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Posts posted by jlmoses
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That is wonderful, Phil I can't wait to get our catalogs! Hope to see you there. Jonilynn
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Generally we do not draw a second sample.
Since the purpose is to be sure there was no error - WBIT, we have 2 phlebotomists (nurses or lab) identify the patient by AABB standards (pg 368, 18th ed. Technical Manual).
Unequivocal ID of the patient shall be made before drawing blood specimens. If any errors or discrepancies are found during this process of ID, blood specimens shall not be drawn until resolved.
BLOOD SPECIMENS MUST BE LABELLED AND SIGNED IN THE PRESENCE OF THE PATIENT. Minimum requirement as stated by AABB: “2 independent patient identifiers and date collection”. Patient’s last and first names, unique ID number (visit ID, MR#, DOB, BB#), date and phlebotomist’s signature, as well as the signature of the 2nd verifying person. The 2nd person signing must be present in the room when blood is being drawn. If 2nd signer was not in the room when phlebotomist verified the patient’s information, (s)he must confirm the patient’s ID again. Patients may not be banded after blood has been taken out of patient’s presence. If the phlebotomist leaves the room prior to tube being signed, the specimen must be re-drawn. If two signatures and/or hospital IDs are not on the tube, a second specimen drawn at a different time (must be properly labeled).
All patients must be banded with either a hospital ID band or the Red Blood Bank band (drawing of an out-patient). This band must remain on the patient from the time of specimen collection until the transfusion episode is complete.
Since only Blood Bank tubes are signed this way, we would not use a hematology tube. The OB nurses identify,sign, and label the cord specimen in this manner as well.
FYI, the only floor we really have to reject specimens from now and then for not following the "RULES" - you guessed it- the ER.
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Thank you all for your posts. I found an article from ARC:ractice Guidelines for Blood Transfusion: A Compilation from Recent Peer-Reviewed Literature.
RBC 15 minutes to 1 hour
PLTS 10 minutes to 1 hour and
FFP immediately prior and post transfusion.
T&T would like hospital wide consistency and with the push for Patient Blood Management, this would be a great time to incoporate.
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I was taught that hemoglobiin should be tested 4 hours after transfusion, Platelets and FFP should be tested 15 minutes to 3 hours post transfusion.We are not currently checking (for the most part) with in any established time-frame.
Do you have any established guidelines for rechecks?
Is this necessary? I can not locate current information on the subject.
Is it up to the physicians?
How do you know if the patient has had a "bump" if you do not check the platelet count?
How would you know if additional transfusion(s) were needed?
Thank you. Jonilynn
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I found where I got the coupon. Give it a try you might just find something www.rightonscales.com/web/my-weigh/
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We have been using a DURASCALE 100 from MY WEIGH. It is great. You should look on line for a coupon for MY WEIGH. I don't remember where I found it but it dropped the price to $42.00. It has a lifetime/30 year warrenty. Never had to calibrate as it stays the same. Have used it for 7 years.
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Thank you. Jonilynn
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Yes, but only the request. We do not receive a diagnosis or have any proof that the appropriate screening questions have been asked. I am trying to have questions pertinent to transfusion added to the nursing review of the patient history upon admission.
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Can anyone tell me if the blood bank needs to receive a written order form for a transfusion? We do not receive anything other than the computer order for Type & Screen, crossmatchx2.
We do not know whether or not the patient has been screened for past hx of transfusion, has been pregnant, all the things you would want to know. Is there a regulation that can get me answers?
Thank you, JL
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thank you for the response
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What is SCARF?
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Although they aren't happy about it, pharmacy handles it all.
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We have an Echo. We have had this sort of reactivity on the Echo and then negative on bench. Then, several months later, we found an Anti-E. We also had the same thing and then later picked up a Jka. Both specimens were sent to a reference lab and nothing was picked up. We had positive reactions that looked like an iffy E , sent to reference and they got negative reactions; only to receive information from the patients family that "years ago, he had something in his blood and he needed special units when he was in Florida. Calling the FL. hospital, he had an anti-E! Immucor has a "teaching" section on their web site. Picking up anti Es before other methods was discussed. I have heard from other area hospitals that Jka is also being picked up by them. I certainly do a complete xm on any pts with a question. It's sort of funny as I have made an appt to review this with our pathologist and medical director this afternoon. jl
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They are entered into the system as a JIC - Pink BB tube. They are kept in Processing; not delivered into the Blood Bank. That way, if for any reason they are needed, we can "see" them in our LIS.
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After pipets are washed, dried and cooled, take one of the pipets and fill with distilled, deionized water. After you allow several drops to pass through, you will place drop on pH paper. If the pH is 5-7, you can use them. Greater than 7 re-wash.
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Done. Please let us know the results. We can all improve in some way.
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I was told by a CAP inspector that if we didn't confirm all the antigen testing we sent to a reference lab, we shouldn't be repeating/confirming any antigen testingperformed at the reference lab. In other words, we were confirming the antigen testing that we had anti-sera for, but not the ones we do not have the anti-sera for.
Since we stopped retesting, we have had 3 inspections and have never been questioned about this.
jl
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Would you send me a copy of your procedure, please. My e-mail address is Jnorton@yorkhospital.com
Thank you, Jonilynn
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Our Daily Maintenance: Inspect Interior Bowl - wipe with damp sponge.
Inspect tubings and connections.
Weekly maintenance: Saline Volume dispense check (list the ml amt ) Reference the section/page in
OP Manual
System Flush Reference OP manual section and page
Semi-annual checks are done by BIOMED
Comments and corrective actions
Have you tried to call the Manufacturer? You might get help from your supplier.
Older blood banker
in Off Topic
Posted
We have quite a few part time and per diem that rotate through Blood Bank. I think if you are solid in Blood Bank and that the Procedures and policies of the Blood Bank are written well than there should be no issue. But then again, I'm 60!