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Everything posted by BankerGirl

  1. Meditech is not flexible and will not allow you to make exceptions for a specific patient population, but you can extend the outdate of individual specimens up to 999 hours. It still flags that the blood type and antibody screen are not current, but these can be overridden to allow you to use the specimen for crossmatching. It will, however. fail on the EXM, so you will have to perform an actual crossmatch.
  2. We perform a type and screen on all of our labor patients at admission, so we do not repeat an antibody screen after delivery; but if the patient is in our facility and they want to give her antenatal RhIG, we do one before we issue it. We have identified a few patients who had already developed an immune anti-D so the treating physician had been able to monitor their pregnancy more closely.
  3. We set our blood product orders to reflex off of the transfuse order. This accomplishes two things for us: the physician only has to enter one order, and we don't have staff calling us and asking if they need to order irradiated, cmvn, leuko-reduced, etc. We perform electronic crossmatch (sorry Malcolm, that's the term) so we do not set units up unless they have a transfuse order unless they have a clinically significant antibody (or history of one) or the patient is in OR and the physician requests units be packed in a cooler for quick access.
  4. True, Scott, but I learned a long time ago the difference between talking to my coworkers/director and communicating with those outside the lab. My director still freaks out when I tell her that, but I try to remember to mention that those weren't the "official" words I used. I still take offense to the physicians who want to blame lab for their failure to order tests and the nurses failing to follow instructions, though. I have learned never to respond in the heat of the moment if it isn't absolutely necessary.
  5. Thank you for your comment, John. My statement is also not popular with my Laboratory Director, but it is true none the less.
  6. This is how we treat it. I have no way of verifying that there wasn't a verbal order from the physician to transfuse. We do have the physician order to transfuse on their checklist as well, and there have been nurses who just checked it and went about their transfusion without an order. I have to explain several times a year that it is the Dr.'s responsibility to order what he wants, Lab's job is to prepare what the Dr. orders, and the RN's responsibility to carry out the physician's orders. Not always popular, but we can't babysit everyone.
  7. I just answered this question. My Score PASS
  8. One thing I would add to Dansket's post is that the standard says group O, it does not say O Neg. If your specimen types Rh Positive, you may, according to the standard, switch to O Pos and save your O Neg inventory for actual Rh Negative patients.
  9. Thank you to all who weighed in on this subject.
  10. This question was raised recently: why do we always place Red Cells in the upright position for storage and shipping? The shipping part is easy--that's the way the Blood Supplier says it is supposed to be. I cannot find an answer to the storage in the refrigerator. Does anyone know of any standards, recommendations, etc for how to store Packed RCs in the refrigerator--and why? Thank you,
  11. We use Mobilab with Meditech and we love it! When we "upgraded" to Meditech 6 we tried the PHH module that Meditech has and it was a disaster, so we went back with Mobilab. Maybe it would be OK if you didn't know how good Mobilab was, but I can't recommend it.
  12. Same here, so we don't issue more than one platelet at a time.
  13. This does not happen often at my facility, but our policy is similar to AMcCord's. If already infusing, the nurses continue the transfusion and document that. If not infusing on arrival, we are rarely notified prior to the ambulance departing, so we rarely get to send the units back. If there were appropriate shipping conditions/paperwork, then we would accept into our inventory; if not then the units are discarded and the transferring facility notified.
  14. I just answered this question. My Score PASS
  15. We also have a communication log. It doesn't have to be anything fancy, ours is just a spiral bound notebook. We also give verbal report to the oncoming shift. This isn't fool proof, but it helps.
  16. I have a question about the "newborn card". I am not familiar with this card, so forgive me if this is the case. Does this card contain IgG, and is it incubated at 37 prior to centrifugation? And when you perform the testing in tube, do you incubate and carry it through AHG phase? This is how we detect weak D.
  17. Yes, why would this be different than any other physician's lab order?
  18. We do much the same, except we don't use the BBID numbers.
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