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pbaker

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pbaker last won the day on June 13

pbaker had the most liked content!

About pbaker

  • Rank
    Member
  • Birthday 05/05/1960

Profile Information

  • Gender
    Female
  • Location
    Liberty, MO
  • Occupation
    Blood Bank Supervisor

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  1. I am curious regarding specimen collection when patient is in the OR. For those of you that have a phlebotomy team for the house, do you send someone to OR or does the OR staff collect specimens?
  2. We have the same set up for basically the same reason - a patient was transfused with no transfusion orders. However, blood bank only gets notification of the product order. Also, no specimen collection label will generate if only a transfuse order is placed. We had a case where a transfuse order was placed on one patient and a product order was placed for a patient with a VERY similar name on the same floor. RN came to pick up blood for the patient with the transfuse order and couldn't understand why we did not have it ready. "Patient was bleeding!!!!!" Our transfuse and product orders are going back to being linked together so you can't order one without the other.
  3. We very rarely transfuse neonates (like 3 times in the last 4 years). Because of the rarity, we no longer stock a quad unit. We have gotten approval to give the baby the freshest O= on the shelf until the quad unit can get here from the blood center. Here is my question for others like us. When you get an emergency request for blood for a neonate, do you take the time to aliquot for the nursery or do you issue the entire unit and let the nursery physicians aliquot what they need?
  4. Nursing orders to transfuse are just that - NURSING orders. The blood bank does the testing required for the product orders received and makes sure blood products are available and/or ready. If the RN/courier appears at the window to pick up a product and we have a valid product order, we will issue the product. It is very frustrating when the lab gets blamed when the nursing staff cannot follow/clarify a physician order.
  5. pbaker

    KB

    Hematology tried to move it to the blood bank and our medical director vetoed that!! She said it is a stain and stains are done in Heme!!
  6. 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
  7. We always require an ABO/Rh for each admission, just in case someone else is using that patient's information.
  8. 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.
  9. 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!
  10. Our pharmacy runs a daily report looking for Rh neg moms or diagnosis of preg/*** bleed to ensure RhIg was dispensed.
  11. 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
  12. 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.
  13. 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.
  14. We skip the screen and run a selected cell panel to rule out all other clinically significant antibodies.
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