David

Haven't used them for 20+ years.

Haven't used them for 20+ years.

We also do one a month, locations chosen randomly.  Last month the tech doing them happened to go to a unit leased to a long term acute care facility.  Issues began when the administering nurse identified the unit as a 'zero positive' and headed south.  After I filed a variiance report for another one of the events, the nurse manager called me, very incensed, mainly because we invaded her turf to do an audit without her permission.  Apparently the 'unannounced' inspection idea hasn't come to LTAC's yet.  Congratulations to you who always have 100% performances.

We also do one a month, locations chosen randomly.  Last month the tech doing them happened to go to a unit leased to a long term acute care facility.  Issues began when the administering nurse identified the unit as a 'zero positive' and headed south.  After I filed a variiance report for another one of the events, the nurse manager called me, very incensed, mainly because we invaded her turf to do an audit without her permission.  Apparently the 'unannounced' inspection idea hasn't come to LTAC's yet.  Congratulations to you who always have 100% performances.

We also do one a month, locations chosen randomly.  Last month the tech doing them happened to go to a unit leased to a long term acute care facility.  Issues began when the administering nurse identified the unit as a 'zero positive' and headed south.  After I filed a variiance report for another one of the events, the nurse manager called me, very incensed, mainly because we invaded her turf to do an audit without her permission.  Apparently the 'unannounced' inspection idea hasn't come to LTAC's yet.  Congratulations to you who always have 100% performances.

We also do one a month, locations chosen randomly.  Last month the tech doing them happened to go to a unit leased to a long term acute care facility.  Issues began when the administering nurse identified the unit as a 'zero positive' and headed south.  After I filed a variiance report for another one of the events, the nurse manager called me, very incensed, mainly because we invaded her turf to do an audit without her permission.  Apparently the 'unannounced' inspection idea hasn't come to LTAC's yet.  Congratulations to you who always have 100% performances.

We've been instructed to issue type O's (Rh depends on patient gender).  Our institutional Ebola task force decided opening the tubes to get plasma and cells to test and crossmatch created too much risk for the staff.  Other lab testing will continue because both Hem and Chem have automated track lines that do not require human handling or opening tubes.

We've been instructed to issue type O's (Rh depends on patient gender).  Our institutional Ebola task force decided opening the tubes to get plasma and cells to test and crossmatch created too much risk for the staff.  Other lab testing will continue because both Hem and Chem have automated track lines that do not require human handling or opening tubes.

When talking to patients also be sensitive to their situation.  Many, many years ago as a young BB'er I found an anti-D in a 30 year old woman which, I thought, was likely a passive anti-D.  According to our policy I went to her room to collect a history.  She had a couple of visitors but I went ahead and asked about recent pregnancies or situations that might have called for RhIg injection.  She denied everything.  I returned to the lab ready to document it as an active sensitization.  Shortly thereafter her nurse called and said the patient wanted to talk to me.  I returned to her room and found her visitors gone.  She admitted to a recent pregnancy, it's termination and subsequent dose of RhIG.  The visitors present at my earlier visit were her parents and were unaware of the situation, so she had lied.
That taught me to be a little more discrete with my interrogations, and reinforced the realization of the value of patient interaction.

When talking to patients also be sensitive to their situation.  Many, many years ago as a young BB'er I found an anti-D in a 30 year old woman which, I thought, was likely a passive anti-D.  According to our policy I went to her room to collect a history.  She had a couple of visitors but I went ahead and asked about recent pregnancies or situations that might have called for RhIg injection.  She denied everything.  I returned to the lab ready to document it as an active sensitization.  Shortly thereafter her nurse called and said the patient wanted to talk to me.  I returned to her room and found her visitors gone.  She admitted to a recent pregnancy, it's termination and subsequent dose of RhIG.  The visitors present at my earlier visit were her parents and were unaware of the situation, so she had lied.
That taught me to be a little more discrete with my interrogations, and reinforced the realization of the value of patient interaction.

