Peggy

We split by sections, I will assign a tech to do Type and screen. Another for antibody ID, etc.

Thankyou all for all the good info

Typo, we tranfuse approx 450 with less than 2% not returned or incomplete

We transfuse approx 150 units per month. Our not-returned rate along with our 'returned but incomplete' is less than 2%. This is alot of work, but consistency makes it easier. Our techs review slips in the AM as part of 'morning routine' and inventory resolution. They make calls to the floors, send notices, and if needed go to the chart. With what I think are good numbers, the job now is not that time consuming. I suggest you meet with nurse educators/managers for a re-education of the importance and regulatory requirement of unit tag return, times, signature, etc. I have in the past, sent 'notices' along with the unit at time of issue. You can make them up in word. Just remind the RN to return the completed unit tag following transfusion etc,etc. I would change the notices from time to time for variety. It really does work! We also have a 'stamp' for the Blood bank copy with the reminder . I hope the suggestions help.

Thanks! As far as the reverse on recheck, we do you it for electronic crossmatch ,and iimediate spin prior to electronic we were doing rechecks. This was our policy. I could not find any specifics in the regs for reverse typing on rechecks. The definition of ABO type was the argument. CAP refers to the definition, I believe the FDA was OK with foward, either way it was vague and my state went with a citation. However, I have found that not all in our state were cited and continue to do foward only on rechecks... If you find any literature regarding this issue and electronic XM, please let me know...Thanks

Curious, did you ask your inspector for a suggestion? We do not perform daily or any QC on panel cells. We use Ortho panels and the insert reads: CONTROL OF ERROR For quality assurance the panels should be tested periodically with weak antibody. I would try to argue that citation. With a positive screen, a panel(s) is performed, based on the results or lack of conclusive results, we all consider the performance of the panel cells as part of the investigation.

We are looking to decrease cost for our systems laboratories. We had some ideas for change, We are looking to see what others are doing. We use a combination of gel We use a combination of gel technology (not automated) and tube 1. We currently antigen test in tube. Moving to gel would cut down on the now very expensive anti-sera used. I realize validation is required. What is your lab doing for antigen testing. 2. We were cited by our state on not performing reverse typing on our same specimen ABORH rechecks. As a result, our use of affirmegen has increased significantly. I do not believe our state has mandated this nor cited others. We are looking to approach the state for a revesal. Do you perform reverse typing on same sample rechecks? 3. DAT on cord bloods, we perform on all. Do any out there perform only when moms screen is positive or the possibility of ABO discrepancy exisits? I realize a pos DAT to a low incident antibody may get missed. Your feedback appreciated!

We are looking to decrease cost for our systems laboratories. We had some ideas for change, We are looking to see what others are doing. We use a combination of gel technology (not automated) and tube. 1. We currently antigen test in tube. Moving to gel would cut down on the now very expensive anti-sera used. I realize validation is required. What is your lab doing for antigen testing. 2. We were cited by our state on not performing reverse typing on our same specimen ABORH rechecks. As a result, our use of affirmegen has increased significantly. I do not believe our state has mandated this nor cited others. We are looking to approach the state for a revesal. Do you perform reverse typing on same sample rechecks? 3. DAT on cord bloods, we perform on all. Do any out there perform only when moms screen is positive or the possibility of ABO discrepancy exisits? I realize a pos DAT to a low incident antibody may get missed. Your feedback appreciated!

When a physician orders a DAT, and it is IgG positive, does your institution automatically perform an elution if the patient has an 'OK' hemoglobin and no record of transfusion? I assume in most cases, the physician is looking to diagnos/monitor. I am on the fence with this one, and not consistent.What is everyone else doing?

I like the control cell suggestion, we seem to allways have plenty left at expiration

I would just tell them exactly the scenario you described and let them evaluate clinically. Perhaps, she should consider not taking the vitamins.

wow show dog, what is your discard rate of auto's? Our hospital does not collect autos, we receive under 10 units a year. This was cut by our Medical Director speaking with the physicians. The bottom line, most were not getting transfused, it was simply a habit of practice for some physicians. The practice here has changed, auto collection seems outdated and the cost savings is an added plus.

New jersey here also, welcome!

Like David said Anti D is the easiest (no antigen typing required). We have MT students here and I do this frequently. Take any Rh positive patient, add anti-D. Rotate, incubate for about an hour or so(no less). Spin and it is ready to go. Works pretty good.

We also have had good luck with eluates using DAT gel as the indicator to perform them