Kathyang

We have all of the units listed as you mention above in the Blood Bank system but the Dr's only see the 4 main categories. If they want anything special in the unit (irradiated, washed, etc.) they have to use a special comment. This way they don't get mixed up on which product to select.

Yes. We have been using Epic/ Softbank for 2 years now.

We use saline just to make sure they aren't just agglutinating.

I have procedures for the Ortho Workstation. I am not sure if Ortho comes and trains or not. We had the MTS stations before the Ortho workstation. You will need some kind of fluke thermometer to take the temp since it only tells you if it is heated or not. There is no temperature gauge. If you never have used gel before they may train you on it. Don't but the big rack, it takes up a lot of space and the boxes that the gel cards come in works well. I will attach the workstation procedure. If you want any other procedures for gel let me know.BB4-24 Ortho Workstation ver.1.doc If you want our validaton I can also attach it, just let me know about that too.

Just for knowledge, my mother-in-law had 6 Rh positive kids and she was Rh- Negative. There was no RhoGam back then. She came in later to have surgery and still had no Anti-D. She was not weak D positive either.

We treat the OR patient like any other patient that gets blood. They can ask for an emergency release but we still require them to bring a piece of paper with patient's name, medical record number, date of birth, and Blood Bank ID if the patient has a BBID wrist band. They may bring a chart sticker down to get blood since it has all but the BBID number on it. The BBID number must be written on the piece of paper. They don't always like this process but we need to know which patient since they will probably have more than one patient. It is our way to cover for legality purposes.

I don't know that it is a regulation but studies have proved after 12 hours people start making more mistakes. We saw this with a tech who worked 14 hours in a Blood Bank where I previously worked. We could see by the work that was done in those last 2 hours. Also sometimes the work that needed completed but wasn't.

I was wondering if anyone would be willing to share a Cooler Validation procedure with me? I just use a thermometer and Hemotemps. Thanks.

I have a form which covers the 6 CLIA requirements that we use through out the whole lab. Each area has put on their own requirements. I will try to attach it. I have a separate one for evenings and nights since they don't do all the same testing as days. BB competency day.docx BB competency evenings night.docx

With Gel, we test anyone who is 2+ or less. Most of our weak D's come up 2+. If they haven't had genetic testing, we give them RhoGam to be safe.

We do a confirmatory ABO/Rh on all patients if we don't have a historical. We do electronic crossmatches when antibody screens are negative, no history of clinically significant antibody, and we have two types, which could include a historical. If there is only one type, we give "O" type with immediate spin until a second type is completed. the second type must be on a different specimen drawn at a different time.

We bought a thermometer with the wire probe. We insert it into one of the gel wells and place it in the workstation.

At my previous job we only did the front type for our "retype" ABO and no inspector ever said anything. Basically when you do an immediate spin crossmatch, you are only checking the front type of a patient since you are using the patient's cells, not the plasma.

We test the father of the baby. If he is Rh- Positive , we automatically give the mother RhoGam.

No!

I would like to know what people use when they issue blood to the floors. I am getting a lot of repercussion from the floors here in our hospital. They have used coolers for years, not monitored, so they still have to get it to the floor right away. The coolers also sometimes e get used to bring specimens down to the lab. Every other place I have worked used biohazard bags or even plain bags to transport the blood. I have switched to biohazard bags here and the nurses are all complaining that it is "cold and not compassionate" since visitors may see it. I would like to have feedback. Thanks

I do AABB Assessments and as far as I know you need to follow your insert. It says nothing about running 2 controls or using an expired control. The only thing I read is that in older cells, the reaction may be weaker.

Do you do the Verax testing to extend the platelets? Also is there another hospital close that you could work out platelet usage?

We save segments for 49 days from the time we receive them. We only get bags back for transfusion reactions.

We have the nurses place the wristband in BPAM. They have to put it in to start the blood. We also had to create a test in Softbank called BBID and the answer it Y. In the comment box we scan the BBID number and it goes across to Epic do that number has to match. I an attaching what the screens look like in Softbank. Wristband.docxWristband.docx

We have been doing the 2nd draw for a while. 1. Pre-ops we do the day they come in for surgery. 2. Outpatients that are being transfused, we usually give them type O and an immediate spin crossmatch until they come in a second time. If they aren't getting blood, like a pre-natal, we get them when they deliver or wait until they are admitted as a patient. 3. When we get the first specimen and see there is no history, we order another type on them. We always wait though until we have that first tube. 4. yes we require a second draw at a different time. We use both BBID bands and positive patient ID. We let the same phlebotomist draw the second tube since we make them put another sticker from the blood bank band on the tube and use positive patient ID. The phlebotomist don't know when we are going to ask them to draw another tube. 5. If it is a patient that has already gone to the OR, again we will use O blood and do an immediate spin crossmatch. 6. We give platelets on one type since we don't always give type specific. We have educated the doctors to let them know that we need this second type. Some of the ED docs don't like to wait but usually we try to get the second type before the type and screen is completed on the first specimen. Kathy Angel

We often transfer a patient to the larger hospital in our system that has had a type and screen completed here. They will get their own specimen and would never use ours. I know we would not accept a specimen from another facility. I would do an emergency release first. I agree that specimen identification would be a big danger. I would think that you could say no just as a patient safety issue or do an emergency release if the blood is needed that quickly. That way the Blood Bank would be covered is anything happens.

We have a consent for refusal, but also has a list of products that they can accept, including RhoGam

The Standard from AABB was 2.1.3. The CAP was Gen 555.00. The CAP deficiency I am going to argue, since that is testing personnel only.

Actually with our QC that we do in tube, the negative control for Anti A and Anti B is O Pos cells. That is CorQC from Ortho.