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EMB4879

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Everything posted by EMB4879

  1. EMB4879
    Our policy and Nursing SOP states to start immediately. If any problems occur, we say to return for evaluation (temperature) and if the product is out of temp range, we give them 4 hours to use the product (from time of issue). Most of the time, the product is wasted. If the waste is it due to an error that was preventable, such as calling for it but they are truely not ready to infuse, and then it is wasted due to lack of readiness, we then charge the floor. If they did not start the product due to other reason, such as patient spiked a temp, going to CT, etc. then the hospital aborbes the cost. Hope that made sense
  2. EMB4879
    Does anyone from Oklahoma have any updates with the recent tornados? It may be still early... but since we have had our 1st ever hospital wide tornado drill it might be nice to hear. I did see the past post on Joplin, which I made lots of updates shortly after that happened, but didnt know if anyone else had experience (partically with the power outage/building destruction)
  3. EMB4879
    · Temperature: A ≥1˚ C rise, or ≥ 2˚ F rise, in temperature above 37˚ C or 98.6˚ F · Hypertension (blood pressure increase of ≥ 50 mmHg) · Hypotension (blood pressure decrease of ≥ 30 mmHg) · Respiratory Distress with Hypotension · Bronchospasm
  4. EMB4879
    I was wondering the same thing?? Ideally the specimen is good (if no recent history transfusion/pregnancy) indefinitely or at least until 72 hours post transfusion. We are a level I trauma center and switch to type specific ASAP! Even if only 1 tech types the specimen (some times twice or once manually and once on the ProVue). We save our O neg and O pos as much as we can. Emergency release is for those patients you dont know anything about! You could have a patient with no specimen, or specimen with testing incomplete. This I would have imput from your medical director (who hopefully has a blood bank backgound?)
  5. EMB4879
    Does anyone know of an article or a continuing education about determining if a patient has true anti-D or Rhogam? Obviously, patient history will determine this, but it would be nice to know that there is something else out that one can read to reinforce this. We typically use reaction strength as a clue; however, some of our new techs aren’t considering this so sometimes it is called what it isn’t. No good!
  6. EMB4879
    We have had the policy for quite some time, have an agreement with the center including par levels, and have policy for switching Rh neg to Rh pos. We are a trauma center, perinatal center, even the designated disaster hospital in this region. This is not anything new with our supplier. They have always done an audit, but are getting more and more pickier on what they want (though nothing has changed). Anything that has to do with quality and purity of the product I understand. I even called the FDA and they agree our MTP does not qualify as something that is needed. We have passed our last three AABB and CAP without any deficiencies. I have gone through the CFR and there are somethings I can see, but they do NOT perform these tasks for us and therefor I do not believe they require this. This is not a new game to us, we are not a smaller hospital, and we are all know were to find what AABB, CAP, TJC, and FDA require. Sorry had to vent.....
  7. EMB4879
    Ok, our blood supplier does perform annual audits to ensure we are maintaining the products, keeping their purity and quality...but where do you draw the line? I see where some information is required since products are moved around, but having a Massive Transfusion Protocol (which we do), no me is NOT their business. We are AABB, CAP, CLIA accredited, no problems with Joint Commission or FDA (when we were licensed), so what right do they have to need this information. :mad: The Contract we just renewed and nothing really specific about it, mainly about storage and pertinent testing records/process, but now they are requiring more and more (in addition all referring to the standards and CAP requirements). They say it is to fulfill their FDA requirements.....is this really true or should I call them out? Any input/info/suggestions please give...I have until Oct to argue, and believe me I will
  8. EMB4879
    I would like to know how to get more people involved. We had one meeting were it was myself, my supervisor, and out medical director....no one else came. I dont know when the last time we actually had physicians on board. We do have the nursing educator come, but that is about all of our "steady" attendees!
  9. EMB4879
    Just leave it blank, it states that on the paper work somewhere.
  10. EMB4879
    I would like to know also, I have validated the procedure for doing this but we havent started to use it (due to finishing recent inspections/training new grads/computer upgrades....we all know how it rains). We were going to use the alarms on the units (fridges/freezers/incubators) and do alarm check on those and just using the Isensix as a chart recorder. I am not 100% sure we can do this, so we havent gone further with it...that my project for this week!
  11. EMB4879
