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Nancy L.

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About Nancy L.

  • Birthday 12/06/1957

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    Laboratory Manager

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  1. We use the Mini-Vidas for dDimer as well as for some other assays. It is very easy to use. Run time is 20 minutes. We don't run very many of them so only being able to do a few at a time is not an issue. Providers are happy with it. Calibration is simple. QC failures are rare. The only negative for us is the expense. We run other things on our vidas as well. I would not get a vidas just to do ddimers.
  2. A good friend of mine who lives in a distant state is a chronically anemic MS patient. She is quadriplegic so is not physically active. She became extremely weak and confused and was taken to the hospital where she was found to have a HGB of 1.6 gm/dl. They panicked and quickly gave her 6 units of packed cells. Surprise, surprise........she had a heart attack. She recovered and is doing well. What were they thinking slamming in so much blood so quickly. Her poor system hadn't had that much blood in circulation for months. Talk about overload!
  3. We do the same as AFiddler. For our UA w Culture if Indicated, a culture is reflexed by the system if there are positive dipstick results of leukocyte esterase, blood, nitrates or proteins and microscopic findings of >5 wbc's per hpf or WBC clumps. The culture will not reflex if there are >2+ squamous epithelial cells. In that case, a comment is resulted that the specimen is not appropriate for culture as >2+ squamous epithelial cells is indicative of contamination. A new clean catch or cath specimen is requested if a culture is desired.
  4. When there is more than one specimen container per accession number, cerner systems assigns a letter suffix to differentiate. For example, the green top tube would be Acc#A, red top Acc#B, and lavender Acc#C. In this way all containers of the same accession number can be placed in their own storage location. Letters assigned to containers can be seen in container details. We are in the process of switching to Cerner from Meditech (global organizational decision) and are also setting up specimen storage tracking. We look forward to not wasting ridiculous amounts of time searching through racks to find a specimen for add on orders et cetera. One key piece though...just like any other organizational system, it must be used in order to work. If someone removes specimen from rack without following through with tracking in computer it could get very aggravating. Good luck!
  5. We are in the beginning stages of shopping for new chemistry and immunochemistry analyzers. We are looking for an integrated chemistry/immunochemistry system. Abbott gave us a nice demo of their Architect system. Would anyone be willing to share their experiences/insights regarding the Architect? What do you like and dislike about it and why? I'd be happy to have other tech's thoughts instead of just the sales person's. :cool: Thanks!
  6. Has anyone heard of using a DAT to screen for FMH? We have used the Rosette tests in the past. One of our students tells me of another facility that does a DAT. They examine the DAT under the microscope and if they see any agglutination at all, they send the specimen out for quantitation. I have some misgivings about this and am wondering what others think of this idea.
  7. I concur Terri! This year we moved into a new lab (after being displaced to a temporary location for several months) and our entire organization (hospital, lab, blood bank, and 14 clinics) are going to a new computer system. We are in the midst of the build right now. We are due for our next CAP inspection right at go live time. Seat belts definitely needed! We have postponed a proposed change in blood bank methodology (from manual gel to automated or possibly solid phase). Never a dull moment! Happy New Year!! I'm looking forward to the New Year when one of my favorite traditions is to throw away all my to do lists at home (wish I could do the same at work) and declare myself to be all caught up on all my duties! True, some things will need to be readdressed but really, there are many things that just don't need done and I happily let them go! It's nice to be all caught up on everything, even if it's only for a couple of days!
  8. My immediate knee-jerk response is: No, Of Course Not! However, I seem to remember in the back of my mind, the rare possibility that the mother's AB type could be due to a rare cis-AB where the A and B antigens are both on the same allele allowing for the passing on of the O antigen on the other allele. I'm typing this after a very long day with no reference books at hand and may be imagining things. I look forward to hearing from the real experts.
  9. Welcome Wendy!! I have found this site to be very informative and fun at the same time! Glad to have you.
  10. rravkin, Thank you for your suggestions. We are, in fact, in the process of doing pretty much as you suggest. I am developing a flow chart procedure and have set up scenarios for techs to "dry practice" to give me feedback for the flowchart. I have also made up "Emergency Release Packets" that contain all the tags, uncrossmatched blood stickers, forms, etc. that would be needed in a massive transfusion or emergency release situation. As much information as possible will be filled out ahead of time. Our current (soon to be previous) procedure is quite thorough and complete and way too cumbersome to be a quick reference. I am trying to make it as easy and as efficient as possible since we all know that these things always happen when the least experienced part time tech is covering blood bank! Once I have the flowchart procedure and packets complete, we will have drills to get everyone comfortable and follow that up with q 6 mos competencies. We meet all requirements now but my goal is to ensure timely competence and efficiency - not just compliance. Thanks everyone for your comments!
  11. We inspect at the time of receipt (documented in computer), daily (log book), and at time of issue (documented in computer).
  12. We do very similar to what Malcolm suggests. Nursing personnel or transport can come pick up the blood product. It is checked out by a blood bank tech and the transporter. The patient's complete name, wristband number, blood type, donor identification number, unit blood type, unit expiration date are all double checked by both people comparing the information in the computer, the unit, crossmatch card attached to the unit, and the blood product requisition form that must be brought by the transporter. Only those who have received competency training (which must be repeated annually) are allowed to pick up the blood. Once the transporter has the blood, they must take it directly to the nursing unit and hand it to an RN.
  13. I very seldom post a reply on any of the bloodbanktalk threads but I very often read through them. I feel that I have way more to learn than to offer. This thread is a great example of that. Thank you, Malcolm, for a simple yet thorough explanation! I am a generalist (have been for 30 years). A few years ago I added lead tech in blood bank to my generalist duties. This forum has been a great in helping me to learn more. Thanks everyone!
  14. We have found that one has to be sure to finalize the filing of the issue of a unit of blood before the screen closes. We had a tech complete the check out process including all double checks with the messenger picking up the unit, resulted everything in meditech but got interupted and didn't actually file the result. The screen closed itself out and it wasn't discovered until the next day when it appeared that there was a unit missing from inventory. We were able to recover the information and reenter it but definitely not an optimum or desirable situation. Another reason to close or lock your session before you walk away - it makes sure you complete what you were doing. To be fair to the tech - it was our night tech. She is the only one in the lab which means she has to answer the phones, draw the blood and do all the lab work in addition to maintenance, QC, and other duties. Our night techs are great jugglers and manage to keep a lot of balls in the air. I know I'm too old to do that anymore!
  15. While we are aware we can keep meditech open using analyzer batch screens, it is our policy to lock the session anytime we walk away from the terminal. It is too easy to get multiple screens open under several tech's accounts and end up resulting something under someone else's name. I only want work I've done released under my name NOT work that someone else has done that I will be held responsible for. It's not that difficult to reenter my password when I return to the terminal. I believe the safety feature is worth the minor annoyance. I have no problem with keeping the batch open while I am close to the terminal if I am the only one using it.
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