PalmerSil

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I, too, am a generalist, and have been for my whole 34 year career. I enjoy Blood Bank, but after our small hospital was bought by a large hospital group, we were trained to do the work the way the the group does Blood Banking. It was good to go through the training. It wasn't that everything was changed, it was that we were now going to do testing the same way as all blood bankers in the group. So, as slsmith said above, you might want to wait to see how your BB does things. At our hospital, we run types, antibody screens, DAT's, fetal cell screens and crossmatches (electronic and serologic if indicated). Everything else is sent to the main central Blood Bank. My advice to you is to figure out how you do testing (whether on your own or the "company way"), and always do it the same. Set up your tubes the same way every time; add reagents in the same order, etc. This way, if there is ever a question about your testing, you know that you always do it the same. Also, during training, don't just do the minimum. Test until you are comfortable with the process. You want to be confident in your work. Lastly, always take responsibility for your work. If a problem arises or your work is questioned, be ready to explain what you did. Knowing the procedures and processes will help you be able to troubleshoot these issues. Good luck in your new job as a Generalist. As I said, I have been doing this for a long time, and I still love what I do!

Being a generalist with Microbiology experience, here is my take on this: The unit should be reported as positive for bacterial contamination. I would not, though, report the gram stain as "positive" because that is changing the result that the microbiologist reported. They did not see any organisms on the gram stain, so it is negative. If the transfusion reaction workup only allows for a positive or negative result of a gram stain, with no place to report the culture result, then maybe report it as negative with a comment that the culture was positive. Ultimately, the culture shows that the unit was most likely contaminated, and that needs to be part of the transfusion reaction workup report. If the report doesn't allow for both the gram stain and culture report, maybe it should be changed to being positive or negative for "bacterial contamination" as opposed to "gram stain" (which, technically, isn't really reported as positive or negative).

We also involved nursing for vitals. At our last JC inspection, it was brought up. Since we do very few, we opted to discontinue this service. We now refer patients to the Red Cross.

We still use thio broth on deep wound cultures or cultures from normally sterile sites. I haven't heard of any papers on growth in thio, and none of our providers have asked about growth in thio.

Welcome! This site can help with just about any questions you have about blood banking! Sometimes it's way over my head, but I have learned soooo much from the amazing people at BBT!

I work in a small lab with generalists, and we had to start requiring that they write the lots every day instead of "same lot" because we had a couple of incidents where a new lot was put into use and they still noted "same lot" (the person putting the new lot into use also didn't note it-or QC it:cries:). Nothing against generalists-I am one, but human nature often leads some people to get a bit lazy when it comes to checking lot numbers vs. having to write them. Making the techs write the lot numbers seems to have helped them to watch for new lot numbers when opening new reagents and gel cards.

We have been using the Vitek 2 for several years now. I have not used any of the other systems, but we are quite happy with the Vitek 2. My only complaint is that the computer programming is somewhat tedious. It was obviously not set up by a lab person! Once you get used to it, though, it flows well. We are a small hospital, and are all generalists working in Micro. Because the computer isn't so user friendly, the techs who don't spend a lot of time in Micro have a little more trouble getting around the computer. The ID and sensitivity testing seem pretty well set up and their knowledge base and expert system is very good. They also seem to be pretty quick to inform the users when there is a problem with something. They recently had trouble with PIP/TAZ on gram negative sensitivity cards, and are keeping us informed about when the reformulation will be ready (FDA has to approve it). Their customer support people are pretty good. We usually get help quickly and issues resolved in a reasonable time frame. Overall, we are happy with the Vitek 2 and I would recommend it.