Jump to content
PathLabTalk

jayinsat

Members
  • Content Count

    243
  • Joined

  • Last visited

  • Days Won

    13
  • Country

    United States

Reputation Activity

  1. Like
    jayinsat got a reaction from kaleigh in Thawed Plasma ISBT Code   
    You cannot use E2121 for all of them. Each of those frozen products have a corresponding thawed 24hour and a thawed 5 day plasma code of their own. You have to use those. We go straight from frozen to 5 day thawed so we only use those two. Here is a screen shot of our database.

  2. Like
    jayinsat got a reaction from David Saikin in Thawed Plasma ISBT Code   
    You cannot use E2121 for all of them. Each of those frozen products have a corresponding thawed 24hour and a thawed 5 day plasma code of their own. You have to use those. We go straight from frozen to 5 day thawed so we only use those two. Here is a screen shot of our database.

  3. Like
    jayinsat reacted to Cliff in CAP staff competencies   
    It drives me nuts when I go to a talk and the person speaking says we all make competency too hard.  It is hard, it's really hard.  I don't care if you have 5 staff or 50, it's hard.
    That said, we've tried to make it as simple as possible while still trying to make it a value-added process.
    First, follow the CLIA rules, period. (<-- link and attached) Next, follow the rules of all your inspectors / surveyors...  We are FDA, AABB, and TJC, and DPH for NRC.  For TJC they define annual and 6 months...  Follow their rules.  DPH says AABB is law in my state, follow their rules. When we created our competencies, we added a [1], [2],... after each element so we could show our inspector what element was being met by what.  It was a little extra work one time but saves us during an inspection. If you're fortunate enough to have an electronic system (we recently moved to MediaLab), yay, otherwise, ensure you've reviewed the heck out of your completed forms.  Try to design them so it's easy to see if you have any blanks.  Inspectors have an easy time finding things that should have been signed. Again, it's far from easy.  We, like many places, are understaffed and overworked, and we have a large Blood Bank, so it's hard.  In a perfect world we'd have at least a 1/2 an FTE to manage this program, but like most other places, we need to absorb it as another task to be completed.
    CLIA_CompBrochure_508.pdf
  4. Like
    jayinsat got a reaction from Sonya Martinez in CAP staff competencies   
    CAP competency requirement is labor intensive, regardless of how you document. I have been trying to put more on their competency assessment tool they offer. Setting that up alone is labor intensive. It is the number 1 cited issue of most labs in America. It is not that we are not competent, of course. We have a hard time showing it the way CAP wants it. It really requires a full time QA position just to keep up with the competencies of all the staff in every department.
  5. Like
    jayinsat got a reaction from AMcCord in Thermometers for taking temp of returned blood products   
    We just switched to the MaxQ MTP coolers and love them! My validations showed it held temps for 24 hours, even when opening the lid every 15 minutes for the first 2 hours and hourly after that. Plus, we filled the cooler with warm FFP (4 units @37C) and cold RBC (4 units @4C). The cooler cooled down the FFP units to 6C within 3 hours. The RBC'S never went above 5C. 
  6. Thanks
    jayinsat got a reaction from mpmiola in Barrier method   
    We use the BCTA (Barcode Enabled Transfusion Administration) module in Meditech. 
  7. Like
    jayinsat got a reaction from Sonya Martinez in Thermometers for taking temp of returned blood products   
    We just switched to the MaxQ MTP coolers and love them! My validations showed it held temps for 24 hours, even when opening the lid every 15 minutes for the first 2 hours and hourly after that. Plus, we filled the cooler with warm FFP (4 units @37C) and cold RBC (4 units @4C). The cooler cooled down the FFP units to 6C within 3 hours. The RBC'S never went above 5C. 
  8. Like
    jayinsat reacted to Joanne P. Scannell in Thermometers for taking temp of returned blood products   
    I'm also wondering how one manages to validate that all units of blood remain within temperature range when the ambient temperature and handling is not consistent.
    We can't even validate our coolers for the same reason ... and one never knows if the cooler is left open or the units are removed then replaced.
    Are you using 1-10oC or 1-6oC?
    FDA instructed us to use 1-6oC for the coolers because they are really 'in storage'.
    If not in a cooler, we can go up to 10oC because they are 'in transit'.  I haven't implemented that part yet, but I will be soon.
  9. Thanks
    jayinsat got a reaction from Joanne P. Scannell in Thermometers for taking temp of returned blood products   
    We use 1-6 for coolers, however, the BT-10 only shows breach above 10 so, there's that. We place a NIST certified thermometer in the cooler to show that it is 6 or below upon return. We do not scan these units with the temp gun.
    It's 1-10 for anything returned not in a cooler. 
  10. Like
    jayinsat got a reaction from Joanne P. Scannell in Thermometers for taking temp of returned blood products   
    We use one from Fisher. It is certified and we replace it every 2 years when the certificate expires. I am curious, for those who have the 15 minute limit, did you validate that in all scenarios in your hospital?
  11. Haha
    jayinsat reacted to Malcolm Needs in Micro only reactions   
    Have you thought of hiding his glasses?
  12. Sad
    jayinsat reacted to David Saikin in Transfusion Errors   
    We all have these transfusion event stories.  Rec'd a phone call in the middle of the night years ago.  3 out of 4 units were transfused to the incorrect patient.  Fortunately both pts were O Pos.  We used Typenex numbers.  BB tech switched the 2 patients; could only be resolved at the bedside. 2u transfused in dialysis.  When asked about the "red" numbers I was told that they no longer checked them as they always matched.  I informed them that they gave 2u the day before to the incorrect patient.
  13. Sad
    jayinsat reacted to mrmic in Transfusion Errors   
    Ok, I'll start.  The story of "Who turned off the Light".
    The year was 1999.  Hospital "Notme Medical Center" supported an outpatient clinic for patients requiring transfusion, some due to sickle cell anemia.  Often these were young adults that came into the clinic very early in the morning.  After their blood was collected and they were waiting for the crossmatched packed red cell units to arrive, the patients preferred to sleep (pre i-phone years).  Normally at least one light was left on, usually the bathroom light, while they were waiting.  At 0530 the first of two tagged crossmatched compatible group O RH Positive red cell units was verbally crosschecked with the nurse Jane at the transfusion service door to be taken directly to patient Smith's  room for transfusion.  At 0625 the first of two tagged crossmatched compatible group B  RH Positive red cell units was verbally crosschecked with nurse Kathy at the transfusion service door to be taken directly to patient Brown's room for transfusion.   At 0633 nurse Kathy called the transfusion service to see if she could return the blood for patient Brown since someone had already started the first one.   What! Said the BB technologist, the one I just checked out with you was the first unit for patient Brown.
    Follow-up:  Nurse Jane had crossed checked the tagged red cell unit for patient Smith with another nurse at the nurses station and it was for a sickle cell patient in room 123 bed A.   She went to the room she normally has gone to in the past, and when she looked into the room, although the lighting was low it was enough to see it was a young adult black patient in the room in bed A.  Although a little groggy, the patient confirmed she was expecting the transfusion.  After starting the unit, the patient appeared to tolerate the transfusion well and the nurse left the room.   After speaking with the BB tech about returning the unit for patient Brown nurse Kathy went back to the room and discovered patient Brown was in bed A and had a red cell unit almost completely transfused but was unit was tagged for patient Smith.   Patient Smith was in bed B.   Both patients were young black adults but had switched beds because patient Smith did not want to be in the bed close to the door.  Luckily the group O unit was compatible with patient Brown and was tolerated well by the patient.
    Needless to say, we required Nursing Education Services to review policies regarding the importance of patient identification and cross checking the tagged unit with another nurse at the bedside NOT at the nurses station.  A poor practice that seemed to pop up once in awhile.
     
