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goodchild

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Everything posted by goodchild

  1. That's exactly why I was curious to see some screen captures. The image quality on the new analyzers (GD Erytra and Ortho VISION) is TOO good.
  2. Mabel, would you be willing to post images of some of the problems you're encountering with specks above the button? I'm very curious. Is the analyzer reporting these as "?" or as negative?
  3. This is a very good/loaded question. See also 42 CFR 493.1256 "Standard - Control Procedures": (d) Unless CMS approves a procedure, specified in Appendix C of the State Operations Manual (CMS Pub. 7), that provides equivalent quality testing, the laboratory must— (7) Over time, rotate control material testing among all operators who perform the test. After my interpretation of the CAP standard and the related CFR, I implemented a rotation of QC across all shifts. It was the bane of our day shift technologists (previously night shift did rack QC and evening shift did ProVue QC), but on the other end, we've virtually eliminated FDA biological product deviation reports related to routine QC problems and everyone seems to have a better handle on QC as a whole. I am in the camp that disagrees that 'regular' or 'over time' can be interpreted as "when we need them to do QC for annual competency assessment."
  4. I can't agree more, with both of your posts.
  5. Recent scenario we had, I thought was relevant: Patient with newly positive antibody screen, ordered for transfusion of two RBCs. Had been admitted for about a month; now diagnosed with numerous medical problems that were previously unknown to the patient. Patient was transfused a total of six RBCs with the last transfusion five days prior. The bench technologist wasn't able to determine a specificity with plasma testing but the autocontrol was positive. (Recent grad, a more seasoned technologist might have suspected the specificity based on pattern of positivity.) DAT was positive with polyspecific AHG and anti-C3. Our procedure indicates to proceed with elution in this case if the patient was transfused in the last 45 days. Eluate testing clearly identified anti-Jka.
  6. I am very interested in how you handle this setup in Meditech.
  7. There is a Replace BBK Crossmatch Test routine, which can swap the IS XM mnemonic to your IAT XM test mnemonic.
  8. Anytime I suspect weird interactions with reagent cells, I recommend grabbing a few units from the shelf and seeing what those results look like.
  9. That's a very good thing to keep in mind, thank you for posting that.
  10. anti-D presumably due to RhIg, antibodies which fall into our bucket of "cold antibody", and Knops system/Ch/Rg/Cost antibodies. We may have another look at it before it's published to live and procedures updated.
  11. It's interesting that you posted this because the supervisor and I reviewed our Meditech Antibody and Antigen dictionaries just recently. It hadn't been done in many years and whoever set it up previously configured antigen warnings and IAT XM for every antibody, so review/revision was a long time coming! One difference from the discussion here that we decided upon was to retain the requirement of IAT XM for antibody of undetermined specificity (INC).
  12. We've enabled edits of specimen expiration, the issue is that we have the product safeguards in place (Product dictionary, page 6, B for Type and B for antibody screen). When a patient comes in through an outpatient area they get a clinic account. The Oncology transfusion or surgery is on a completely different account, so if blood is ordered, it can't be crossmatched without the blood type and antibody screen results. Sure, in the requisition desktop you can move the type and screen from the clinic account but that's actually out of compliance from a billing perspective.
  13. How does everyone with Meditech C/S handle outpatient Type and Screens which need to be used for Oncology or inpatient transfusion? I would love to hear some solutions.
  14. This may shock anyone using Meditech TAR at their hospital but we have successfully implemented TAR in ED and OR (i.e. anesthesiologists) this year !
  15. Where did FDA address transport containers (coolers) as storage?
  16. After that laundry list what's left to love? I do like the user interface. . .
  17. I'm not a JC assessor but I think referencing the current edition technical manual as a supporting document for a procedure makes sense. If you cite the AABB technical manual for a specific guideline/verbiage/bit of info, then it doesn't make sense (to me) to state current edition, because the cited information could change.
  18. Perhaps check with your LIS analyst to see if they can create a separate antibody in the dictionary that would represent RhIg and set the clinical significance of the antibody to 'no.'
  19. We have Meditech C/S 5.67. If you could help me figure out the best way of managing circumstances where pre-admission/procedure Type and Screen are ordered/collected on an outpatient (Lab outreach) account but the crossmatch/transfusion is to be on the surgical/oncology account, I would be extremely grateful. We use the product configuration that looks for BT/ABS results on the account within the last x number of hours. We don't want to transcribe results.

    1. amurphy

      amurphy

      We actually just finished an enhancement for this feature this past summer! It's available in CS 5.67 PP10, and was tracked on issue LIT-1707.  Do you perhaps have an upcoming update?  Prior to this priority pack, we have a knowledge base article, # 29416, that details the options available.  

    2. goodchild

      goodchild

      I have a copy of KBA #29416. I don't know if it's something conflicting in other dictionaries but the steps it describes has no bearing on the fact that BT/ABS results need to be on the surgical/oncology account to be able to crossmatch. While attempting the steps in the TEST system, we still get the expected error "Patient has no verified blood type within x hours."

      Thank you for the info and I'll ask our IS analyst about PP10/LIT-1707.

    3. amurphy

      amurphy

      A couple of years back, we introduced an enhancement to allow the current verified blood type and/or antibody screen to be on any account on the medical record. This was complete for C/S 5.67 PP8, via CS LAB Request # 12879. It sounds like this was either not implemented, or you have not yet updated to this release, but you may also want to look into that.  

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