ElinF

I just answered this question. My Score FAIL  

MTP and Emergency release is a verbal phone call to the blood bank with a signed form during the event. Routines need an order faxed from the provider or orders placed into Epic. Happy New Year!

So our sister lab was cited last week (September 2022) by TJC for not QCing panel cells. That lab had at one time been a branch of a reference lab so of course they never QC'ed panel cells for reasons given above. We are arguing back that it is a procedural QC process that we would never do a panel if the screen was negative. So if they don't react when they expect them to then we do other processes. (ie repeat, check for gel junk/misc reactivity in the screen, run it on tube, etc). Our lab does QC our panels on receipt (because a TJC surveyor told us to years back) to make sure they are reactive, but we currently do not Qc them every day of use. And the IFU now states that we need to look at our "regional and national guidance, standards, regulations and professional preferences. and Each lab must develop specific procedures..." All AABB states is to have a QC policy that works basically. I told our manager to ask them exactly what they want. (I am sure every surveyor will be different, and we may just have to satisfy them with the smoke and mirrors QC unfortunately.)

I cannot even begin to imagine. I am so sorry. I would hope for the scanning too.

A few of our newer employees state that their previous employers had required this, but I had never heard of this. We were trained by our ortho rep back in 2005 or so to pipette straight up and down for both reagent cells and plasma. My question is since many labs are automated for blood bank now, how do the analyzers pipette the samples. Is there an air gap in the testing with the Provue or the Vision?

She an oncology patient who gets regular transfusions. She was just unfortunate to get Flu B this year. We have been transfusing her for years.

How do you handle units being returned (within the appropriate temperature and time frame) from a patient who is isolated (and units not in a cooler- but it was in a biohazard bag- did they take it out of the bag? I don't know). We don't have very many returned units, but this past weekend we had a patient under precautions for COVID-19 and her unit was returned to us. You can't sterilize a unit...so then I got to thinking, what about other isolated patients. The patient actually has Flu B. So is it ok for this unit to be used for someone else? I have never actually had this problem that I know of.

We perform upon receipt and after repairs for the full calibration. Spin speed is checked annually.

We are a smaller hospital, but surprisingly we have had a lot of Emergency Releases lately that would have been MTPs had our policy been ready. It is now! (It mimics our sister hospital which is a big hospital, although not a trauma center) We have 1 form that we use for the physician signature and the stickers from 4 RBC units and 1 plt unit. This is given to the Trauma "scriber" and they write down as each unit is transfused. The paper is returned and we input the dispense times as noted on the form. We were using our emergency release process in Millennium, but it takes to long to print all those forms and have the physician sign each one.

Does anyone else use Smart Temps and hate it (love it in theory)? I cannot get it to notify me when I need it to. It works sometimes, but I have dinked around with this for hours and I am not getting anywhere. Their customer service has been very nice and responsive, but I am still having such trouble. Just venting really.

I could "listen" to Malcolm explain stuff all day!!

This is amazing and most definitely deserved!! I love reading your responses to EVERYONE'S questions and your knowledge is unbelievable. Thank you for all your help!

This sound like what we are doing...You are now my best friend so we can trade tips and secrets! haha

Twice a year our suppliers send a slip of paper in the transport container asking us to take the temp and fax it to them.

This sounds better. Thanks so much!!

We are a small laboratory, with a somewhat busy blood bank, but will start storing platelets here on site after having too many patient scares needed platelets, and starting an MTP process here soon. What is the smallest platelet incubator out there? We currently have Helmer brand fridge/freezer, but it looks like theirs model holds 16 units. Too big. We currently order platelets as they are ordered by physicians and take the temp every 4 hours, but this will not be feasible if we have them on site all the time. thanks for any suggestions! Elin

So ours has a dial we can set. I usually set it to a reasonable amount of rotating... not to fast, not too slow... What should the values be for optimal agitation of the platelets?

We are going towards Epic and Epic Beaker next year. For blood banking they are looking to go with WellSky. But I would love to join this conversation regarding the Epic standpoint.

We We got shamed once for the same people doing qc... Aka midnights. So we had to mix it up so more people did qc. Now we do midnight techs on weekends and holidays and day shift during the week.

I suppose we could thaw it in cold water, it would just take longer...but in an emergency that wouldn't work...

We will be without water in our lab (actually all departments) for several hours next week for a water valve replacement. Any hacks on thawing FFP without warm running water? We usually thaw in a plain 'ole bucket with a thermometer. I am not a very good thinker out of the box... except for microwaving water and getting it to the correct temp first, I can't think of anything else.

When is the 30th ed of the AABB standards going to be published?

Could you draw 2 separate blood bank tubes at the time of the PAT testing using a 2nd phlebotomist? Really It doesn't matter when the 2nd tube is drawn...whether it is the day of surgery or before... Explanations will have to be done with the patient of course as to why they are being poked twice, but the importance of it should be emphasized...

We have Cerner Millennium and are all of our computer systems come to us via our reference lab. We use a printed piece of paper that has a sticker on the bottom. The Top part we keep and scan into medical records and has all the info regarding unit and where the nurse/tech signs and the bottom has a sticker that has all pertinent info we place on the unit. The reference lab uses the same so we just did what they did... It was a little challenging to get all that info on a small sticker- I don't think the IT dept was very happy with me! haha Elin

If we find we don't have history on any crossmatch patient (or type and screen that could turn into a crossmatch) we search for another tube we may have the lab (samples from the past week). Other than that we had to start accepting draws from all over the hospital with the nurse's identification (which was hard for us small lab blood bankers to do...we want to control it all!) If needed we then send the phlebotomist out and get a 2nd tube (which we usually use as the crossmatch tube and the nurse draw as the confirmation tube.) If we cannot get a confirming 2nd tube we give universal products until we can get a confirm tube. If the patient is originally O positive or negative, we don't confirm them with a 2nd type because they will get O anyways. (unless they are getting FFP). I feel so much more comfortable doing this. I hated giving blood on just 1 draw ABO results! Hope this helps.