     
     
  14. Like
    jayinsat reacted to AMcCord in Retention of records for patients with passive Anti-D injection   
    We are scanning all completed patient antigrams, worksheets, and reference reports into our BB LIS. That information is accessible (and printable) from the comment section of the patient profile.
  15. Like
    jayinsat got a reaction from YorkshireExile in Retention of records for patients with passive Anti-D injection   
    We use MEDITECH MAGIC 5.6.7. Long ago, we started entering our Immucor Cell Panel lots into the QC function, along with the individual donor cell reactions. Over the years, our database has grown to where, every month, we only have to enter 1 or 2 new donor cell, out of the 16 on the panel, into the database when entering the new months donor panel. When we have a Passive D, we enter the cell reactions from the panel in the antibody ID field, which stores the reactions indefinitely in MEDITECH. That allows us to not have to keep the antigrams for passive D's. Everything is in the computer and easily accessible. BTW, doing it like this allows MEDITECH to calculate the antibody ID probability. It's a nice feature if you have the time to build and maintain it.
    For all antibodies, we only keep the antigrams. Every other reaction is recorded and maintained indefinitely in MEDITECH and the ECHO backups.
  16. Like
    jayinsat reacted to carolyn swickard in Convalescent Plasma Tracking   
    There is a recent Covid-19 document on the AABB website for Drs to see the current considerations and protocols for CCP.  They recommend Group A or group B plasma for AB Covid-19 patients.  Sort of like the use of Group A FFP for trauma pts. 
    Vitalent (formerly United Blood Services) is letting us stock some CCP - it sure helps.
  17. Like
    jayinsat reacted to MAGNUM in Convalescent Plasma Tracking   
    ARC does not allow stock supplies of the COVID plasma.
    On the somewhat same note, how do you take care of your AB patients when the blood center cannot or will not supply AB convalescent plasma?
     
