rbayliff

A question came up recently during a CLIA inspection regarding the use of the checksum digit at the end of the DIN, and I am looking for some clarification. My understanding, was that when using a system that reads the barcodes, the checksum did not have to show on the printed reports, but if the DIN is being used manually, the checksum digits must be included. I spoke with our blood supply center, and they know of a lot of hospitals that the system doesn't show the checksum digit as well. Help?

Macropharma makes a therapuetic phlebotomy bag that are 20 per case are are individually packaged so you don't run into expired bags. They can be purchased either with or without needles. They are a 600 ml bag.

Don't forget the 30 minute time frame to return the unit to the blood bank is not the standard anymore, it's now temperature based. I realise this thread is whether or not to accept the unit that has been spiked (which we do not), but I see lot's of comments with the old 30 minute rule.

If you are currently using the Immucor fetal screen kit that they are discontinuing, they are providing a free validation kit to make the transition to the new kit. There is a form from Immucor to fill out requesting the validation kit and selecting when you would like to receive your shipment.

I need some help here, my pathologist is asking for a reference range to be included on reports for K-B stains? Does anyone else report reference ranges? I thought as a calculation, is there really a reference range?

I'm trying to find out what paperwork I need to save and what I can do away with. Historically, this blood has printed copies from Meditech and hand written information, to the point that some things are in triplicate. We keep copies of the packing slips and invoices showing units that are brought in-house, and then print a Meditech paper report "Unit Inquiry", then hand write the units on a log (for all platelet units). For RBC units, we print every retype worksheet that we create. But, at the end of the month, I print a final unit disposition with details, that shows when the units were brought in, what the retypes were with reactions, who did the retypes and on what day they were done. This same report also shows if the unit was transfused (and to whom), transferred or destroyed. So, basically, I'm wondering why we keep all the paper copies (for years) when the end of the month reports that are also kept for years, are a complete listing? What is everyone else doing? I'd like to move into the "paperless" age.

I had asked our reference lab how they QC'd their panels (each antigen?) and they pointed out that the manufacturer left it pretty open for interpretation, but they just used a weak antibody and ran a panel, proving that the panel was able to identify a known antibody.

In regards to delays in starting transfusions, the AABB tech manual states that transfusion services should have set limits before a unit should be considered unsuitable for reissue (usually 30 minutes), but it goes on to say "If the temperature of a refrigerated component rises above 10 C, reissue is not permissible. If a unit has been entered (spiked for transfusion), it may not be returned to the transfusion service for reissue. It must either be infused within 4 hours of the time it was spiked, or it must be discarded. (Page 622, 17th edition)

I had seen the reference to QC our panel cell periodically in the package insert. When I called our reference laboratory, they confirmed that they do QC their panels when they receive them. Since they have access to weak antibodies, they freeze plasma specimens to use as QC. Since we don't have access to some of the less frequent antibodies, we used a diluted antisera to create a weak reaction. They informed me they do not do a positive and negative for each cell, just prove that the panel is able to identify the known antibody.

3.9.2 states: An alternate system shall be maintained to ensure continuous operation in the event that computerized data and computer-assisted functions are available. The alternate system shall be tested periodically. Processes and procedures shall address mitigation of the effects of disasters and include recovery plans. How does your facility "test" the alternate system? How do you document this? Thanks.

We were cited for RBC units. Her comment on plasma was to "give yourselves plenty of room, since sometimes the plasma is sent out before cooling to the 1-6 degree range."

I had a doctor the the other day whose patient had a warm auto. When I explained his options, his reply was "Can't you fix it?"

I don't remember any changes in our anti-D reagents during that time. The tech that did the KB this weekend commented that she thought it odd that it was macro positive (which was a clue to me) but she didn't pick up on it. The tech that did the initial type is concerned since two people got different results on the same specimen. My concern is why does it sometimes show up and other times it doesn't.

This past weekend, we had an OB patient that typed upon admission as A Negative. She delivered an A posititive infant. The mother's fetal screen post-delivery was positive, and the same result was obtained upon repeat. DAT (poly-specific and IgG) were both negative. The tech went on to perform a KB stain, which was negative. She then retyped the patient, using the original admission specimen, and the patient was showed a 2+ positive on the Du test. Our policy is to do the Du testing on all Rh negative samples. When the tech reviewed the patient's history, the patient was typed as A Neg in 2007, A Pos (Du Pos) in 2008 (both of those were by the previous bb supervisor), and A Neg again in 2010. In 2007 and 2010 the Du test was negative. Why is the Du sometimes positive, and other times negative? We use the tube testing method for our types.

As I read this thread, there are a lot of places that are using the 30 minute standard for returns to the blood bank. I was cited for this during our AABB inspection last month and am in the process of updating our policy to reflect the current standard. The more I dig into this, the more questions I have. Thanks everyone for your insight.

Hi all, we've purchased a new freezer for our plasma and cryo, and I've been trying to find out what we need to do to validate the temperature is accurately recording before moving product into the freezer. We compared the digital readout, chart recorder and an NIST thermometer for 24 hours and noticed +/- 10 degree differences at times between the three. I'm interested in what you do in your facility or any advice you have. Thanks!