NancyC

Staffing is a nightmare, we are < 100 bed rural hospital in a retirement community and have multiple open positions on all shifts, using multiple travelers and non-registered techs (for micro assistants, send-out dept. processing and covid testing). Losing techs to retirement and traveling (as they say they can't continue to train travelers and pick up their slack knowing the travelers are making so much more money). Most hires are new grads so training is more intensive. Everyone is training fatigued, morale is down, techs are burnt out. We are sometimes training two techs at once! We do offer sign on bonuses (5-10 K) and similar bonus incentives to existing techs to cover the night shifts, but still having trouble. We are doing some 10 and 12 hour shift experimentation with travelers and hired a tech to work just weekends who has not yet started training. We are hiring two international techs who agree to 3 year commitment and obtain a green card at end of 3 years for night shift coverage. Housing is is hard to find and unaffordable here as well. Everyone has gone to vacation rental property (if they had rentals) so now there is minimal rental inventory and housing prices have not come down from the severe increases of recent years. No end in sight to staffing shortages. I can't wait to retire next year! It is time for contract negotiations to start so hopefully there will be some big pay increases to ease this crisis.

We do the same as David, issue the freshest O NEG unit we have, irradiated if fresh. We issue the whole unit of pack cells and nursing staff remove desired quantity to infuse and airlift is generally on their way to take the baby to Children's hospital. We transfuse about once every 10 years or so.

So in that case John, does each tech have to do their own QC because the human factor varies amongst humans. We view the Vision as just a hard working tech that works 24/7 and rarely takes vacation and that always scans its specimen barcodes without fail (the specimen verification is the human part of the equation I feel safer having the Vision performing).

QC on Vision is sufficient. If all reagents and card lots are the same, the only difference is if the analyzer pipettes or a tech, it is all the same methodology. I verified this with CAP. We have had a Vision and manual gel since 2016, running QC on Vision only. We do also use the tube method and QC that separately as it is a different methodology. Curious as to which regulatory agency states Gel methodology is different if manually pipetted?

Years ago, we did transfuse a Rh positive patient who developed anti-D and upon investigation, he did have a partial D.

The nurse's "transfuse" order can be turned on to print when released. That is what our nurses bring to us out of Epic for blood pickup. The patient label is the downtime procedure for when the printer isn't working or for surgery patients because that workflow does not use transfuse orders.

We keep a segment pulled at issue for 10 days placed in a cup with issue date.

Our KB test is considered a Miscellaneous Hematology test and we have designated readers who perform the CAP surveys to prove competency since we get so few of them. Some of the techs are generalists who float into the blood bank and some are Heme techs. As long as your SOP spells out whose responsibility it is to read the slides, the department should not matter. Competency is required though.

Hi Ray, we have been using Epic/WellSky (previously HCLL) since 2013. Nchristensen@olympicmedical.org

Congrats!

We emergency issue the freshest O NEG unit we have (not always irradiated) and nursing staff administers how much of it is needed. We transfuse a newborn maybe once every 10 years on their way out via airlift to nearest pediatric hospital.

We having been using the ALBAQ controls for 7 years as DAT controls without issue and I do not plan on changing. However, I did put into place a back-up plan to test a donor unit, if we should ever receive a false positive result on our DAT NEG control to cover our deviation from manufacturer's instructions.

OR tisssues regulated under the hosptial CLIA license, not regulated by blood bank license. When asked to have BB take over, my CAP consultant said "say no and run". I just showed them (OR) the difference in regulations and they kept the tissues.

Done by the BB (ordered as misc. Heme test) - all float techs are generalists and only a handful kept competent to read (currently 5 techs), all stain slides. TAT = 24 hours.

We have made it policy that if the bleeder is an adult male or a female beyond child bearing years, they automatically get O Pos. We only have 6 - 8 O Negs at any given time and we are 2 1/2 hours away from our blood supplier so we are protective of our O Neg supply.