BankerGirl

I agree with the above statements. Our nurses usually get two units infused withing 4 hours so they don't have to use a second blood administration set.

I'm sorry, I didn't actually look at the article since I was searching for another topic, so I don't know if this is it or not. It sounds like it might be.

First question is what version of Meditech are you on? Second question is are you printing the Crossmatch/Assignment cards or the IT (Issue Transfuse) Cards? We had this problem with the Crossmatch cards when we first started with Meditech, so our analyst had us use the IT cards instead and we have not seen this problem since. I have recently seen a KB article on their website that addresses this with the Crossmatch cards, so you may want to check there.

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I had one reaction report early in my career that was only "bleeding tongue" and when I took it to my pathologist, he just rolled his eyes and waved me off. Just yesterday I read the information sent by ARC regarding allergic reactions to psoralen in platelets and they had this to say: "...no cases of psoralen or amotosalen hypersensitivity have been reported to Cerus, the manufacturer of INTERCEPT (psoralen-treated) platelets. Psoralen-treated products have been in routine use in patients in Europe (15+ years) and USA (3+ years) with over 5 million psoralen-treated components administered with no hypersensitivity reaction to psoralen reported to date." Not saying it is impossible, just not previously documented.

I don't know about all Rh Immune globulin preparations, but Rhophylac cannot be given IV for Antepartum prophylaxis. It is cleared too quickly if given IV and doesn't protect the mom through to delivery. For our postpartum patients, however, the IV administration is huge for patient satisfaction.

Have your blood types been mapped? The Echo sends back blood types differently than Meditech accepts them. I believe that your Meditech instrument specialist needs to do the mapping for you. I don't remember the exact term, but he or she should know what needs to be done.

Thank you Baby Banker. I always wondered but never took the time to investigate.

I realize what you say is correct Malcolm, but that is what my supervisor called it and that is the way it was reported back in then.

When I was a very young tech, our supervisor had us carry every Rh negative result through "Du" as it was called then. I also had an O Neg labeled unit test O "Du" positive.

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We accept them as long as they don't have a really nasty antibody history (Warm or multiple antibodies) since we perform electronic XMs. Sometimes we have to get samples redrawn due to unexpected issues, but that is the exception, not the norm, so we try to work with what we get if possible.

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We used to require this as well, but as you said, we rejected many samples due to missing initials, mispelled names, missed numbers in the MRN, etc. When we went with Electronic patient verification we had to change that policy for phlebotomy to use the new system, and things improved dramatically. No one has the Mobilab scanners except our phlebotomists, so the number of people we have to educate is kept at a minimum. This is not to say they never cheat the system--they have--but it is much easier to manage 20 phlebotomists than 1000 nurses, specialty techs and anesthesia staff, so we feel pretty confident in our system.

If you follow AABB guidelines, you have to keep them on O until the second type has been performed. However, if the first sample is drawn using an electronic positive identification system, it can also be used to perform the retype. We try our best to get the initial blood sample drawn using our Mobilab system to positively ID the patient. We perform the Type and Screen on our Echo and the second type by tube. The rare times a patient goes bad in the OR and we need that second sample, we require them to draw it.

I don't understand this. Not only are they being selfish with the blood products, but also with all of the PPE and other supplies that are in critically short supply nationwide. I guess I should feel better about at least cutting the number of elective procedures that we are doing, although we are still doing way too many. The blood shortage is forcing our physicians to abide by the guidelines that we instituted 7 years ago, and it's forcing our Pathologist's to enforce them. My optimist self hopes that once this emergency passes, the will understand the reasons why we shouldn't over-transfuse and will change their habits. The pessimist in me thinks that won't happen, though. I guess we'll see which one comes out on top.

Actually, I believe that the daily QC takes care of that, as the saline is used the same in patient specimens and QC material.

When we were using gel, for the antibody screening negative controls we ran one with each diluent and the third with saline. Now that we are automated, we use saline as the negative control for the Check Cells in tube.

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We just did a history conversion from Meditech 5.67 to Meditech Expanse. I chose 10% as my target and used a random number generator to blindly select the records to validate. I also made sure to add a few patients that I knew had antibodies and special requirements, but found several just using the generated numbers. Have fun!

We also use the electronic alarm functions on our equipment, and at our last assessment the inspector brought up the chart pen moving. She told me the purpose of the alarm checks is to make sure the pen moves. I disagreed with her, said the purpose of the alarm checks is to ensure that the alarm is activated, and we check the movement of the pen each day when we do our temperature checks. She thought about it for a while and ended up not citing us for this. I know there are facilities who have abandoned their graphs for centralized electronic monitoring, so I don't see how they can require that a pen move when these sites do not even have pens or graphs.

We had a patient that seemingly converted from A Positive to A Negative. We sent the patient to our reference lab and through whatever voodoo they do, discovered that she had proteins masking her D antigens. I don't remember her specific disease process, and I don't think it was anti-D, but they reported that the patient was indeed A Positive.

What version of Meditech do you have? Finding vitals can be very challenging because yes, they may very well be documenting in the vitals section outside of TAR, especially if the aids are performing this task because I don't think they can access the TAR. What kind of daily transfusion record report are you looking for? There are a few standard report options depending on what you are looking for, but I also had an NPR report created so that I could export it to a spreadsheet and sort the data using various criteria.

I have to say that the demands on blood bank will depend GREATLY on who your facility selects as a surgeon. When we first started CVOR cases, we packed 2-4 units in a cooler and were required to have 4 platelets on hand. Our blood supplier thought that was ridiculous, because none of their other hospitals performing CVOR procedures kept that many platelets. That was 20 years ago, and the surgeons did not wait for Plavix to decrease in the patient's systems prior to operating. We later stopped packing blood for the surgeries because the surgeon thought it was ridiculous, since he never used it. I had never heard of TEG or Rotem until we became Trauma certified, and then we were not asked to get one. Our last surgeon barely used any products at all, but insisted that we get a TEG because that was "state of the art" care. I don't think he ever looked at the results. Since his retirement two months ago, we have had locum tenens physicians who don't know what to do with TEG results, so don't order them, and we are back to using multiple platelets, as well as other blood products. Best of luck to you.

We are AABB accredited but not CAP. Our hospital is accredited by HFAP, as is our lab. Our HFAP inspection falls 3 to 6 months prior to our AABB inspection, and the AABB one is the same quarter as the new Standards become effective. This makes it rather challenging to prepare for both.