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mollyredone

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Everything posted by mollyredone

  1. mollyredone
    It seems the Jka/b 5 minute is cheaper, although maybe not as much volume per bottle, so we decided to not do IgG method on it. We still have the other IgG antisera, but since we're switching I decided not to validate.
  2. mollyredone
    No, but we used to raise Rhode Island Reds!
  3. mollyredone
    Does it look like the older workstation, minus the wells for tubes?
  4. mollyredone
    I just recently validated Fya, Fyb and S in IgG gel cards. I used 20 units and 20 patients. My controls were panel cells, 1 negative and 1 heterozygous positive. We will be switching to Jka and Jkb 5 minute incubation antisera soon, so I didn't test them.
  5. mollyredone
    Terri, So you are charging for the IRR units, right? I'll have to check with our medical director and get her feelings about it. We do have a "relflex" antibody ID that nobody questions. My feeling about the oncologists is that they should be cognizant of their patient's requirements and order accordingly. That's just sloppy ordering if they don't, but we wouldn't want to jepardize the patient.
  6. mollyredone
    So if you are audited and whoever finds that you have ordered and CHARGED for IRR products and the doctor didn't order it, how does that fly? I am concerned about both situations-giving IRR products when they are not ordered by the physician, and getting an order for regular PRBCs when we have a previous marker in our computer stating the patient needs IRR products. This latter has happened with our oncology docs and I call and ask them to submit a new order, requesting the products the patient needs, or stating that we can delete the marker. For the former situation, would you give IRR and not charge the patient, and contact the doctor and inform him that you feel IRR products are warranted, and request that future orders specify IRR?
  7. mollyredone
    We do call when there are delays in getting units, but we have "unit ready" slips that are the second part of the unit tag that we tube to the floor. They bring this down (after verifying that the blood bank band number on the patient matches the one on the unit ready slip) or tube it down when they want a unit. It works out well for us.
  8. mollyredone
    Yes, we have a contract with them to do antibody workups and a procedure here. I don't know if they have a procedure in place at the VA. We just changed blood suppliers, so we don't currently supply blood to them.
  9. mollyredone
    We do antibody ID's for the VA hospital in town. They only perform screens, so if they have a positive screen, they send us the sample to work up. They have ARC as a blood supplier, but we don't so if they need units they would order them from ARC. If we can't finalize the workup, we would forward it to the ARC for completion. They are billed for whatever workup we do.
  10. mollyredone
    Our blood supplier validates their boxes and sent us a copy of the validation. They validate in warm weather and cold weather.
  11. mollyredone
    Carolyn, Are the units you get from your supplier labeled as R1R1 units? We don't get anything like that, but we do get a historical database than we can use to select units to antigen type.
  12. mollyredone
    Mabel, I'm so glad you posted an update! We haven't had any situations like that here that I know of, but this reminder will help jog my memory...at least for a little while!
  13. mollyredone
    Malcolm, The patients to whom I was referring are ESRD, our repeat inpatients for dialysis. When they are inhouse, we will transfuse them daily with dialysis if Hgb <10 or Hct <30. I always check for comorbidities in the chart and the doctor's notes. This same nephrologist transfused PPH two days in a row, asked for another the third day, with a Plt count of 35. When our pathologist called him, he stated that he wasn't the primary doctor for this patient, his oncologist was. We called the oncologist who said he didn't need PPH. So why was the nephrologist ordering them???
  14. mollyredone
    What computer system do you have? We have Meditech and the "pertinent" values pop up when we are ordering product (INR for FFP, Hgb for PRBC, Plt for PPH) and when we bring up the patient to result testing. Most of our docs are using reasonable transfusion criteria. Our one outlier is the nephrologist who insists on transfusing patients if their Hgb is <10 OR Hct is <30. So they can have a Hgb of 9.9 and a Hct of 30.3 and they will still get a unit with dialysis! We're trying to convince him not to transfuse if either of the parameters is over 10 or 30. It's an uphill battle.
  15. mollyredone
    We only do weak D on infants when the mother is Rh negative, and on mothers when an FMH is strongly positive. Most of our positive FMH (which are subsequently reported out as inconclusive) are in mothers with a positive weak D.
  16. mollyredone
    That requirement says it is for computer crossmatches.
  17. mollyredone
    Thanks everyone! Happy Holidays! Did Cliff retire? Is that why we have no Christmas lights to smash this year???
  18. mollyredone
    I'm reviewing my procedures and would like to find out how many BBs automatically include a patient autocontrol with an antibody screen if the BB specimen is slightly hemolyzed. From what I can find in the technical manual, it says it is not recommended as part of routine testing, but doesn't specifically address hemolysis. If the specimen is moderately hemolyzed, we would request a redraw, but sometimes the hemolysis is barely noticeable in a pipette. Thanks!
  19. mollyredone
    Patient Antibody Letter.docWhen we send out the letters to the patient, our front office looks up their address on record. The letter is signed by the Medical Director, but follow up inquiries are referenced by me. Here is a copy of our letter.
  20. mollyredone
    We get the antibody cards from ARC in Portland and mail them to the patient with a letter stating that they can call us for further information. We plan on making our own cards and mailing them out with antibodies we identify.
  21. mollyredone
    Phil, It's on the right side of the drawer!!
  22. mollyredone
    Barb, that PA sounds ridiculous!! Sometimes it's scary to think they can even order blood on people. Our medical director is having a dinner/lecture this month, inviting all the PAs and NPs in the outpatient area to inform them of how the lab/transfusion service/histology departments work. As for other autologous, we have 179 beds and used to have quite a few autologous donations for our orthopods, but that has really dropped off recently. We did have one patient that we suggested autologous for, since she had a strong warm and anti-C, anti-e and anti-K!
  23. mollyredone
    Mabel, You are right. It was St Lukes in Boise, an 860 bed hospital. I have that case study as well as one from a 265 bed hospital in Boulder, Colorado. I signed up for their weekly bulletins, which have interesting information. OP, it sounds like you have it covered with a 30% decrease without using their services!
  24. mollyredone
    Goodchild, Thanks so much. I just have the common checklists and the TRM checklist. I'll talk to my lab director to see what I need to do.
  25. mollyredone
    This summer we did a trial supplier run with Lane Blood Center in Eugene Oregon. They would email a historically negative database to us with each shipment-just the units that were sent to us. It was heaven! Saved us a lot of time and anti-sera. I asked ARC if they could do that and they said no.
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