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Posts posted by tbostock
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Thanks Malcolm. Great photos!
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We don't have a separate SOP just for this (probably should), but we have a LIS "how to enter" procedure that sums up how we handle any changes in our computer system.
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I also had quite a few CAP inspections that were less than professional. More subjective; they seemed to want to cite you for what they were cited for at their hospital. The AABB is much more process driven and much more objective and helpful.
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We do all the same as goodchild except the last part. We send to ALL locations and we send all blood products except for emergency release (we hand deliver them) and syringes for the wee ones (we also hand deliver them).
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Ooh, very interesting!
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It doesn't mattrer if the patients antibodies are not showing. That just means that the titer has dropped off to undetectable levels. You should only allocate blood that is e, C, and K negative. DO NOT listen to Whitney poplin!!!! If you give units that are positivevfor those antigens, you can stimulate an immune response, Which will cause a transfusion reaction!!!
If you read the original posts, this patient did not have an Anti-C or Anti-K, they just couldn't be ruled out, but later could be ruled out. In that case, it's not necessary to give C and K negative, but again, most of us would continue to give C and K negative, just as a preventative measure.
P.S. This is an open forum where everyone's posts are valued; we gently correct when we disagree, but we want everyone to feel welcome and that this is a safe place to ask questions.
- L106, carolyn swickard, AuntiS and 1 other
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Yes. We use the BiotestCell 3 screening cells. We do the QC every morning.
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We use Temp Check
https://www.hampshirecontrols.com/rapid-response-temperature-verification-system.htm
You will have to annually calibrate it with a certified thermometer.
P.S. Don't ever apologize for asking questions. We love helping the newbies here!
- amym1586 and John C. Staley
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1. Do you have laboratory supervisors physically on-site 24/7 or do they take call on "off hours"? We have supervisors here M-F from 5 am to 6 pm, and Saturday and Sunday from 7-3. On eve/night shift, the techs just call the supervisor for that department; one tech is assigned to be charge tech for each shift and they have to be supervisory qualified per NYS Dept of Health standards.
2. If they are on-site, is it as a supervisor or a working bench tech? We are not allowed to work the bench, it's a union hospital.
3. If they are on call, is there a charge tech? Are they compensated extra to be "in charge"? Yes, charge techs get charge pay when they take charge.
4. Do you have a supervisor for every department (micro, BB, chem, heme, phleb, etc.)? Yes, but chem/heme are combined (Core Lab Supervisor), and we are trying to get a position for Eve/Night shift supervisor because it is becoming difficult for the day shift supervisors to keep up with competency requirements.
5. How big is your facility? About 380 beds.
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We just have our shelves clearly labeled and have never had a problem with inspectors.
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Thanks, David.
Our old refrigerator's audible alarms cannot be fixed.
We are going to rely on security to call us.
Here's the Joint Commission regulation; says the alarms must be audible. Time to get a new refrig.
QSA.05.04.03 : The laboratory uses alarm systems for refrigerators and freezers to monitor storage temperatures for blood and blood components.
Program: Laboratory
Chapter: Quality System Assessment for Nonwaived Testing
Rationale: N/A
Elements of Performance:
1. The laboratory has alarm systems for each refrigerator or freezer that meet the following requirements: - Alarms are audible. - Remote alarms are present for use when staff are not in the immediate area. - Alarms, including remote alarms, are monitored continuously. - The alarm system is battery operated or powered by a different circuit than the refrigerator(s) and freezer(s).
2. The laboratory has written policies and procedures for responding to the activation of the blood-storage alarm for refrigerators and freezers.
3. Policies and procedures for responding to the activation of the blood-storage alarm for refrigerators and freezers include the following: - A list of staff to notify, in order of priority - Backup or alternative provisions for blood storage - A process for maintaining records
4. The laboratory makes available to blood bank staff its policies and procedures for responding to the activation of the blood-storage alarm for refrigerators and freezers.
5. The laboratory follows its policies and procedures for responding to the activation of the blood-storage alarm for refrigerators and freezers.
- Sandy L, Mnm and David Saikin
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Other than the obvious (maintaining the highest quality standards):
1. Better, not just more rigorous, inspections. The assessors are trained and are required to do continuing education. It is a more process-improvement type of assessment, instead of just getting through a checklist.
2. Access to AABB services (publications, etc) at a reduced rate.
3. Networking with other BB professionals. Using consultation services if needed.
4. Discount for annual meeting. Yes, it's that good...ask if your hospital would pay or reimburse for at least part of this.
5. Support for Patient Blood Management.
Also, the Joint Commission uses AABB standards, so if you are already maintaining your standards, you should stay accredited to get the benefits of belonging to AABB.
- rebeccarjthomas, kirkaw, cmontgomery and 1 other
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Yes, I would investigate if you can do this in your LIS. Yes, it would be a lot of work, but much easier once it's built.
We put our daily QC on a QC template that is resulted every day. Then we have other tests that are only done on day of use that can be manually added to that template when needed.
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Warning: this site is addictive.
Welcome aboard. -
My concern would not be for your age as you have a wealth of experience and knowledge. My concern is that now in Blood Bank I find it really hard to keep per diems competent. They would have to work at least 1 day per week to keep up with all of the ever increasing changes we have. I had a couple per diems who used to only work 1 day a month and we had to let them go because they just couldn't remember things, and would spend the first two hours just remembering all of their passwords, reading emails, signing updated policies, etc. And they were very frustrated every time they came in because of the increasing workload, etc.
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It's not a drug though, it's a blood product
The FDA has put it in the same category as drugs, and requires a pharmacist review. Probably not in the UK though.
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If you are Joint Commission accredited in your lab, this is no longer a problem. Joint has a standard QSA.05.18.01 that states specifically "The requirement that suspected transfusion related adverse events are reported immendiately to the lab, whether or not the the physician responsible for the patient deems it necessary to report the event."
This changed what we do to: if we hear about it - it gets worked up. (that's if my team member remembers the change!!!)
I have attached our old paperwork for the Transfusion Reaction Workup Request and the Transfusion Reaction Workup. Feel free to use what might help you. We are still struggling to get this in Meditech - tried to make it too fancy and have finally decided to back down to simple T-Tests, but now don't have the time to build them with my IT Coor. (Oh well!)
This is correct if you are accredited by the JC, you will get cited for having the physician order the reaction or continuing a transfusion when there are signs/symptoms of a reaction. Ours is policy based (medical staff approves the policy), they have signs/symptoms, they get the workup...period. We even have a statement in the policy that the physician cannot restart a transfusion that the nurse has stopped until the Medical Director evaluates the workup and gives the OK to release more units.
- Eoin, Malcolm Needs and tricore
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We have it in our BB. The Pharmacy had it but signed one out for the baby. Thank goodness an astute nurse did not administer it. The Pharmacy does have a supply of Rhophylac but only for IV administration for ITP patients.
The Pharmacy does, however, have to sign off on it as it is considered a medication by the FDA. So we have a "double" order where one goes to BB so we can do the testing and dispense it. The other goes to Pharmacy for review and sign-off by a pharmacist.
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Straight from the AABB:
The AABB has decided not to accept IQCP. You must follow the manufacturer's written instructions or follow the CFR regulations for quality control, whichever is more stringent.
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Use of A FFP in emergent situations
in Transfusion Services
Posted
No policy yet, but here's a couple good articles, if you don't have these already.
Jnl Trauma Balancing Risk and Benefit article.pdf
Jnl Trauma Emergency Use of group A plasma.pdf