catmontgomery

I just answered this question. My Score PASS

Thank you for your review and suggestions. We had a strong Transfusion Committee which did keep the blood bank usage in good order, the MDs up on education and process until half of the committee MDs retired within the past couple years. During our meeting today, it was agreed to have the free consultation from the group and review the findings.

Has any one invested in an outside blood management group for their hospital? This appears to be a hospital initiative to obtain help from an outside organization to help with cost cutting measures and increase safety. Our hospital is looking at a consulting group to help with blood management. This includes educating physicians and nurses about appropriate use, suggesting/setting up guidelines for product use for surgery and routine anemic/blood loss situations. As the hospital looks for ways of cutting costs, they are looking at a group which will help decrease blood usage, patient length of stay, increase patient safety,and cut costs 30%-50%. Our hospital Quality Management department would oversee the process if this group is contracted. Currently we have a Pharmacy and Transfusion committee which meets every two months and the sub-committee/transfusion committee meeting quarterly to twice a year. We have guidelines for transfusion triggers that are considered liberal (8 hgb for blood, plts given for varying situations from 10,000 to 50,000, etc) with review of non-compliant physicians as needed. As one of those blood bank supervisors who works on the bench occasionally along with the usual blood bank quality management, technical supervisor,blood bank computer tech, blood bank support for nursing, reviewer of our contracted perfusionsists cell saver use, etc without additional help, my reports are general in nature and not in depth as needed due to time constraints. Any suggestions for questions to bring up at an upcoming meeting to discuss hiring this group. The management group is suggested by our buying group affiliates. Lab manager sees potential in cutting costs in blood product usage. Our Laboratory Medical Director sees scenarios where blood product availability would be limited and patients at risk. Thank you for any suggestions or comments. Cat

Cliff, Your ideas are great! Snowflakes for those of us who miss the snow and stress reliever light bulb tasks! Thank you for your time and energy in keeping this site up and going so well!

Our blood bank started scanning and editing all original paper documents not in the computer to M-files. This will help until all documentation is done in our computer (ie temperature logs, completed component tags,etc). Documents are an easy look up when this is done.

I agree with Dr. Pepper...our lab is cold not quite as cold as outside (21F). I like the snowflakes!

We have the Helmer CW for the past 3 years, easy maintenance and not a complaint from any of our blood bankers. Prior to the Helmer CW we did have two Sorval cell washers, it seemed we were having multiple problems with them even after having both rebuilt within 6 months of each other and then they never worked well at all. We performed maintenance as indicated but it wasn't enough.

We use the poly specific gel card for our adult DATs and any transfusion reaction workups. Easy and clear to read. We QC these cards day of use. We use the IgG cards for our baby's and when the poly specific gel card is positive.

Recently we had 4 patients with WARM AUTO & COLD AUTO Antibodies (all within less than 2 weeks). We perform GEL type & screen and DAT testing, then tube testing (Screens/Panels with LISS and some with out additives) and elutions -all Panagglutination. We did cold absorptions, prewarm, etc . We use to keep RESt and W.A.R.M reagents until they expired, rarely had to use them, now the cost is too high. Our Chloroquine Diphosphate and EGA reagent haven't been replenished either, so we sent specimens to our blood supplier ref. lab to do further testing for alloantibodies, and DNA phenotypes, etc. We have had 3 out of 4 of these patients who had incompatible crossmatches, so we are giving them antigen negative RBCs and our biological crossmatch procedure. We perform an H/H, DAT, LDH, Tbil, and a UA prior to each transfusion and after the first 50ml of blood transfused. When the patient's blood bank armband expires, we repeat a Type/Screen/Panel/DAT/Crossmatches. How often do others see WARM & COLD Auto antibodies on patients? What testing do you perform? Thank you for any help you have offer.

We looked at Ortho's ProVue and Immucor's Galileo 4 years ago. Echo was not available at the time of our decision. If you are on GEL it will be easier to continue with GEL method instrumentation, if the ProVue goes down, you have a good backup with manual GEL. We love our ProVue, yes it is not your everyday STAT instrument, we have managed to do emergent STATS on the bench at times that the ProVue is performing alot of ASAP or Routine testing. We have had great service from Ortho, if there is any question that they can not answer they get back to u s or even send service. We love having the QC performed on the machine. Maintenance is minimal, if you have a probe crash-service must replace the probe-after techs have learned how to operate the instrument with general care the probe crash shouldn't be an issue. If you are looking for instrumentation to help with safety issues (manual bench testing has increase errors compared to instrument testing) the ProVue will help, even more when you have a bidirectional interface.

We have gone from a paper system to SafeTrace Tx at my current job (I have used Cerner classic and Meditech in other hospital blood banks). SafeTrace Tx does require attention to blood bank. It also is great on safety needs for our blood bank. We set up the tables to fit our SOPs, and it has cut down on many clerical & clinical errors that may have occurred without it. The generalists that float in and out of blood bank find the system backs up our SOPs well, forcing them to do what they were not doing in previous blood bank paper or computer settings. Once you use this system, it makes you more confident that the right results and components are going out safely.

This year during implementing of our new blood bank system, we incorporated the historical information of components from our old LIS to disks. I can now retrieve lookback information on past components from our old system.

We have a majority of MTs and few MLTs working in our blood bank. All Techs who work in our blood bank go through training and competency testing prior to staffing the bench in blood bank. Annually, we have competency checks on all of our blood bank techs using CAP testing, written competency tests, and visual work inspections by the blood bank supervisor and another supervisor familiar with blood bank. We feel all our MTs and MLTs are competent in providing quality results and products.

What do you do in these cases? One department, labor and delivery, draw our intial lab specimens (including a Blood Bank Hold specimen) at the time the IV is set up. This department has recurring problems with obtaining their medical record numbers/hospital armbands in time to draw/label their tubes and make out the blood bank armband. It was suggested they not wait for a hospital armband, just use the name and date of birth the patient gives you, but this becomes a problem when we have patients with the same name and date of birth. A current suggestion was to have the blood bank specimens drawn at another time when needed. The Nurses believe there is no time when a bleed or c-section occurs. In emergencies we would give them O Negative RBCs, etc. The past year we have made great strides in assuring our patients who require blood products are identified by exact name and our hosptial medical record number. We do use a specific blood bank armband, recording the name and medical record number, date/time, and intials of person drawing on the label. The blood bank armband is checked against the hospital armband at the time of attaching to the patient and at the time of transfusion. I am concerned that the identification of the patient at the bedside may be compromised if the patient has not received their hospital armband before the specimen is drawn. Does anyone have similar problems? Any suggestions?

We have been using Rhophylac for a short time (about 2 months), the derivative appears to be equal or better than the BayRho D we were using, administration can be IM or IV, and we were offered a more reasonable price than on orders of Rhogam or BayRho D . Our OB physicians requested the product, they liked the idea of IV or IM administration from the same product. The IV administration appears to give quicker coverage for the patient.