BankerGirl

This was addressed in a previous thread. I can't remember exactly what it was called but it is fairly recent.

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Beer is what the going currency is around here. Seriously, though, you are welcome.

The way to handle this is to create a separate product for the pheresis units in the product dictionary. We have them set as RCLK (whole blood derived), and RCLKP (Pheresis derived) and RCLK2 (pheresis second container). This way they do not appear as duplicate units in Meditech and scan correctly in both LAB and TAR.

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Well, I just finished reviewing transfusions for last month and there are 7 transfusions with no end time.

A name is satisfactory to get the ball rolling, but they are required to sign all orders eventually or our hospital suspends their privileges. Once they are signed, their privileges are reinstated.

Agreed Malcolm. With Meditech, there is a BIG red warning when the transfusion time parameters are exceeded, and some of the nurses following the offender will end the transfusion, while some won't. Some enter a nursing note, and some ignore it. Most of these happen in our outpatient infusion area where the patient is dismissed before those transfusion time parameters are exceeded and they don't have the chart open anymore, but some still occur on the other nursing units. Our outpatient nurse manager will always take care of it when I notify her, but the other units do not.

If you use Batch Enter or even Quick Enter Units, the source of all of the blood units must be the same. We don't use these functions because we get units from many different ARC Regions in one shipment. We were burned by someone not noticing the different region on some units and just scanning them all without paying attention. Then none of the DINs are correct and it was a hassle for me to fix them individually as they were discovered. If your antigen typing is barcoded, then I am jealous because ours is not. The Quick Enter Units routine does have an Antigens field, but I don't know if the barcoding would work. It would be worth testing, however.

This is the answer to your question: a current specimen. A historical blood type is not a current specimen!

Nothing has changed for manual result entry (and it must be BU# by the way), but Richard was asking about performing the retype on automation. This requires a specimen barcode as I mentioned.

We have about one of these per month. If I can get an end time I put that time in; otherwise I just enter the end time as 4 hours from start and file a Risk Management variance.

We have Meditech, and I have built charge only tests for all of the reference lab charges. I manually add these once the workup comes back. There are some that aren't billable, like the after hours charge, so we absorb that cost.

I was asked about the courier training a couple of inspections ago. She asked what training they received. I told her I wasn't sure because they were nursing personnel and they were trained by nursing. That's all the further that conversation went. I can't think of a standard covering that, so if you can let us know what one he cited, that would be appreciated.

Our system is down at the moment, so can't give you the exact dictionary page, but for the products you wish to retype, you first create an order group that contains the retype group (or profile). Then in the product dictionary, under Assoc Unit Order Group, you put that order group in the desired field, probably Non-Affiliated Source. Then when you enter your unit it will create a specimen for the retype. You cannot use the RBC Unit label, because the testing is on the specimen number. Hope this helps.

Melvolny asked about a rule on starting blood within 30 minutes, not returning blood. I don't believe that you will find anything other than what R1R2 stated.

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What is your primary test method? We tried the Bio-Rad blend several years ago and didn't like it. We were using gel at the time and initially had good correlation between our results, but shortly after we switched it out, we had many patients who were Rh positive in gel and were Rh negative in tube (we used the tube reagent to perform retypes on new patients). Inevitably, they would be positive after incubation at 37, but our techs were very frustrated because we were getting so many discrepancies between the two methods. We switched back to the Immucor monoclonal blend and were much happier. We have since switched to the Echo for our routine testing, and use the Series 4 reagent in tube if needed to save from stocking a third anti-D reagent, and we are again getting a few discrepancies with testing previously performed in gel, but that is much less frequent.

I think that this is very possible. We have seen some thawed plasma look like egg drop soup after several hours in the refrigerator. If you place it back in the water bath for about 5 minutes, cryoprecipitate will go back in solution and should be fine to transfuse. If it still looks the same after warming, then you shouldn't use it.

Was the inspector referring to the ISBT label or the IT form? If it is the IT form, look at KB article 27704. This will change the number that prints on the card so it matches the ISBT format. I think that may be what was troubling the inspector, although what he said doesn't make sense. I'm just guessing that he heard this previously and didn't remember the correct reason that it troubled him. If that is not the case, then I don't have any suggestions other than to plead your case with CAP after the citation is confirmed.

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Thanks LAS! We have been on Meditech for 10 years and I couldn't imagine that this would change. This really makes me wonder what this person was talking about.

We are in the process of building our Meditech 6.16 system and I have a couple of questions for those of you who have already been through this. I heard the following from a site that recently went live: "...you cannot look up a unit of blood by number and see which patient got that unit. It makes look backs for the Red Cross very, very difficult." Is this true? Thanks in advance