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April 2024 Challenge

BankerGirl

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Everything posted by BankerGirl

  1. BankerGirl
    It would seem that we are in the minority in that we perform a type and screen prior to ANY RhIG administration. Hmmm.
  2. BankerGirl
    No problems so far.
  3. BankerGirl
    Sandra, Our previous computer systems were all converted in one of two ways into Meditech. Meditech won't utilize the type from these systems as a second type but they are viewable in the BBK History as either comments or as conversion types. This is why we order the BTHX test. It is just a blood type and must be resulted manually.
  4. BankerGirl
    We test our cord bloods on the Echo by removing an aliquot of the cells from the EDTA tube. We can usually get clot-free cells this way. Any small clots are removed prior to analyzing.
  5. BankerGirl
    To answer Dan87, we use 10% because that's what we always have used. Not a good reason, I know, which is why I googled this after reading your question. I found one post that states the heat transfer characteristics of components is different, like Scott said. Then I dug further and found a statement in "Textbook of Blood Banking and Transfusion Medicine" that said water is acceptable because it is less dense than the blood components and would, therefore, fluctuate faster than the blood components and allow action to be taken before said components would actually be affected. SO, I think we will stick with 10% since mostly what we have is packed red cells.
  6. BankerGirl
    We also bought our glycerin from the local pharmacy. Dilute it to 10% with water. I keep a diluted bottle in the refrigerator for top-offs and the concentrate at room temp.
  7. BankerGirl
  8. BankerGirl
    We use 4x4 inch adhesive labels printed out of Meditech. We purchase them from PDC Healthcare, I believe, and they are FDA approved for use on blood bags. Removing them is usually not an issue if the label hasn't been on for more than a few hours but if they are returned and placed back in the refrigerator overnight, then they can be nearly impossible to remove intact. The adhesive seems to really like the cold, as well as certain platelet pheresis bags.
  9. BankerGirl
    I initially brought up the subject after noticing that a nursing student co-signed a transfusion. Our risk manager made the decision after some discussion (we don't employee LPNs in nursing roles here). Granted, the nurses and physicians don't always know what blood types are compatible, but they are not shy about calling to ask us, and I don't know that a nursing student or similarly trained person would even notice the difference. As for issuing from BB, we do the same as kate murphy.
  10. BankerGirl
    This subject came up recently at our facility and it was decided by our Patient Safety Committee, of which I am a member, that the co-signer would need to be qualified to administer blood. This means, RNs, Perfusionists and Anesthesiologists. The thought process was that if the co-signer is not qualified to administer blood, then they would not be knowledgeable enough to know exactly what they were verifying.
  11. BankerGirl
    Are you planning to request antigen negative units for these patients, assuming that you have antigen typed the patient prior to the DARA treatment initiation? If so I think this would definitely be the way to go. If you are not requesting antigen negative units, then you have units already in your blood bank that would be just as compatible as the ones sent from your blood supplier. As for a true emergency situation, I would think that you would have to do the same as for any patient with incompatible crossmatches.
  12. BankerGirl
    I hate these too. Not really difficult but tedious, so I farm that out to someone else whenever possible.
  13. BankerGirl
    I'm not sure if it is elsewhere, but I know that there was an Echo Customer Communication notice entitled Guidance for Interpreting Galileo Echo Images that covers this. It is actually on my competency quiz this year since we had this happen.
  14. BankerGirl
    This intrigues me. Does this calculation automatically fill in the previous history? I asked Meditech if this was possible and they told me it was not so we are manually resulting the history.
  15. BankerGirl
    Sorry Malcolm, my statement was not clear. I meant that if the DAT was positive you may not need to give Rh Negative blood, not that you should do a Weak D. Poor sentence structure, inadequate proofreading. If the DAT is negative with a positive Weak D reaction, it may NOT be an autoantibody and the patient would need Rh Negative blood. I think this post makes sense, but I have been having issues with communication lately.
  16. BankerGirl
    I don't see any reason to perform a weak D on a patient with an anti-D as you are going to give Rh negative blood anyway, unless like Malcolm said, the DAT came out positive. Why do additional testing with no clinical value? If the patient DOES type positive with Weak D, then I assume you would change the blood type to Rh positive and still need to give negative blood. Seems to me like that would just be confusing to most folks (clinicians and technologists) for no reason.
  17. BankerGirl

    TEG 6S

    BankerGirl replied to Eagle Eye's topic in Billing

    I doubt that they will respond. I asked and was told that they are not supposed to give out that information because they are not coders.
  18. BankerGirl

    TEG 6S

    BankerGirl replied to Eagle Eye's topic in Billing

    I used 85576 x 3 for the Platelet Mapping and 85347 x 2, 85576 x 2, and 85384 for the citrated assay. We just started doing these so I don't really have any feedback from the payers to say if that is correct, but I got them off google for another hospital that used them. I can't find the exact one now so can't tell you what hospital that was, sorry.
  19. BankerGirl
    I just saw this post, and in the event that you do not know this, API now has an automated DAT survey available. Last I heard, it was not yet accepted by CAP, but they were to evaluate the results from 2016 and make their determination.
  20. BankerGirl
    We have two hospitals for which we perform blood bank testing. Both send us a sample and we perform the type and screen, crossmatch, and any additional work necessary and then ship them the units, fully tagged with the reports. Neither of these hospitals stock any blood products. They have hospital volunteers act as couriers. Regs I don't know about, sorry.
  21. BankerGirl
    We tried to do that but there was a problem so we gave up. I just stuck with the mnemonic. Sorry, but it has been a while, and I can't remember what the problem was.
  22. BankerGirl
    We use a combination of the Temperature indicators and the Temp-Check thermometer. If issued in coolers, we use the place the temp indicator on the unit prior to issuing. If it has started to turn when returned, then we take the temp to determine whether to quarantine or not. If the unit is not issued in a cooler, we use the thermometer to check temp if returned in a reasonable time frame (less than 15-30 minutes or so) and again determine whether to quarantine. (We don't use the 30 minutes to determine acceptance, just if we will bother checking the temp.) This may be a bit of overkill, but I don't trust ED or OR to not remove units from the coolers. Like was mentioned previously, they could have repacked it in time for it to turn cold again.
  23. BankerGirl
    Try leaving the units and the temp indicators in the refrigerator while you put them on. Be extremely careful not to touch any part of the indicator except the outside edges. Then prepare your coolers and be sure that the indicators are not touching any room temperature materials in the cooler. Good luck.
  24. BankerGirl
    Hi Ann, I didn't phrase that too well so thought I should clarify. Anesthesia does do a two person check, just not in the computer. With TAR you have to have a second qualified person enter their user name and password into the module before you can start the transfusion. Anesthesia does all their documentation on paper and does not want to put anything in electronically, not just the transfusions. If that were the only thing, we could probably persuade them.
  25. BankerGirl
    We have had ED on TAR since the beginning, but Anesthesia is our hold out. They claim that they don't have the staff to document real time or to do the 2 person verification. I have thought about eliminating the 2 person verification since the computer verification is acceptable, but I haven't done it yet. Maybe that would encourage them, but honestly, I doubt it.
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