cthherbal

I just answered this question. My Score PASS  

Thanks for the interesting post. Are you part of a health system? Perhaps another blood bank supervisor could come assess you, or you could pay a private consultant to do so.

No need to wash. We run Cord Bloods on our Ortho Vision. Could it be contaminated saline, perhaps? I would repeat using freshly prepared bottle of saline.

Yes, cell saver.

We contract the service to an outside vendor, but we review their compliance reports at transfusion committee meetings quarterly. Very low usage here (4 collections in 2022 with no blood returned to patients).

Regardless of gender, we do a weak D tube test on any patient who test at 2+ or below with the Ortho gel anti-D. If patients are possible weak D, we will transfuse with Rh negative as a precaution.

I agree with the others who state to consider getting rid of the separate blood bank ID bands. We do not use these currently. We have Cerner LIS and Epic EMR. The nurses scan blood bags and patient armband at bedside when starting the transfusion. As an aside, we do bedside collection labeling in Epic. We do track Wrong Blood in Tube. When we first went live on Epic, those numbers increased, but once workflows were reinforced, the number is now very low. The one WBIT we had in 2021 is where someone found a way around the system I believe someone mentioned it above, "scan overrides". Problem detected in blood bank when confirmatory sample did not match original type and screen blood type. Luckily this person no longer works here. :)

Thanks, everyone. I wanted to validate it especially for 2nd/ 3rd shift staff when there is only 1 tech staffed in the blood bank. They could put on the segment, sample then do other things.

FDA approval came through last year.

no

Has anyone automated the immediate spin and the IgG crossmatch using the Ortho Vision?

Yes. Phlebotomists perform this procedure at our facility.

Personnel Licensure - ASCLS

We take temps using an infrared thermometer of one unit in each box and document in our LIS (Cerner). In my 6 years at this position we've only have had one issue where blood was outside the 1-10C requirement, and maybe one other time for platelets outside 20-24C.

Level-1 still states: Not for use in warming platelets, cryoprecipitate, or granulocytes

we bill CPT 86078 from AABB website: Billing for Blood and Transfusion Services- Frequently Asked Questions and Answers (aabb.org) Billing for Transfusion Reactions Question: What is the appropriate billing date for CPT code 86078 Blood Bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report? Answer: The date the transfusion reaction workup specimen(s) was collected should be the billed date of service. This includes all services performed in conjunction with the transfusion reaction regardless of date of completion. Reference 68 Fed. Reg. 74607, at 74611 (Dec. 24, 2003) Negotiated Rulemaking: Coverage and Administrative Policies for Clinical Diagnostic Laboratory Services

AABB 3.9 Information Systems The BB/TS shall have processes to support the implementation and modification of software, hardware, and databases relating to the requirements of these BB/TS Standards. Standard 5.1.1 applies. These processes shall include: 1. Risk analysis, training, validation, implementation, and evaluation of postimplementation performance. 2. System maintenance and operation. 3. Documentation written in language understandable to the user. 4. Display and verification of data before final acceptance, when data are added, or when data are amended. 5. Evaluation, authorization, and documentation of modifications to the system.

I did a swiss cheese diagram after the fatality in the US a few years ago to hit home what COULD happen. Attaching, feel free to tweak for your use. It speaks to just one of the reasons why we require the sample confirmatory sample, and probably the most important one, WBIT. Swiss cheese TX incompatible transfusions patient death1.pptx

We have the Ortho Vision which interfaces to our LIS, Cerner. Pretty reliable overall and only 1-2 service calls per year. We run type and screens, Cord bloods, Unit Confirmations, and Panels. We do see a few ? reactions every day where my staff are allowed to view the gel card and edit grades based on their eye view.

Hi, Sarah. What did you end up deciding? We have a Vision but don’t currently run titers on it. We use manual gel, and haven’t had any problems with proficiency testing.

We do not use SAGM in the US, but this is an article that talks about upper limit of hemolysis. https://www.ajts.org/article.asp?issn=0973-6247;year=2007;volume=1;issue=2;spage=47;epage=51;aulast=Sawant

Standard 8.2

Good day, all. From our monthly LIS reports (we use Cerner), I have just been tallying the data manually. # of O pos units transfused to non O pos patients (RBCs)/ total units transfused # of O neg units to non O neg patients (RBCs)/ total units transfused # of AB to non AB patients (plasma)/ total units transfused

Yes. Depending on how you have your system set up, it would require a serological crossmatch as opposed to electronic.

Yes, it’s required by my state, (NJ) to report.