mawomack

We have a hospital wide policy that accounts for exceptionally long names. So yes, we make an exception if the first name gets truncated. Name and DOB are the required identifiers. However, we have a separate Blood Bank armband system (not Typenex, it is home grown).

Our old transfusion therapy policy says we are to call all stats? We recently were disciplined because one tech at one campus did not call on a stat platelet order. do you call all stats? XM orders only? component orders? Do you call when you issue blood through the pneumatic tube system? Thanks, Mary Ann at Florida Hospital

It has been our experience that the nurses resent being watched by lab. We are piloting a new method whereby we ask each floor to conduct X number of audits and turn in to our QA person for review. We divided up by quarters, so each nursing unit is assigned a quarter and an number of audits to perform. This has been well received by nursing at a large hospital. We reserved the right to perform audits from Blood Bank on those units that were struggling.

We split off SDPs only (no pooled platelets) based on Technical Manual 5-10 ml/ kg body weight. We use sterile docker and syringes. If original unit has not been depleted more than 10% then we issue out remainder. Because these units are still in excessive of the 3.0 x 10(11) platelets.

When the transplant takes place to you immediately change the patient's blood type so they get RBCs that are compatible with both the original and engrafted type? Or do you wait until the change in type takes place (engraftment)? What about for FFP and Platelet transfusions? Mary Ann Womack, Florida Hospital

We have Sunquest 6.4 for our LIS and i-Extend/Cerner on the HIS side. I want to create electronic documents on the HIS side for 1) uni tag/transfusion report form for documenting start/stop/vitals/etc. 2) transfusion reaction orders/documentation/clerical checks/results 3) "electronic" blood request slip. I am looking for "best practice" so as not to reinvent a good process. Mary Ann Womack, Florida Hospital Maryann.Womack@flhosp.org

how do you determine the dose/amount to give? based on patient weight? platelet count? standardize volume? of sterile doc'ed pheresis.

Apparently we are the only hospital in Central Florida that is still giving reduced volume random donor platelets to our neo/peds patients. With the 26th Standards we would have to institute pH testing upon issue. What are others doing for neo/peds platelet transfusions? splitting pheresis units? Do you have a volume or calculation that is being used. Thanks for your advise.

We opted to use the blood suppliers blood boxes. We validated shipping/receiving. This process should be re-validated annually. this is a good question for AABB "ask the experts"

We loved our Gel & had 3 Provues at our 7 hospital system. But, we converted to Echos (7) and Galileo (1) because of: 1) We could place automation at all of our 7 hospitals with a reagent rental deal 2) We could guarantee cost stabilization for 5 years (which Ortho would not do) 3) We could finally automate antibody panels, which has saved a ton of tech time. 4) Immucor is actually listening to the customer and is making improvements on the next versions of the instruments based on what we, the customer, has to say. Ortho hasn't responded with any hardware or software updates in quite some time.

You have probably already tried this, but did you go back to Immucor and ask for further justification and/or a reduction in costs? Are you going to purchase or reagent-rental of your Echo. We had a major labor savings by using the Immucor panels on the Echo.

Not only are there problems in ER & OR, but our outpatient areas that transfuse on a regular basis send the patient home with the armband. When the patient comes back they are presenting the armband (not attached, usually in the patient's hand/pocket/purse/etc.). Obviously for RBC transfusions we are getting a new sample, but this is not the case with FFP & PLTS, where if the armband number stays the same we don't require a new specimen. Should I be concerned?

Our policy allows for the physician to sign after the crisis has passed.