  18. Like
    jayinsat got a reaction from Henrique in Irradiated Units Missed   
    The age old problem of how do you make people pay attention to the details...If you figure this out, let me know. I haven't yet.
    Do you not have an "IRRADIATED RBC" product in your dictionary that the physician could have chosen? That puts the responsibility on them, where it should lie. A comment is not an order and, if they are relying on that, they are forcing your techs into a position of failure. I would suggest you add an irradiated product order to your dictionary. If the physician wants that product, they must order that product that way.
     
     
  19. Like
    jayinsat reacted to carolyn swickard in Irradiated Units Missed   
    We have a question that the Drs (and myriad other "orderers") must answer on the RBC and PLTPH orders (Meditech Magic) in order to get Irradiated products.  Originally the questions was just "Irradiate?  Y/N"  and we were happily (naively as it turns out) anticipating the Drs having greater control over their orders and getting it right more often - WHAT A JOKE!  Since so many of the Drs do not deal with blood all that often and did not know really what irradiation was or what it was for - there were MANY wrong orders.  We soon changed the Question box to also contain a statement "For Immuno-compromised pts only".  This slowed it down a little, but we still rely on calls, computer history (we can also add a marker in Meditech that comes up every time for the pt) and taking a look at the pt's White Cell count ourselves - lots of calls.  There is a mistaken impression that many providers have that "any" cancer patient is immuno-compromised" and needs irradiated units.  Needless to say - that is not necessarily true.  In fact, our Oncology Service orders less irradiation that almost any other service and sticks to strict, current Irradiation Guidelines.  
    So - give them something they have to order (irradiated RBCs/ PLTPHs) or answer (Irradiate Y/N) and still expect a lot of record keeping and phone calls for clarification - "What is the indication for starting irradiation?  is a diplomatic way of wording it.  Best of luck.
  20. Like
    jayinsat reacted to AMcCord in Irradiated Units Missed   
    If your facility has Epic an order set can be built for product orders that has a list of indications. They have to pick one to complete the order. If they choose 'Other' there is a line that has to be filled in with the indication. That thins down the inappropriate orders quite a bit.
    I agree - many providers think 'cancer' is an indication for irradiation. We do make phone calls to clarify those orders. Often when we tell a hospitalist that the patient is seen by Dr So-And-So an oncologist and we don't routinely transfuse irradiated to that patient, they drop the order for irradiation.
  21. Thanks
    jayinsat reacted to Malcolm Needs in IHD Webinar Featuring Our Own Malcolm Needs   
    Yes, it will be available as a recording after the event, but I don't know for how long.
  22. Like
    jayinsat got a reaction from gagpinks in IHD Webinar Featuring Our Own Malcolm Needs   
    I just saw this seminar being offered by Bio-Rad with our own, infamous, Malcolm Needs as the presenter. I registered and thought I'd pass the word to all of us here. Here is the link:https://info.bio-rad.com/ww-IHD-transfusion-w-registration-lp2.html?elq_mid=48765&elq_cid=10201434&elqCampaignId=30837&utm_campaign=30837&utm_source=eloquaEmail&utm_medium=email&utm_content=Email 13ER EM-R-CM-385201-FY21-TCHS-AWEN_BR-JRNL-TRF News 19 Nov&elqTrackId=6ecbbea5f2bb46849981687404578a8e&elq=7c5f74470efa434dbd4351e512f7ae7a&elqaid=48765&elqat=1&elqCampaignId=30837

  23. Thanks
    jayinsat got a reaction from Malcolm Needs in IHD Webinar Featuring Our Own Malcolm Needs   
    I just finished listening to this webinar. Excellent Job @Malcolm Needs. Your south London accent was not at all distracting and your presentation of the material was sufficiently thorough and relevant. Hopefully I get to meet you face to face one day.
  24. Like
    jayinsat got a reaction from John C. Staley in Irradiated Units Missed   
    The age old problem of how do you make people pay attention to the details...If you figure this out, let me know. I haven't yet.
    Do you not have an "IRRADIATED RBC" product in your dictionary that the physician could have chosen? That puts the responsibility on them, where it should lie. A comment is not an order and, if they are relying on that, they are forcing your techs into a position of failure. I would suggest you add an irradiated product order to your dictionary. If the physician wants that product, they must order that product that way.
     
     
  25. Like
    jayinsat got a reaction from AuntiS in IHD Webinar Featuring Our Own Malcolm Needs   
    I just saw this seminar being offered by Bio-Rad with our own, infamous, Malcolm Needs as the presenter. I registered and thought I'd pass the word to all of us here. Here is the link:https://info.bio-rad.com/ww-IHD-transfusion-w-registration-lp2.html?elq_mid=48765&elq_cid=10201434&elqCampaignId=30837&utm_campaign=30837&utm_source=eloquaEmail&utm_medium=email&utm_content=Email 13ER EM-R-CM-385201-FY21-TCHS-AWEN_BR-JRNL-TRF News 19 Nov&elqTrackId=6ecbbea5f2bb46849981687404578a8e&elq=7c5f74470efa434dbd4351e512f7ae7a&elqaid=48765&elqat=1&elqCampaignId=30837

×
×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.