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BankerGirl

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Everything posted by BankerGirl

  1. BankerGirl
    bevydawn1, Here is the rule I had in 5.67. Hopefully it helps. The Data Flds From is BSP. (([f bsp ctime]-2400)/100)^X, (72-X)^Y, [f bsp exp hrs set](Y);
  2. BankerGirl
    This should be true, but then it brings up the question I have asked before, which is why do they order the tests if it doesn't affect patient care? I have asked our Peds physician group and received no answer. Before this year we never did a cord blood workup unless it was to determine RhIG eligibility for mom or the baby was jaundiced. This year, however they are insisting on all O Pos moms as well. Of course they didn't tell us this, so we were caught off guard and short of supplies for DATs. When I asked for the evidence on which this decision was based, I was flatly ignored.
  3. BankerGirl
    What version of Meditech are you on? I did this with a rule in v5.x and also in Expanse 6.x. I found it on the KB section of their website. I don't see it anymore, but I can email you my rule if you are interested. I also found KB article 43874 that addresses extending specimen expiration date to 72 hours after surgery date rather than specimen collection date. It is based on location, and may or may not be applicable to you.
  4. BankerGirl
    Same here. We have Meditech set to expire as close to 3rd day at midnight as we can get it, but we cannot make exact. It is always within an hour so it is rarely a problem, but I wish they would allow days instead of hours!
  5. BankerGirl
    We stopped performing Eluates on cord blood years ago. We initially said only if mom had a positive antibody screen, and then went to if Dr. orders. They never do, even when mom has a known antibody and the baby is severely affected. They know the source of the problem and treat the baby accordingly.
  6. BankerGirl
    We dropped the poly for the same reasons you are considering. We have an Echo and perform ours on there and have tube reagents for backup or in case the sample is too small to run on the Echo. We are AABB accredited, but not CAP (we use HFAP) and our processes have not been questioned by either agency.
  7. BankerGirl
    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.
  8. BankerGirl
    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.
  9. BankerGirl
    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.
  10. BankerGirl
    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.
  11. BankerGirl
    Thank you for your comment, John. My statement is also not popular with my Laboratory Director, but it is true none the less.
  12. BankerGirl
    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.
  13. BankerGirl
    I just answered this question. My Score PASS
  14. BankerGirl
    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.
  15. BankerGirl
    Same here.
  16. BankerGirl
    Thank you to all who weighed in on this subject.
  17. BankerGirl
    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,
  18. BankerGirl
    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.
  19. BankerGirl
    Same here, so we don't issue more than one platelet at a time.
  20. BankerGirl
    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.
  21. BankerGirl
    I just answered this question. My Score PASS
  22. BankerGirl
    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.
  23. BankerGirl
    I just answered this question. My Score FAIL
  24. BankerGirl
    I agree with Malcolm.
  25. BankerGirl
    We do the same.
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