jasonviau

Does your facility have a policy requiring a separate ID band for patients who may require transfusion (Typenex, etc.)? If you do, and you draw a Pre-Op Type and Screen, do you require the patient to wear the band from the time the sample is drawn until they return for surgery? Please include the name/location of your facility in your response. Thank you for your help.

I'm so glad I happened across this thread this morning. Currently, we are only testing neonates for weak D. Just today, after reading through this thread, we had a woman present to Labor and Delivery. Her prenatal report from a reference lab stated that she was O Positive. We had history from a previous admission of her being O Negative, and the sample sent from L&D tested O Negative. The patient's nurse was quite flustered as to how there could be such a discrepancy. Turns out, the reference lab uses a Provue. I was able to explain to her the differences in sensitiviy between the manual tube and automated gel methods. I like the idea of 2+ or weaker on a machine being reported in tube. We're looking at automation; I'll have to remember to include that in my policy.

We are in the process of building and validating HCLL. One of the lovely things included is an interface with Digi-Trax software. Since >99.9% of the blood products we currently transfuse are Red Cross units, we need to have Codabar-sized labels for print-on-demand unit modifications (thawing plasma for example). HCLL will print a new label with the new expiration date barcoded. In fact, I'm told that this is required, as the user must scan the barcodes for HCLL to do a label check. We need the 1.75 x 3 inch label for the source-ABO/Rh-expiration label. I've looked on all the websites for Digi-Trax, Computype, RRDonnelly, etc. No one seems to be selling these labels, or at least no one is advertising them. Are there any HCLL users that have a vendor/catalog number/price for these??? Thanks in advance for your help.

I agree that there is a problem not being able to access the results in our parent company's computer. My question is, if the problem were fixed and we could access those results, are those acceptable to use for confirmation of ABO/Rh? They were technically performed by a different laboratory.

Part of the admission protocol for Labor and Delivery is to send a type and screen sample. We have a hand full of patients each month that do require transfusion after delivery.

We had an ER physician ask for 2 units of uncrossmatched O Neg for her bleeding patient. About 10 minutes after they were sent, she called back yelling that we gave her "Zero negative" blood.

The hospital I work at recently started requiring a second sample to confirm ABO/Rh on patients without a history. Great idea. However, the lab is a contracted service at the hospital. Prenatal profile testing is done at the lab company's reference lab in another state and the results are in a computer system we do not have easy access to. We are now experiencing problems with women coming in to deliver thier babies at our hospital, and we have to ask for a second sample. The doctors are mad because their patients were already tested by the same company who runs the hospital's lab and we should be able to use those results. I looked over the CAP checklist and AABB Standards for some guidance, and I only found a CAP item referring to being able to accept an Rh result from another CLIA-accredited lab for issuance of RhIG. I hate to have the patients drawn again if we don't need to, but I want to make sure we're doing the right thing. Is there any regulation as to what can be used for a historic result? Can we use the ABO/Rh performed at another lab of our parent company as the second type? Ugh!

We also report out "Anti-D due to RhoGAM". The problem we're now trying to deal with is whether to report the antibody screen as positive or negative. We use electronic crossmatch, so our computer system is now prohibiting us from using this function with any patient who has ever had a passive Anti-D. I suppose anyone using Immediate Spin crossmatch would be in the same boat. Has anyone else dealt with this successfully?

I have requested that a new position be created in my Transfusion Service department for QA/Compliance. Not too surprisingly, I'm having some trouble getting it approved. I was hoping that someone would be willing to share info about their facility. Are you AABB accredited? Bed number and services provided? Do you have an individual (or individuals) whose primary responsibility is QA/Compliance, or is it included with other duties? How many techs, senior techs, supervisors? I am the lone supervisor of an AABB accredited Transfusion Service at a 299 bed, urban, Level II trauma center and teaching hospital. There are 8 technologists in my department to cover 24/7. All of the QA/Compliance stuff is currently falling on my shoulders along with the regular supervisory duties. Any info would be appreciated.