pbaker

We have found it helpful to find historic antibodies that are no longer detectable.  We honor them no matter who ID'd them, thus preventing a potential delayed transfusion reaction.

The blood center that we use has an antibody registry.  Any hospital they service can enter patient antibodies found along with any other pertinent information regarding the workup.  When we receive an order in the BB, we always check our internal patient history and the blood center history.  It has been helpful many, many times.

We are going to change next week to doing "selected cell panels" on patients with previous antibodies.  I don't care if the antibody is still there, since we will honor it regardless of reactivity.  I just want to know if there is anything "new".  Why would I want to run an entire panel when I could do the same thing with 3 or 4 cells?

We are going to change next week to doing "selected cell panels" on patients with previous antibodies.  I don't care if the antibody is still there, since we will honor it regardless of reactivity.  I just want to know if there is anything "new".  Why would I want to run an entire panel when I could do the same thing with 3 or 4 cells?

We are going to change next week to doing "selected cell panels" on patients with previous antibodies.  I don't care if the antibody is still there, since we will honor it regardless of reactivity.  I just want to know if there is anything "new".  Why would I want to run an entire panel when I could do the same thing with 3 or 4 cells?

When we pooled them together, we changed the date to 24 hours.  We also lost the ability to return them to the supplier if they ended up not getting transfused.
 
We no longer pool them together.

jlmoses - We just had to stick a patient for the third time because the nursing staff does not follow policy.  The first time they forgot to document the 2nd employee identifying the patient.  The second time both identifying employees failed to notice that the patient did not get armbanded.  Hopefully, the third time is a charm.  I would be very careful about relying strictly on following of policy for patient safety.

B with parentheses makes a sunglasses smiley face. 

When we pooled them together, we changed the date to 24 hours.  We also lost the ability to return them to the supplier if they ended up not getting transfused.
 
We no longer pool them together.

We also use the same reagents.
If collected during the same admission, we do not allow the person who collected the original specimen to collect the second confirmation specimen.  This is to encourage positive patient identification instead of just saying, "I was just here, I know who you are".

BM/PBSC transplant candidate or recipient
 
The nursing staff asks the patient at admission assessment.  If yes, a notification prints in the blood bank.  If ordered by a physician, we clarify the reason.
 
I once had an ER doc order CMVN Irradiated because he "didn't want his patient to get anything".  When I explained the real reason for the product, he changed his mind.

BM/PBSC transplant candidate or recipient
 
The nursing staff asks the patient at admission assessment.  If yes, a notification prints in the blood bank.  If ordered by a physician, we clarify the reason.
 
I once had an ER doc order CMVN Irradiated because he "didn't want his patient to get anything".  When I explained the real reason for the product, he changed his mind.

We also use the 3 and 3 rule.
 
Don't we rule out on single homozygous cells all the time when the screen is negative???

Did the patient get a stem cell/bone marrow transplant?

Did the patient get a stem cell/bone marrow transplant?

Did the patient get a stem cell/bone marrow transplant?

Did the patient get a stem cell/bone marrow transplant?

We don't do weak D on adults, so all Rh neg moms (with pos babies) get Rhogam.

We do not thaw anything until they submit a request for delivery, meaning they are ready to actually transfuse and then thaw group specific.  We waste very little.

If the antigen testing is actually performed by the blood center, we do NOT repeat the testing.  They mostly send us "historically" typed units which we then reconfirm at our institution.

The state of Illinois mandates an OB Hemorrhage protocol.  Our hospital is still working on an actual "massive transfusion protocol".

All of our blood products are leuko-reduced. We give CMV seronegative to BM/SC transplant patients until we know their CMV status. If they are CMV +, they no longer get tested units.
We don't usually transfuse neonates (we transfer them out), but if we ever had to, we would get CMV seronegative from the blood center (if the physician can wait)
If we get an order from the physician, we do question it. We have found many physicians don't have a clue as to why to give CMVN products.
I had an ER physician order CMVN/Irradiated for his patient. When I explained which patients truly need those products, he said never mind. He was just trying to prevent the patient from "getting anything".