In the States, we are constantly trained on the matter of HIPPA security.  If, on rare instances, I go to speak to a patient directly, the first thing I ask is are you comfortable discussing your care with visitors in the room.  I don't begin any discussion if they answer no.  That may not prevent this type of issue mentioned above but it covers my butt from and inadvertant HIPPA violation.

When talking to patients also be sensitive to their situation.  Many, many years ago as a young BB'er I found an anti-D in a 30 year old woman which, I thought, was likely a passive anti-D.  According to our policy I went to her room to collect a history.  She had a couple of visitors but I went ahead and asked about recent pregnancies or situations that might have called for RhIg injection.  She denied everything.  I returned to the lab ready to document it as an active sensitization.  Shortly thereafter her nurse called and said the patient wanted to talk to me.  I returned to her room and found her visitors gone.  She admitted to a recent pregnancy, it's termination and subsequent dose of RhIG.  The visitors present at my earlier visit were her parents and were unaware of the situation, so she had lied.
That taught me to be a little more discrete with my interrogations, and reinforced the realization of the value of patient interaction.

When talking to patients also be sensitive to their situation.  Many, many years ago as a young BB'er I found an anti-D in a 30 year old woman which, I thought, was likely a passive anti-D.  According to our policy I went to her room to collect a history.  She had a couple of visitors but I went ahead and asked about recent pregnancies or situations that might have called for RhIg injection.  She denied everything.  I returned to the lab ready to document it as an active sensitization.  Shortly thereafter her nurse called and said the patient wanted to talk to me.  I returned to her room and found her visitors gone.  She admitted to a recent pregnancy, it's termination and subsequent dose of RhIG.  The visitors present at my earlier visit were her parents and were unaware of the situation, so she had lied.
That taught me to be a little more discrete with my interrogations, and reinforced the realization of the value of patient interaction.

You can fix paperwork, you can't fix exsanguination.  I repeatedly tell our staff not to let paperwork interfere with patient care.   While recognizing the value of correct, complete and timely records, sometimes you just have to shovel the red stuff out the door.

Despite my dislike of people who feel everyone else wants to know their opinion, you're gonna get mine, finally.  i have been an advocate of BB banding for most of my med tech career, which started when some of you were in diapers.  If you want stories where they prevented a mistransfusion let me know.  We band everybody that has BB orders, with a (very) few exceptions.  I understand the K.I.S.S. argument and when you find a system that everyone uses as intended every time, we can talk.  Until then I'll like some redundancey.  The fact that the band is labeled and applied to the patient at the bedside at the time of draw greatly increases my, and my staffs, comfort level that the unit of blood we return to the nurse will be given to the patient bearing the same number.  Can the system be 'jobbed' and not provide any benefit?  Sure, but since we've not had any transfusion accidents here in my 12 year tenure I think it does something good.  We transfuse   20-22,000 units/year so we have able opportunity to screw up. As Mabel points out, though, any system is only as good as the people using it.

Despite my dislike of people who feel everyone else wants to know their opinion, you're gonna get mine, finally.  i have been an advocate of BB banding for most of my med tech career, which started when some of you were in diapers.  If you want stories where they prevented a mistransfusion let me know.  We band everybody that has BB orders, with a (very) few exceptions.  I understand the K.I.S.S. argument and when you find a system that everyone uses as intended every time, we can talk.  Until then I'll like some redundancey.  The fact that the band is labeled and applied to the patient at the bedside at the time of draw greatly increases my, and my staffs, comfort level that the unit of blood we return to the nurse will be given to the patient bearing the same number.  Can the system be 'jobbed' and not provide any benefit?  Sure, but since we've not had any transfusion accidents here in my 12 year tenure I think it does something good.  We transfuse   20-22,000 units/year so we have able opportunity to screw up. As Mabel points out, though, any system is only as good as the people using it.