Sheila

Thanks so much for pointing out another positive aspect of my job at a VA Medical Center: No breast milk! (Along with the no cord bloods, no pediatrics, etc)

Remember that old TV commercial, the one with the underwear and the old lady underwear inspector who says, "It doesn't say Hanes until I say it says Hanes"? That's how our blood bank is; it doesn't say A Pos until I say it's A Pos, etc. I would get a new specimen or give type O until I got a new specimen, and did the T&S myself.

"Our institution was accredited by both CAP and AABB "since the beginning of time", but we dropped our AABB accreditation about 10 years ago. Two things triggered that: 1. Back when AABB started the "Quality Plan" riggamarole, we jumped on board. I spent an enormous amount of time and effort writing up and organizing our Quality Plan. When our next inspector walked in, she looked at our impressive array of Quality Plan Manuals lined up on our shelves and said, "Oh, I see you have the Quality Plan stuff. I haven't seen any of that material yet." and proceeded to complete the inspection without so much as touching our precious Quality Plan "stuff". Prior to that, we had several AABB inspections that were of poor quality (ie: very superficial or the occassional ridiculously picky.) (I know this is not typically the case, but it was our experience.) 2. AABB's annual fees for institutions starting doubling around that time, and lab management & hospital administration decided that the hospital wasn't getting enough benefit for the money it was costing us and they decided to drop our AABB accreditation and membership. I was not supportive of this decision, but I can honestly say that I don't think it has made a bit of difference in the quality of our Blood Bank Department. I am an individual AABB member, so I try to keep up with current information (so the hospital gets all the benefits even though we are not an AABB institutional member.) However, I don't know what will happen it my future successor is not an AABB member. " THIS is why our institution dropped our AABB certification too. The inspector didn't even open the QA Plan notebooks and instead cited us for a couple of picky things. She was a physician and knew about as much blood banking as most do; in other words, practically nothing. Since I am at a VA, we are FDA inspected and JCAHO inspected, as well as CAP. I don't miss the AABB assessments at all. I am an individual member so I can buy their books at member price.

I only do the long procedure annually. Daily QC checks include size of cell button, using check cells on the negative tubes to insure adequate washing, etc. when we run our regular daily reagent QC. Weekly, the cellwashers are rinsed through with bleach, per the recommendation of the manufacturer. This is documented on a checklist posted at each work station.

Our last BB director, who left a year ago, was a big proponent of Rhophylac and switched our hospital and the university hospital across the street to it. We use very little here, but at University they use a high volume and they are happy with Rhophylac.

Yes, he handed me that form at the very beginning. FDA has always inspected VA facilities; even those that do no on-site product modifications. But I had the same thoughts about the exterminator question; I'm wondering if somewhere out there a bunch of blood bags were contaminated with insects or something.

Same here; we got this freezer in May and except for the dinky little charts, it's been great. Pet Peeve: WHY can't any two instruments have the same chart drive? We have six different charts for six different freezers/refrig.

Another good one is when the phone rings and the nurse asks, "You got any blood for this hip?" Or this colon, this heart, this lung, etc. Poor patients are only a body part sticking out of the drapes to the OR nurses. Fave diagnosis: FBR (Foreign Body Rectum). Most recent was a LARGE home-grown cucumber. Patient had a perforated colon and ended up with a colostomy. Same patient had FBR five years ago; a "gourd" in that instance. What do you want to be that "Veggie Tales" is his fave cartoon?

LOL at these. The bit about nurses being unwilling to give Rh Neg blood to Rh Pos patients occurs so frequently here that I purchased some neon-green stickers that read, SAFE ALTERNATE BLOOD TYPE and I plaster the bag and the form with them. This has helped a lot, although there are still a few that don't believe the sticker, either. One of our patients has four antibodies, and of course his providers never remember to order his blood in advance. The last time he was in, the doc called to ask what the hold up was and I explained (I thought) about the antibodies, and the doc then says, WELL JUST SEND UP SOME O NEGATIVE. They think O Negative solves every BB problem in the world. Lastly, the funniest thing I've heard a doc say was uttered by one for whom English was a second language. His patient was bleeding and he came down himself to sign out blood. We asked how the patient was doing (wanting to get an idea of how many more units to set up), and while looking at the floor and shaking his head slowly back and forth, he says: "This patient is probably very terrible". Since then, anytime there is a patient circling the drain, so to speak, we refer to the patient as "probably very terrible".

The waterbaths are Genesis bps (http://www.genesisbps.com/preparation_accessories_root.html) but they don't sell the weights. I will send an e-mail to the Thermogenesis folks, thanks!

Nope, those aren't the ones (although they would probably work). Thanks for looking!

Yes, we are a VA facility and thus have always been FDA inspected. However, the University hospital across the street has frequently been FDA inspected as well, perhaps due the misfortune of being located so close to a VA! There is a major blood center just a few blocks away too, and another major hospital in the near vicinity. I think the FDA stays for the week and "makes the rounds". I was warned early last week that the FDA had been at University. We have also always received a letter in the mail at a later date. I believe the inspector goes back home and does some research, then sends the letter, because there have been a couple of times that the letter mentioned items not mentioned during the inspection itself.

An FDA inspector showed up at lunchtime last Friday. He was not the inspector we have had for the past several times. He was very professional and courteous, and stayed about five hours. This facility does no irradiation, washing, etc.; we are strictly a transfusion service and do no product modifications except thawing frozen products. I must have xeroxed 50 different forms, procedures, certificates, etc. The dude was definitely fond of paper. He even wanted copies of position descriptions, and wanted to see employee performance appraisals. He had a question I've never been asked before by any inspector. He wanted to know if the building was treated by exterminators for elimination of pests, and if so, was it done in house or contracted, and if contracted, the name and address of the company. ??? This is relevant HOW? At any rate, I'll find out how we did after the FDA sends a letter to the hospital director.

Our facility has two Genesis waterbaths for thawing plasma and cryo. There are also four cylindrical stainless steel weights that we put in the overwrap bag with the frozen product to help the product sink and thaw faster. I have no idea where these came from; but I would like to order more as we started with eight and are now down to four. Does anybody know where to get these? So far I have checked MarketLab, Genesis, and Helmer with no luck.

Hi, all. I've been a member here for a long time but don't generally post anything. I am the Transfusion Service supervisor at the VA Medical Center in Oklahoma City. I've been in this position for six years, and worked in the blood bank section for 18 years before that. The FMH posts have been most helpful to me of late, as the veteran population now has a greater percentage of females of child bearing age than ever before. Our facility does not have an OB service; the patients go to the University of Oklahoma hospital across the street. The patients do come to the VA for routine GYN care. Thanks to all who take the time to make this forum worthwhile!