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PAWHITTECAR

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Everything posted by PAWHITTECAR

  1. As long as no blood products are stored there you should be fine with daily temps like any other "reagent" refrigerator in the lab. I would ensure that I had a procedure that clearly states that no blood products are stored there and maybe a sign on the refrigerator reminding people to not put blood products in this refrigerator.
  2. When I took over as technical supervisor this small facility was not doing any antibody work-ups at all...everything went to reference. Our pathologist covers many small hospitals accross the state so we only see him infrequently. I discussed this with him, along with a cost analysis of what we were paying reference and how mush it would cost to work up the "simple" ones in house. The decision was made that when I was "available" I would work them up in-house and otherwise they would be sent out. I have the techs call me if they get a positive screen and I then make the decision on sending it out or holding it for me to work-up. Saved ~$25,000 in reference charges in 12 months..... I do not do any elutions, absorpions or antigen typing.. I send that all out. Only one of me and not enough time to do everything...
  3. I have worked in Blood Bank for 20 years. I felt comfortable fairly quickly but credit that to the techs that trained me during my clinical rotations and at my first job. They were both BB "superwommen" and made sure I know everything inside out. That said I think how long it takes to be comfortable varies by the person... I know tech that have worked in BB nearly as long as I have and they still do not feel comfotable... A very wise woman once told me that true blood bankers were not trained...they were born.
  4. We actually use quite a few Per Diem Techs. The schedure is made with the regular full and part time techs then the holes are filled with Per Diem techs. If anything is left the staff is offered it for overtime.
  5. We had a case recently where a patient came in through the ER, she gave the nurse an Antibody card for a Jka that was identified years ago in Texas. When we called to get more info we were told that the patient was not coherent and no family was available. We did the screen (positive), and antibody Id and found a E, K (no sign of the Jka). 2 units were set up(E,K,Jka neg) and transfused. The next day they ordered 2 more units, a nurse from the floor called to say that the patient was insisting she had another antibody card that she could not find. I spoke to the patient and she told me she had 2 cards from different hospitals, she was also able to tell me all (or at least several) of the hospitals she had been transfused at. I proceded to call all of them and found another hospital in Texas that had identified E, c. We antigen typed the units she was given and 1 was c positive. Post transfusion had a lovely c. Morale of the story...Always listen to the patient....
  6. Eoin, I too am going to be a theif...It is an excellent idea!! I can see it being a great motivational tool. I think I am going to expand it and use it with the transfusion "errors" that I report to the nursing units. I can see some of the nursing managers here being very competative to make sure their numbers are better that the others.
  7. Kathy, I was in the same place last year when I took over here...I have streamlined a lot of the procedures (doing away with alot of obsolete tasks). There are several notes posted as reminders for things that were getting missed often. I have a couple tha say "ABSOLUTELY NEVER DO..." and the techs know that if they do they will be in deep do do with me. I came in and personally talked to every one of the techs when I took over and let them know what I expect and that if there is a pattern of not following the rules they will no longer float through BB. My Lab Manager and the CFO have fully backed me and told those techs that if they were banned from BB they would be terminated. It is amazing I do not get near as many errors and when I do just a quick "meeting" and it is resolved.
  8. Wow...I'm just happy if I can get my blood bank mopped at regular intervals..
  9. Well, I for one am manning the fort so those with young children can spend the holiday with them...I'll get home in time to watch the fireworks...
  10. Malcolm, I'm sure you would have made a fine firefighter but the world of serology would have missed out on your fine wisdom.
  11. We do not routinely perform eluates on cord blood for that very reason. It normally will not change the treatment of the baby. If a physician wants an eluate they may request one. We have only had 1 request since I took over last September and that was a miscommunication on a baby that was Rh Positive/ DAT negative and the RN misread the report and told the physician that the DAT was positive. After I called and explained the results to the Doc he understood there was no need and cancelled the testing.
  12. When I took over as superviser here they were still performing weak D testing on every patient, every time they tested. I found cards on 67 year old men with 20 weak D tests. One of the first changes I made was to do away with this...well mostly. My Pathologist still feels that we nees to check women of child bearing age(twice) and of course all babies.
  13. i have seen a unit explode when dropped...of course it was the unit antigen matched for the patient with six antibodies. Needless to say I was sick but not from the sight of blood on the floor.
  14. Everwhere I have worked uses expired panels to rule out/in antibodies. The cost of keeping enough in-date panels to work up all anitbodies would be enormous. AABB, CAP and FDA have all inspected these sites numerous times with no problems and I do know at least once FDA was looking at antibody work-ups.
  15. Mabel, truth be told I inherited this system when I took over last September but it was working so I have left it alone (too many other big things to tackle). I do like the idea of tying the armband to one specific specimen rather than to an admission. It makes them have to take a step back and check something else before a transfusion. I think that causing them to slow down is a bonus. We also do a verified type from a second "stick" before transfusion (if we do not have a history).
  16. We use option B with a new armband for each specimen. no armband needed for FFP or Platelets.
  17. Cliff you know that means that you must live forever....
  18. Amelia, Though I am no longer a generalist on night shift (though I spent 18 years there) I wish to weigh in. Here at my hospital I have made sure that everyone who is trained in blood bank knows that they can call me anytime day or night for a question of if you need an extra set of hands I can be here in 10 minutes. On the off chance that I am out of town the lab manager is trained in blood bank and would be who to call but he's~30 minutes out. He knows that if they call him for blood bank they have most likely called me first and I directed them to him so he tends to respond. I've been in this position since early September and have taken maybe 20 phone calls but only came in once and that was not because I was asked but because I felt the tech sounded overwelmed,
  19. Malcolm, We are but a small backward nation where transfusion medicine is concerned.
  20. We printed an audit log that shows when the name was changed in admissions. This log show the old name, new name date and time of change as well as who changed it. Once we verify that everythink matched and admissions had made the change we reprint unit tags. I can't remember exactly where it was in the Admissions module I think. It worked because we had MediTech hospital wide. FDA inspected us and were fine with the practice.
  21. Wow..glad you got it fixed soulds like it could of been a nightmare.
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