Deny Morlino

Our LIS team created "tests" for the extra tubes collected with any frequency. At times we have a nurse or physician request that we collect an extra specimen. Our phlebotomists are seasoned enough to make an accurate determination as to when an extra is warranted. ED draws their own "rainbow" so extras are frequent from them. An extra lavender tube has a test possibility of XLAV, blue top has XBLU, extra green top gets XGRE, and extra SSTs get XSST. This makes things easier when phlebotomy is looking at a previous order to see if a previous sample is available for use when testing is added.

We use a blood band ID system. Patient identified as John or Jan Doe and cross match performed. Band remains on patient until ID is corrected. As soon as there is a period of time allowing redraw and reband for blood bank, that is completed as well as repeat of blood bank testing with a new specimen with correct ID. The BB band is the source of truth in an unknown ID situation for blood bank and ED until identity can be properly established.

Same as Scott, 50 and 100x oil. Techs count with whatever is most comfortable. Deny

ID required at point of admission here as well.

That was my thought Scott. Oxygenation levels vary from one person to another.

Welcome

Same as the others

We use a 2 part temperature guideline based on ARC's reaction forms. If the temp is greater than or equal to 102.9 F a reaction is called. If there is a 2 degree C rise in temp a reaction is called.

Agree with Scott. We have been using gel for more than 10 years and have not used an auto control. When we use tube method, yes.

Are you referring to paper logs, electronic logs, or both? For paper logs, an overlay template with the areas to be filled in cut out of the template is a handy tool (nursing loves the one the have here for checking completeness of transfusion record). If you are talking electronic records, most software systems have reports available that can be custom defined and saved so that minimal changes (i.e. date ranges) are necessary. As far as training goes, buy in by the people reviewing is paramount to success. If the reviewers are just going through the motions, failure to catch all the omissions is likely.

Kathy, I can sympathize. Add to the headaches the fact that we do not utilize a blood bank module, so everything is paper! My experience having generalists is that they are apt to forget details as they do not work exclusively in one department and remembering all the details is practically impossible. Things that are common across other departments (like the lot number changes) I would be more irritated by since this is an integral part of the job. Examine your processes to see if there is any way to streamline things for the generalists (it has helped me at times). Sometimes you can spend more time "catching" the inconsistent errors than taking the issue as a whole and handling it (day shift reviews all charges here for this reason). Encourage people to leave detailed notes attached to paperwork they leave out, or put the paperwork away. Yes, it is like herding cats at times! Hang in there and find a rhythm that allows you to be productive and not spin your wheels feeling as if you are chasing details all day.

Welcome! I do not have a state specific anwer for your question. As you have stated, there are not any specifications per AABB, Best bet would be to look to the agency that used to be NCCLS (drawing a blank this morning as to the new name) for suggestions. Looking at workload from a patient safety standpoint should give you a good balance in staffing.

I am with goodchild on this one. One place to start is the "why" some physicians insist upon pooled vs. apheresis products. It seems to me there is approximately 6 times the risk of exposure utilizing pooled vs apheresis products in terms of exposure to something causing current or future issues since the recipient is exposed to multiple donor products. You do not indicate if the sampling from the pheresis units is a closed system process or open. This changes the time of expiration potentially for all of the pheresis units entered to create the pool. These are the issues I see immediately.

Welcome to the site

I seem to remember discussion regarding the thawing of frozen plasma as a necessary part of the process to allow transfusion of the product (can't very well transfuse a frozen unit after all). I think that splitting of a unit is considered "manufacturing" and would require registration (we just dropped our splitting policy and no longer provide split units due to low request rate).