BankerGirl

Mobilab uses a Mobilab format. It has items in different places than the ones we have set up in Meditech, but all the information is there.

We are a different reagion from AMcCord but have had the same experience as her. I would definitely recommend you talk with them and see what they can do for you. We don't have the luxury of a closer community blood center. If we did we might shop around just to see what they could do for us, but I have no real complaints about Red Cross.

We use stickers for our assignment/crossmatch info and total Electronic documentaiton with the exception of Surgery, Trauma, MTP and Code Blue transfusions. OR has a different format of electronic documentation where vitals are still only on the anesthesia record. When I started monitoring transfusions, our compliance with vitals was <50% but now it averages >95% but it took several years and relentless incident reports to get there so keep trying. The computer makes it easier for the nurses to document but they can still circumvent the process. I do not do much real time monitoring because that would be way too much time out of each day.

This is how we do it (as bill only tests). If it got done, then it gets billed. Occasionally reimbursement will call me and question charges but I have the charge sheets from our IRL to show that the charges are appropriate. The insurance company pays us whatever they want to, but I submit the charges regardless of reimbursement.

How did you find out about it in the first place? And how did they document the transfusion electronically if the unit was never in your system? Is it in nursing notes or something similar to that? If that is the case, I would think that as long as they followed your transfusion procedure then it should be fine. That is the way we have handled it in the past.

I added tests to result QC results, Lot # and Expiration date to our FHB battery, as well as our KB. They are free text fields. This way these are all documented at result entry and are filed with the specimen results.

We just had a baby come up weak-D pos and I had to decide how to report this. I chose to go with Rh Neg and add a comment that the weak D was pos so mom needed RhIG. It was easier to answer the RN's question once than to worry about changing the baby's blood type after dismissal or having questions later in life.

We order an AGID on the unit which allows us to document the results of the unit and controls, as well as the lot number and expiration date of antisera used. There isn't a place to document the actual control used but you could enter that in comments. We chose to also maintain a paper log for that information, mainly so that it is easy for other shifts to see if QC has been done for that antisera for that date. I keep that for way more than 10 years, due mainly to procrastination and lack of time/motivation to clean out our storeroom.

Hi Amy, We are the transfusion service for three hospitals in our area that don't have blood banks. They follow our blood draw and patient identification requirements, send us the specimen and we perform the type and crossmatch and transfer the blood. We have contracts spelling out exactly what is required of them, as well as us. It is their responsibility to arrange for transport of both specimens and RC units. Two hospitals send the specimen with couriers and someone from their facility will pick up the blood later, while another sends the sample with a hospital employee who then waits "in the Big City" for an hour (usually they shop!) while we get everything ready. I have never been to any of their hospitals but they are required to send the transfusion paperwork back so I can review and make sure they are following policy for transfusion. They also have protocol for how to what is needed for a transfusion reaction and we would work it up here. We have been doing this for many years and no inspectors have questioned the process. They just want to see the contracts and transfusion documentation. We are a non-profit hospital.

I requested a quote for this fabulous-sounding product just now. This would be great for us!

We do exactly as Terri Bostock except that we use the MR# which does not change with each admission. This also also allows us to use hematology tubes when needed.

It's Helmer for us.

ElizabethP, We recently switched to the Echo and I tried running the WB corQC in tube and the only positive (antibody screening) I was able to detect was in screening cell 2 with anti-D. This didn't react at all with cell 1 (also Rh positive) as well as negative reactions with the c antibody sample. I ended up ordering the other corQC kit just for positive antibody QC. I don't understand these results, but it is what it is.

Five Platelets sounds way high. We are similar in size and we ARE a Trauma center and we only stock 3 on weekdays and 2 on weekends. We are 1.5 hours away from our blood supplier. They rotate our platelets 6 days a week so we are always getting fresh platelets to help reduce waste. Of course this is contingent upon their supply, so if they don't get fresh ones in, then they have us keep the ones we have. Our newest neurosurgeon is very annoyed if he gets in a patient and we have given our platelets to other patients, even though that is a rarity, but he doesn't get a say in our stock levels.

The other thing you have to remember is that the charges are not for the blood itself, but for the processing needed to provide the blood. These charges are the same regardless of how much of the unit is actually administered.

We do the much the same as Mollyredone, making copies in case the original disappears. Occasionally the form makes its way back to HIM prior to physician's signature, in which case they will send it back to me (still unsigned!). I have usually already gotten the copy signed by the time this happens, though. Our lab secretary then scans the form into the EMR and I also keep the form in my files.

I agree with Malcolm. We have a pregnant lady who came to us from another town who has an immune anti-D that is reacting very weakly. The gel antibody screen showed 2+ reactivity and the saline titer was zero with a score of zero as well. The previous doctor had sent one previous titer that I am aware of and the results were the same. Hopefully she stays that low, but it will be interesting to follow her to see if it rises. Our last immune anti-D patient had a significant jump in her titer 1 month prior to delivery, but she started out much higher well.

We always do the type. If it's negative we expect a full type and screen but it doesn't always come because the ED doc will sometimes consult the OB doc and find out that the patient just had RhIG in the office. Or, in the case of an alarming number of recent patients (2 ) they already have immune anti-D.

We do exactly the same here and document the date of injection. When the current screen is positive, the LIS won't allow electronic crossmatch, but all that is required is an immediate spin, not AHG, since it is not clinically significant.

This was my thought as well.

We don't have a hospital policy stating this but all of our physicians currently on staff order a type and screen on every pregnant patient with impending delivery. They don't usually do it for patients under observation or admitted for other reasons. For RhIG, we only repeat the post-partum Rh.

We received the investigation report from Immucor, and they were able to duplicate our results. They tested the our panel lot with another anti-Cw and this showed reactivity. Basically, they said we see what you see, we don't know why, but our product is working. Too bad there wasn't enough sample to do more investigating.

Ours is the same as Terri's.

We just had this upgrade yesterday and I noticed that too. It definitely looks strange, but the HX comments box still appears first when you go into result entry. I'm hoping this will work out OK. Time will tell.

I was able to scrounge up about 2 ml of plasma from hematology and blood bank and have sent this to Immucor for their investigation. I don't know what they will find out, but suspect that with the age and limitted amount of specimen, they will not be able to do a full investigation. I will post their response once they get the results.