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Posts posted by NancyC
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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.
- mollymotos and SbbPerson
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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).
- AuntiS and David Saikin
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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?
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Years ago, we did transfuse a Rh positive patient who developed anti-D and upon investigation, he did have a partial D.
- AMcCord and John C. Staley
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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.
- applejw, Ensis01 and Kelly Guenthner
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We keep a segment pulled at issue for 10 days placed in a cup with issue date.
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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.
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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.
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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.
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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.
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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.
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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.
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Are you already Epic/Beaker and adding Mediware or the other way around? We currently have that combination (Epic/Beaker in May 2013 and added Mediware in Oct. 2013). We are affilliated with a larger organization and are what they call "community conect". This is usually used for clinic add-ons, but we are a 100 bed hospital with an extensive outreach service and a Cancer Center so we have a large test menu. So we are the first community connect (maintained on an external server) of this size for this organization and therefore have had numerous problems.We have been extremely frustrated with the Epic/Beaker portion as we do not have any control over the build and it is not being customized for us but 'standardized' for the larger organization which does not fit our needs and in many ways seems to be a reduction in quality of care.
As far as Mediware interface:
Biggest problems are that reflex testing fails so we have to add/replicate additional testing.
Comments are limited in character size and only one comment will cross without failure.
All specimens must be received in Beaker before they cross into Mediware.
Updating the physician database in the Mediware configurator to prevent ADT failures is on-going daily process (due to our large organization affiliation).
System is designed for physician ordering of all blood products and physicians are hard to train (different processes for scheduled outpatient transfusions (Cancer Center patients) vs inpatient transfusion ordering.
Hope this helps. Nancy
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Thanks Denny, how easy is the maintenance? NancyC
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Sorry, I am not familiar with the Sahara plasma thawer, but would like to know how you like your Helmer and if there is anything you don't like about it. I am trying to decide between the Helmer DH4 and the GEM Thermogenesis MT204 for purchasing a new plasma thawer.
Anyone else out there have any input on the best plasma thawer? Thanks, NancyC
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Thanks. We've decided that our policy will be only one (up to 500 ml unit)/week. The last patient we drew two units from did not feel well afterwards. Nancy C
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I am looking for other hospital policies regarding total volume of therapuetic phlebotomy on any given day. Can anyone help me out?
We have a retired MD who now needs therapuetic phlebotomies and is extremely upset with us because we have a policy of not removing more than one 450ml whole blood unit/week. Other area hospitalsI have checked with will remove up to 500mls every three days. We only offer this service on Tues., Wed. and Thursdays which limits us as well.
We want to know what the industry standard is to help us evaluate our policy. Please help.
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Harev, I'm with PaulSunV, we do not give O Platelets to anyone who isn't an O unless it is an extreme emergency and that is all we have. We generally stock A Pos pheresis platelets for our emergency supply and then order group and type specific platelets for scheduled transfusions. If you are going to give O pheresis platelets to a non-O patient, you should plasma reduce first.
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This is to Mary, I don't think we have had a transfusion reaction involving both RBC and FFP. We would follow our RBC TX RX policy and note the FFP as part of the products received in the last 24 hours on the transfusion reaction form. The RBC TX RX is more complete with the pre and post ABO/Rh and DAT data. Hope this helps.
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Sure, if I can figure out how to attach. It may be easier for you to send me your email address, but I will try to attach policy here. I think I have it attached along with our rbc tx rx, so that you can see the difference. Nancy C
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Sure, though I don't know how to send it via this forum, could you send me your email address?
Nancy C
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We have a separate policy for adverse reactions in platelet and fresh frozen plasma transfusions, which basicly states that only the nursing section of our transfusion reaction from is completed before pathologist review. Our policy then contains notes on FNH, allergic and TRALI reactions and what tubes to collect if TRALI is suspected and how to order. I think it's a good idea to state what testing the lab does, or in this case does not do, for staff reference.
Staffing!
in Transfusion Services
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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.