be reporting anything....microbiology would since they are the ones performing the testing. Our BB and Micro departments worked together to set up a procedure for handling transfusion reaction workups that required micro so that everything is consistent with best practices. Micro even takes care of notifying the patient physician in accordance with their critical call policy. After they notify the physician then they notify the blood bank so we can notify our blood supplier etc.
  6. Tracking Transfusion Orders

    We are a similar size hospital as you with a Level 3 Trauma. We use Sunquest with electronic crossmatch. What you are describing as performing the crossmatch at the time of order defeats the biggest advantage of electronic crossmatch ... inventory control. For patients who are electronic crossmatch eligible we only crossmatch the unit at the time the unit is requested to be issued for transfusion. So that clinical staff know that we are not "ignoring" the crossmatch order we created a comment "Blood will be crossmatched when the order to transfuse is released. Contact the blood bank when ready to transfuse." This comment is resulted on the crossmatch order and goes to the patient chart. We have a box on the counter where we issue units that we keep the original crossmatch order in so we know what patients are currently electronic crossmatch. The tech that works that bench goes through it every morning to weed out the ones that are expired. When we receive the transfuse notice we pull the order out, match it to the transfuse order, do the electronic crossmatch and immediately issue the unit to the location (we tube units). If the original order was for more than one unit, we update the number of units on the paper order to reflect how many units are left on the order. The computer of course keeps track of it automatically as units are crossmatched and issued. Works well for us.
  7. Antigen Typing Alternate Proficiency

    RCBCAT is required since CAP specifies that you have to do alternate if there is not a survey available. Now the RBCAT is available, you have to use it ....
  8. Pregnancy Termination and Rhogam

    20 Weeks. Theory behind it is that the prior to 20 wks even if the total volume of blood from the fetus were to have crossed the placenta and entered the maternal circulation it would not be enough to exceed what is covered by a single full dose of RhIg. Also we only issue full doses, we do not stock micro-doses.
  9. CAP Alternative Assessments-Help!

    CAP survey RBCAT twice a year, 2 specimens per shipment, multiple antigen typings on each specimen.
  10. Antigen Typing Alternate Proficiency

    CAP also has a separate survey RBCAT (Red Blood Cell Antigen Typing) its 2 shipments a year, 2 specimens per survey and each specimen has typing for multiple antigens
  11. Original validation of serological centrifuge is done to determine the correct RPM (or CF) and time for obtaining the optimal cell button. Unless you do something to the centrifuge that affects one of these two factors then re-validation is not required.
  12. RBC Inventory Practices

    We keep a 5 day red cell blood supply on the shelf. Our blood supplier sets the inventory levels annually based on the previous 12 months utilization. We are approximately 30 minutes from our blood supplier. They stock us daily M-F and then we can submit requests 24/7 if we have a need.
  13. New reagent lot QC

    All reagents are QC'd in accordance with the package inserts. We use Immucor reagents so our we use "corQC" to QC traditional reagents (ABO, Rh, antibody screen). We use reagent screen or panel cells for Pos/Neg QC for antigen typing sera. The only lot-to-lot QC we do is for Fetal Bleed Screen Kit with a lot-to-lot QC. We haven't had any problems with CAP inspectors with this QC plan.
  14. Rosette test quandry

    First, you have a discrepancy between the Mom's Rh type on the pre- vs. post-delivery specimen. That needs to be resolved just as you would need to resolve an ABO discrepancy. I would suggest that a new specimen be collected from the Mom and tested. If the new specimen's Rh type agrees with the pre- specimen, then it would indicate there was a problem with your post specimen either misidentification or contamination. Repeat the rosette test on the newly collected post specimen. If the new specimen's Rh type agrees with the original post- specimen then you have your answer that the rosette test is false positive due to the Mom having a weak expression of D which interferes with rosette testing. You are not detecting Rh + fetal cells, instead you are detecting Rh + (weak) maternal cells which would explain why the rosette test is positive but the KB stain is negative. You would also then need to follow up as to the pre- sample and whether it was misidentified at collection, etc.
  15. IQCP

    Welcome Skye Unfortunately you have posted your question under the Blood Bank section of this site and I'm afraid we will not be of much help with your question. There is a Micro section on this site. If you click on Home at the top of the page and then scroll down you will see it. The lab department sections are in alphabetical order so Micro is down the list a ways. Hope you get the answers you need.