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Lecia Guill

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About Lecia Guill

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  1. Does CMS allow billing for the component tests in a transfusion reaction workup in the U.S.?
  2. Would some of you please share your TAT's for STAT T&S or T&S with 2 unit XM? We are looking to revise our standard. To compare, the following information would be helpful: 1. How many beds in your facility? 2. What is your TAT? 3. Is the TAT calculated from order to result or receipt to result? 4. Who collects your specimens? RNs, phlebotomists, others? 5. Do you have any automation in your Blood Bank? My facility: 350 beds. 60 minutes from order to result. BB Techs and BB certified phlebotomists collect specimens. Not automated. Previous supervisors threw out most of the outliers so that the goal of 90% within 60 minutes was met. I exclude very few data points, thus our TAT hovers just under 55%. I want to establish a reasonable, meaningful standard. Thanks in advance!
  3. Is there a HCPCS code (P code) to charge for platelets that are leuko-reduced, irradiated, and washed?
  4. Is there a HCPCS code (P code) to charge for platelets that are leuko-reduced, irradiated, and washed?
  5. We have created individual "shields" for the screen cell reagent bottles. We have one reagent rack with holes cut to hold each of the reagent bottles. In this rack we used a card stock weight of paper and cut two rectangles that, when taped into a tube shape, would shield the bottles up to the collars. We have a second reagent rack that has no holes, just "shelves" to hold the bottles. For this rack we used black craft foam cut into rectangles and taped them into tube shapes to shield the bottles up to their collars. These very simple devices virtually eliminated all the non-specific "reactivity" that occured toward the end of the shelf life that we had previously seen with Ortho's 0.8% screen cells.
  6. Regarding the statement "Since we do the AHG crossmatch, we would catch a clerical error, if made..." One caveat: Our transfusion service recently sent a specimen to a reference lab for antibody identification. The antibodies demonstrated 1+ reactivity and were identified by the reference laboratory as anti-Jka and anti-E. The problem is that the antibodies did not consistently react with cells HOMOZYGOUS for the Jka and E antigens. Our thought process had been that incompatibility would always be detected at crossmatch. We have learned otherwise.
  7. I am new to my facility. We currently use name, MR#, DOB, and Blood Bank armband number during the process of issuing (releasing) blood. All these checks makes the issuing process laborious and time-consuming. Our plans are to omit one of the identifiers, either the MR# or DOB in the issue process. DOB is required hospital-wide as a second identifier, but as with the previous post, name and DOB do not always guarantee a unique combination. Name, MR#, and armband number are our unique identifiers for specimens. In the Blood Bank, we don't utilize the DOB in historical record checks. However, it does print out on the Crossmatch/Transfusion Record form and is therefore available during the clerical checks at the bedside.
  8. Malcolm, Rashimi, You're killing me. LOL!!!
  9. My transfusion service will use the specimen for up to 14 days from date of collection. The 14-day outdate was established by a previous Blood Bank Medical Director who sat on the board of CAP. Remember though, once the patient has been transfused, the specimen now "expires" on the third day following the transfusion. On the other hand, I am aware of a facility (major teaching hospital) that will use the specimen for up to 30 days past collection.
  10. I have worked at a facility whose policy was that only Blood Bank TECHS could draw specimens for Blood Bank. I'm sure this came about as the result of a tragic situation. As hospitals are under more pressure to cut costs, specimen collection is being delegated to non-laboratory personnel more and more. In my experience, this has resulted in both poor specimen quality and an incredible increase in identification errors in general (not necessarily for Blood Bank). To do everything in your power to prevent an ID error, have a very clearly defined labeling policy with as many safeguards built in as possible, and don't allow any deviation from your policy whatsoever. During my tenure with a previous employer, we required a "competent" patient, a family member, or the RN taking care of the patient to sign the Blood Bank card confirming the patient's identify by name and birth date.
  11. Historically transfusion services have required that blood products be returned to the Blood Bank within 30 minutes if not transfused and if not placed in an alternate storage container. Other than preventing the product from being discarded due to improper storage, is there any other reason that this has become a standard of practice (e.g., accrediting agency requirement)? We are having some difficulty with nursing compliance at our facility. Pathology's position is that if the product is transfused in 4 hours, what is the harm? What are your thoughts? Do you have any resources to back your opinion? Thanks in advance!
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