mollyredone

Welcome! You will learn so much here! Mari

I was told that nursing will be entering all the vitals into TAR. I know that is not a solution for you, but it will make things easier for us.

It was my understanding that unless you scan the antigram worksheets for a patient with an antibody into a file somewhere that you actually need to keep the worksheets indefinitely, per CAP checklist. Not the blank ones. I was more concerned about how long you had to keep a deceased patient's records. I finally talked to CAP and they suggested 10 years, so I have a drawer full of deceased patients ready to be tossed 10 years after death.

Wow! We are supposed to start TAR next month and that looks like a big issue! Who does the transfusion audits at your hospital? Right now we (blood bank) are doing them and I do not want to have to look all through the medical record to find the right vitals! Thanks for the heads up! If I get an answer from our IT person for a solution, I'll post it.

Sounds like Marmite or Vegemite to me! (and probably tastes like it too!) Not a fan.

We use Ortho and the package insert does say to QC periodically with weak antibodies BUT it also says "Do not use beyond expiration date." Now what??!

Our rapid HIV kit is only waived for fingerstick whole blood! So that's out. Waiting for our pathologist's decision on plan of action.

Most of our surgical crossmatches are for ortho, and are rarely used. We still haven't gotten to electronic XM due to other computer upgrades, but we XM long dated units for surgical patients. That way we are not tying up our short-dated when they probably won't be needed anyway.

We are just beginning the process of bringing TAR on board. We have had real issues with nursing not completing the transfusion forms completely-volumes not written, vitals incomplete, sometimes no verification signatures. Are all of these fields required in TAR? Our nurses do input VS in Meditech, and are also supposed to enter I/O volumes, but the ones in Meditech don't always match the ones that are missing on the transfusion forms. Do your nurses report pre and post breath sounds? Our form has a place for them, but, along with the volume, this is one of the reports that is infrequently filled out. If anyone can share the problems they went through with TAR, I would appreciate it, so we don't have to! Thanks, Mari

a.) The patient is identifed by their blood band. b.) I don't think we have gone two days, but if a patient is scheduled for OP transfusion and goes to the ER instead, or the next day, and still has their band on, we would use that same band. c.)Our OP transfusion patients need a separate armband for each transfusion, unless it is within the 3 days and they are still wearing it.

We don't allow that. They can pick up multiple units (in box with ice and Safe-T-Vues) or one PRBC and FFP, etc, but they have to be on the same patient. When blood is ready at our hospital, we send "unit ready" slips through the tube system. The nurses verify that they have checked the patient's blood band and initial it, then send it back through the tube system. We send our blood (one unit at a time) in secure mode, which means it will not stop alarming or drop into the bottom until the proper code is entered. Family birth, ER and OR still have to send someone to get their units, but we do tube the unit ready slips to them.

Jschlosser, I would be interested in finding this out as well. We are supposedly going live in September. Do you use separate BB bands? We still do, but I'm hoping to get rid of them, since their patient band has a barcode. I'm still hoping to start the process for electronic crossmatch, but we've had so many other updates that I've had to put it off for the past two years!

Thanks, Goodchild! When I informed nursing about the missing info on the paper forms, I was told that they are documenting in the computer, but obviously, without TAR, the verification and volume are not noticeably documented. Do you require documentation of pre and post breath sounds? Our paper form has it listed, but many times that is also missing. Also, if more than one unit is issued, do you have a way to verify that the PRBC has been kept at proper temp, especially if it is the second unit? We have a stamp for Safe-T-Vue that they are supposed to initial when they start the second unit.

We have a terrible compliance issue with nurses not filling out the transfusion forms completely. Right now we are using paper, since TAR hasn't been installed. I did a complete audit for April and found verification signatures missing, vitals missing, initials on vitals missing, breath sounds missing and volumes missing. If anyone has TAR, are these fields required? Do nurses have to fill out verification signatures,etc? TIA, Mari

Luckily I was proactive on that standard and worked with the nursing educators to develop a powerpoint LEARN module that the nurses have to take annually. When we had our inspection last fall, I asked the educators to send me a list of all the nurses that had taken the course, and the inspector was satisfied.

We also do the rapid HIV in blood bank. If I come up with anything soon, I'll be sure to post it!

LAB HUMOR.pdf Just wanted to lighten things up a bit. I can relate to a lot of these...especially aliquoting leftovers for my lunch! Mari

Do you have references for this? I don't have anything different for non-red cell products, but it makes a lot of sense. TIA, Mari

It does not say that the mechanism has to be in blood bank. There are other checklist items in CAP that are just managed by nursing, and that is how we interpret it. Never had a deficiency about it. One item I did take up with nursing was TM.41025, regarding transfusionist training. Nursing had nothing in place, so I worked with the educators to create a testing module that is administered by nursing.

Carolyn, my son is one of those people who might pass out. But at least he would be in a hospital! We use clear biohazard bags.

What standard did they cite, or was this just someone's opinion?

Ours are not in opaque bags, but most are sent through the tube system now. As for the visitors...they're in a hospital!! It's not like you are traipsing through the cafeteria with it, right?

Yes, the ones on my Tupperware spinning rack are!

We stick to the 3 day rule for outpatients. We are a small rural hospital and figure no one is traveling hundreds of miles to come here for surgery! The surgeons write "get TS day before surgery", but we get our share of draws on the day of surgery as well. We have the ability to extend when the patient is inhouse if negative for pregnancy, transfusions and history of antibodies, but seldom do that.

Glad to hear it Mabel! Eagle Eye, we are on the west coast (Oregon) and use a community blood bank that is awesome!