DPruden

TAT's for STAT T&S: 1. How many beds in your facility? 700 2. What is your TAT? 58.33 minutes for 2018 jan-sep 3. Is the TAT calculated from order to result or receipt to result? receive to result 4. Who collects your specimens? RNs, phlebotomists, others? We have mostly RN collection, only the morning run by AHTs (allied health tech-predominately MAs not phlebs) 5. Do you have any automation in your Blood Bank? Yes Previous supervisors threw out most of the outliers so that the goal of 90% within 60 minutes was met. I exclude very few data points, thus our TAT hovers just under 55%. for the same time period as the TAT given, we averaged 68% of stat T/SC within 60 minutes, I do throw out a few outliers, I take any T/SC under 20 minutes and remove those and the same number from the top of the list, under the assumption the both the extremely short and extremely long are probably computer artifact in some way, I usually have about 10 that I take off of the top and bottom.

We start with A plasma for our traumas, so our MDs review for any adverse events if the patient ends up typing B or AB. And we have that written into our policy.

We do this too. in addition, if we don't have 2 types, the blood bank orders the retype and sends the floor a short pink top to use in drawing the retype, and we don't accept standard 7 mL pink tops for retypes (because people were drawing 2 upon admission and carrying them unlabeled in their pockets until they got the retype order).

I have seen facilities that attach the peer review to the Trauma Committee (if you have one) or the P&T (pharmaceuticals and therapeutics) committee, which I think every hospital has in some form or another.

There is a huge price difference between cryo and fibrinogen concentrates, maybe that has something to do with it.

which method number? I didn't see it when I searched

Whew, thanks for that, I thought I had lost my mind briefly (or my sight!)

We do have a NICU and have still had cases where they couldn't wait for the aliquot to be prepared, so we gave them the freshest O Neg that we had on the shelf.

I would read the actual OSHA regulations, there are a lot of statements in there about "reasonable expectation of exposure". https://www.osha.gov/SLTC/bloodbornepathogens/bloodborne_quickref.html Be sure to read the definitions and don't implement rules for a research lab or micro/viro lab that don't apply to blood bank. This whole subject is one of my pet peeves, I would vote for common sense and don't lick anything in the lab!

I used to use a 10mL tigertop tube, it was an excellent brake!

Our cell salvage program uses Tableau and it is pretty nice, but it is all dependent on the data source, blood bank can't use it because we can't get access to the database. We evaluated HC1 and Qlik, we really liked both of them, but couldn't get senior mgmt. to give us the budget for it. We have an analyst working on writing some reports for us in PowerBI, but I am not holding my breath!

I would check your package insert for the reverse cells. If it states something like this "The ABO antibodies of most group A, B or O adults agglutinates A1, A2 and B cells strongly (3-4+). Reactions of 2+ or less may indicate the reaction is due to an antibody other than anti-A or anti-B. Thus, weakly positive reactions should be evaluated carefully to ensure no ABO discrepancy exists and the correct ABO group is assigned.", then I think you need to do more work at least initially. Maybe not every time you see the patient, if your medical director is ok with having a know weak backtype not being worked up. We start with a 5-15 minute room temp incubation, if that doesn't work, increase the plasma/cell ratio and if you still can't get 2+ reactions, go to a 1-6 C incubation with controls. Our computer system has limitation on the reaction strength in the ABORH test, so if we have to result <2+ and call it positive, we have an ABORH discrepancy test that has different rules.

I think the FDA has changed their position on coolers again, it seems like they flip flop on storage/transport every few years.

Our inpatient consents are good for the length of that admission and our outpatient consents are good for a year. We've never had any issues, but you might check your specific state rules.

Brilliant!! Congratulations for a well deserved honor!