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pbaker last won the day on June 13

pbaker had the most liked content!

About pbaker

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  • Birthday 05/05/1960

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    Liberty, MO
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    Blood Bank Supervisor

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  1. When physicians are required to sign for high-risk transfusion (ex. presence of warm auto and no compatible product), what frequency of signature do you require? 1. Signature with each transfusion order 2. Signature once for length of specimen 3. Signature once for length of admission
  2. We always require an ABO/Rh for each admission, just in case someone else is using that patient's information.
  3. What is your process for issuing blood to patients in OR? Are there any special "exemptions" when the surgeon feels this is an emergent need? Do you require patient ID when issuing products? What patient information is required? We are being told that we are "killing the patient" because we have so many rules. Just gathering information from other institutions.
  4. We have a semi-electronic method for documentation of transfusion on the nursing side. I have been auditing every unit transfused since we went live in August of 2016. The electronic documentation is complete only about 80-85% of the time. (OR and MTP are still on paper) We have "dumb" bar code scanners and they sometimes scan the product code, ABO/Rh or expiration date instead of the unit number. They forget to enter the completion time or final volume. They often document two separate units under 1 unit number, sometimes days apart. I have submitted all of the AABB, CAP and JCAHO regulatory requirements for medical record documentation and my director is totally on my side. However, we are getting pushback from upper management stating that they should be able to go back and fix any error or that 80% compliance should be acceptable. Are there any other regulations that could force them to comply? I am very frustrated!
  5. Our pharmacy runs a daily report looking for Rh neg moms or diagnosis of preg/*** bleed to ensure RhIg was dispensed.
  6. We keep two years in the department. At the end of every year we go through our file cabinet and if we haven't seen the patient in the previous 2 years, their file is pulled and put into long term storage. We discard after 10 years. The actual history stays with the patient in the computer forever
  7. We do not read back every unit at time of issue for traumas, emergency issue. We do insist that they bring something printed with the patient name (real or made up trauma) and the medical record number. We match that to the paperwork that goes with the units in the cooler and hand them the cooler. They are still required to perform the bedside check and the time of transfusion.
  8. I have seen uncrossmatched be able to wait for crossmatched. It is amazing how the need becomes much less urgent when they have to put their name on something.
  9. We skip the screen and run a selected cell panel to rule out all other clinically significant antibodies.
  10. We keep them until the monthly invoice comes and then they are discarded. All documentation of unit receipt and final disposition is in the computer system.
  11. Our computer system is set to search for a historic type. If there is none, it will automatically order a confirmation type once the first specimen is received. 1. A type and screen is collected at the preop visit, mainly to prevent any surprise antibodies day of surgery. Another type and screen is collected day of surgery that we transfuse from. This also will count as their 2nd specimen. If, for some reason, no blood bank was collected at preop visit and they have no history, a second specimen will need to be collected day of surgery. We send them the label after it prints in the BB. 2. Outpatients are always coming back to be transfused so, if necessary, we collect the second specimen the day they return. 3/4. The second specimen has to be collected by a different person than drew the type and screen. This can be phleb or RN. They shouldn't even know they need a confirmation until the first specimen arrives to prevent them collecting them both at the same time.
  12. We use employee ID number that is then entered into the system when the specimen is received.
  13. One of the advantages of double red cells is giving them both to the same patient to reduce donor exposure.
  14. I am going to resurrect this topic from several years ago. We only do cord workups for O and/or Rh= moms. We had an AB+ mom with an Anti-K and the discussion came up whether we should request the floor order a workup. They did and the cord blood DAT was negative. Had it been positive, our current policy would be to perform an elution. We got to discussing WHY since we would predict what was on the baby cells and are pretty sure no treatment would change regardless of the eluate results. Back in 2006, it looks like eluates on cord blood was about 50/50 from those who responded. Just wanted to see if that still holds true or if more have done away with unnecessary elutions.
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