Jump to content

BankerGirl

Members
  • Content Count

    386
  • Joined

  • Last visited

  • Days Won

    10
  • Country

    United States

Reputation Activity

  1. Like
    BankerGirl got a reaction from John C. Staley in Nursing Order   
    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.
  2. Like
    BankerGirl got a reaction from John C. Staley in Nursing Order   
    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.
  3. Like
    BankerGirl got a reaction from jnadeau in Nursing Order   
    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.
  4. Like
    BankerGirl got a reaction from SMILLER in Nursing Order   
    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. Like
    BankerGirl got a reaction from John C. Staley in Nursing Order   
    Thank you for your comment, John.  My statement is also not popular with my Laboratory Director, but it is true none the less.
     
  6. Like
    BankerGirl got a reaction from Ward_X in Nursing Order   
    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. Like
    BankerGirl got a reaction from John C. Staley in Nursing Order   
    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.
  8. Like
    BankerGirl got a reaction from Dansket in Nursing Order   
    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.
  9. Like
    BankerGirl got a reaction from Malcolm Needs in BloodBankTalk:Antibody/Antigen Reaction   
    I just answered this question.


    My Score PASS  
  10. Like
    BankerGirl got a reaction from jayinsat in Emergency Release Blood   
    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.
  11. Like
    BankerGirl got a reaction from tkakin in Red Cell coming from other institution with a patient   
    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.
  12. Like
    BankerGirl got a reaction from Malcolm Needs in BloodBankTalk:Antibody/Antigen Reaction   
    I just answered this question.


    My Score PASS  
  13. Like
    BankerGirl got a reaction from gagpinks in When is Rhesus D positive in test tubes?   
    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.
  14. Like
    BankerGirl got a reaction from TreeMoss in Communication between shifts   
    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.
  15. Like
    BankerGirl got a reaction from Sue Arata in Transfusion documentation   
    You don't say who "upper management" includes, but this might help.  We struggled greatly when I first started doing the transfusion review several years ago.  The Quality Review department (all nurses) used to do the reviews and we were always at 100%, partly because they didn't audit all transfusions but mostly because they only looked at blood pressure for vitals documentation.  I couldn't believe that a nurse didn't know that temperature is part of vitals!  When I started doing it they were shocked that our compliance was <50%.  Fortunately for me, our Director of Nursing and Risk Manager were appalled and very adamant that we fix this.  It wasn't easy, but we have been at >95% for several years now.  I would enlist the help of your Risk Manager if you haven't already.  I became a pro at completing incident reports in several systems over the years, but writing up every single instance was what finally turned the tide.  The nursing managers were fed up with investigating incident reports very quickly!
  16. Like
    BankerGirl got a reaction from Texas Lynn in Daily QC (again)   
    We do the same.
  17. Like
    BankerGirl got a reaction from Malcolm Needs in ABO Investigation With Wide Thermal Range AB's   
    I agree with Malcolm.
  18. Like
    BankerGirl reacted to SMILLER in Just for fun   
    LOL!  We would send it to our reference lab!  We have other things to do here...
    Scott
  19. Like
    BankerGirl reacted to Bb_in_the_rain in Mock-up cases   
    For those of who works in transfusion service laboratory and would like to learn more reference cases, I can post some mock-up cases here. If you would like me to do it, please hit the "heart" button on this post. If enough folks want to practice case studies on reference lab cases, I can post mock-up cases here weekly or so.. 
  20. Haha
    BankerGirl got a reaction from AuntiS in CMV "Safe" blood   
    Really Malcolm? 
  21. Like
    BankerGirl got a reaction from Malcolm Needs in BloodBankTalk: Clinical Aspects of Transfusion Reactions   
    I just answered this question.


    My Score PASS  
  22. Like
    BankerGirl got a reaction from Malcolm Needs in BloodBankTalk: Antibody/Antigen Reaction   
    I just answered this question.


    My Score PASS  
  23. Like
    BankerGirl got a reaction from srichar3 in Elution on DAT positive Neonates   
    When I started here we performed elutions on all positive DATs as well, but when I became supervisor we put an end to that.  Busy work for no real benefit; like your Pediatrician, they treat the babies the same.  Just this year, our Pediatric Subsection decided to start performing cord blood evaluations on all babies of O Pos moms.  I know there are several facilities that do the same, but we never have.  I asked our Mother/Baby nursing coordinator for the evidence they used to make this change and have had no response.  I have never understood the long standing practice of performing the cord blood workups on jaundiced babies either.  It seems to me this is all academic and of no real clinical value, but what do I know.  Does anyone have any Best Practice guidelines with supporting evidence for any of these practices?  The only thing I can come up with is that if the baby turns out to be O as well, that may steer them to investigate alternate explanations for the jaundice; but even then, unless the baby is having continued problems, is the information actually used to determine treatment?
  24. Like
    BankerGirl got a reaction from Malcolm Needs in BloodBankTalk: Clinical Aspects of Transfusion Reactions   
    I just answered this question.


    My Score PASS  
  25. Haha
    BankerGirl got a reaction from AMcCord in The moment when the glass broke   
    I forgot about the breaking glass sound!  I have my volume muted most of the time because my computer is constantly making annoying noises.  I get so (disturbingly?) excited when the Christmas lights appear, so thank you Cliff!
×
×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.