    I noticed that too and we are in our inspection window. My question is who is a qualified designee?? I review our daily QA failures and panels and my counterpart reviews a daily grid report....are we qualified?? We do have "automatic traps" for improbable results, however the techs review this then release the results. I think we are going to just leave it at that...there would be no way the pathologist could review all results before being released, even our antibodies would not be able to be reviewed in a timely manner.
  12. EMB4879
    We never received any notification, has anyone else received this???
  13. EMB4879
    I am assuming that this is lot VRA162. We have also had problems with cell 15 on panel B lot VRB160. any other problems???
  14. EMB4879
    Our Transfusion Medical Director has told us that 7 pheresis plts (Rh+) will be coverd by 1 dose of rhogam. This one dose of rhogam can last 2-4 weeks. This we only use for women of child bearing age (which can vary within itself) and if it comes to a pediatic we try to avoid at all cost (unless medical emergency). We had a patient we had to do this twice (give rhogam to a child bearing age female), 3rd time was Winrho. (this patient also had HLA ab's to make it even more fun)! Hope this helps a bit!
  15. EMB4879
    we also do not have a second lot, and my question is, if you dont have a second lot of contol cells how do you know if it the control cells or the anti-C3?
  16. EMB4879
    We submitted our anti-D problem to immucor a while ago and here is some of what the reply letter stated... Immucor has identified and implemented additional standards. The effectiveness of this action was evaluated by comparing lots 506081 (506080, 506082, 506091 – which also had complaints of weaker reactivity) against the new standard. The comparison demonstrated that Immucor would have detected the difference in performance during production had this standard been applied. Based on those findings, Anti-D (Monoclonal Blend) Gamma-clone currently being released will demonstrate better performance. Hope this helps. Once we recieved the new lot, MUCH MUCH better. As for complement control cells, they have always been weak but I will have to double check to see how weak/problems.
  17. EMB4879
    We are a level I trauma center and love it. We use both 24 hour and 5 day. We keep 2 AB thawed at all times along with 2 A's. The AB's are converted right away, then the A's are converted at the end of the 24 hour period. We have seen a huge drop in waste. It is also nice for those orders that are to give then as soon as it is ready, the order is now for hold, or cancelled. :mad:
  18. EMB4879
    However, how do you do this when you only have one blood bank tech working? sure another tech from a different department could verify, but do they really know what to look for?
  19. EMB4879
    EXM...we want to get this going but are having issues with our new lab director even though our medical directoris ok with it. In addition, we are waiting for LIS upgrades which keep pushing back the dates...then is pushing back our dates sicne we done want to validate, then revalidate with the upgrades.
  20. EMB4879
    Yes the 1-2% is just red cells, including autos.
  21. EMB4879
    Our outdate is low, only about 1-2 %. They want it down to zero which would be great. Our argument is if we do decrease stock, or rotate stock, now the units that are set up on a patient, will have to be recrossmatched (increasing tech time, cost, etc.) plus if these are antigen typed units, then we really have to start from scratch and who knows if we will find antigen negative units out of the few we have. The supplier is not far, and we know we could have units in approximately 20 minutes if needed....it is just 20 minutes is unitl that box is in the door and not into inventory and patient ready. With just 1 tech working nights/weekends/holidays (and we all know this is when the worst patients come in), we are VERY resistent. :mad:
  22. EMB4879
    I know this has been here before, but where exactly in the technical manual it states how to calculate your rbc inventory (16th edition). Our supplier is trying to cut down on how much we keep in inventory. No problem with that, we dont want to waste. Overall we transfusion around 8000 units/yr and are a Level I trauma center. We dont want to skim down to low and are afraid this will happen. We are understaffed, and will be teaching students in july/aug on top of it. any help/references/ideas:confused:. Oh yeah, did I mention we are a teaching hospital on top of it. I know more products are ordered "on hold" then needed, and our xm to transfusion ration is high (2:1).
  23. EMB4879

    isensix

    EMB4879 posted a topic in Equipment

    Anybody out there use Isensix? We have had it inhouse for nearly 2 yrs, have yet to validate and use it since we keep getting little glitches about it (such as the network goes down, unannounced, date is lost??). I was not in the position I am in now, so I am pretty much on self training. Other areas in the hospital use it but within the Lab, but we all know blood banking is special. Please let me know of any concerns/disconcers/problems/headaches/work-arounds..etc. Thanks!
  24. EMB4879

    Trending Incidents

    EMB4879 replied to RR1's topic in Quality

    Thanks so much...I recently entered a position and am in charge of this, and there was no real system to follow, kinda was on a whim. I am revamping it and this is great!
  25. EMB4879
    Here is the BCW info, http://www.bcw.edu/ucmro/groups/public/documents/documents/000486.pdf
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