SMILLER

We have a communication log that we make notes on that sits in the center of the Lab near our schedule. Ideally a associate from the previous shift will go over what is on the log with the next shift. We usually have a half hour overlap between shifts tho. Scott

Now that I think of it, perhaps the pathologist is simply offering to help ID a particular cell (they are not really reviewing the entire CBC) that a tech has an issue with. In that case, as long as the patient is not identified, I see no problem--other than the universal precautions thing. Scott

We still use it for certain patients -- like those who produce atypical antibodies and need to have a AHG crossmatch. Scott

I agree with all the comment above. You should not be sending HIPPA protected info from a personal smart phone. And most labs ban smart phone use in the Lab due to universal precautions. Scott

! Thanks for the head's up! Scott

I am not sure about this, but just because the insert describes what a positive result looks like, I do not think that means they are trying to say the interpretation is necessarily positive. That's what your facilities' P&P is for, approved by your pathologist and based on whatever data you want to cite. Scott

Yay! But see CFR 493.1256 (d) (3) (ii) and get back to me on what you think that means. Scott

Besides at the start and at 15 mins, we document every hour, at the end, and 1 hour post. Scott

I agree. The check cells are not controls. They do not need to have a specific "semi-quantitative" result--they just need to have a positive reaction to show that the wash step was adequate and that AHG was added. In your procedure you should just indicate that you get some arbitrary positive reaction: 1+, 2+/MF--whatever. Just be sure you are not writing up something that disagrees with the manufacturer'e IFU. Scott

Ah! Then the MLTs are getting screwed, and the facility may be breaking the law!

I would agree with Mabel, above, where the point of the serial titres is to check if things are getting worse (as in a pregnancy). It seems like you would have to isolate it in all cases, including in the initial specimen, even if the titre is low. Otherwise, if on a subsequent specimen one does have a high enough titre to warrant "splitting" it out, you would have nothing to compare that specific antibodies titre to. We never have had to deal with anything like this so I also would be interested in what others are doing. Scott

I agree with John in his last post. Either MLTs are getting more credit (and pay) than they are due, or the MTs are getting screwed. Scott

On regular UAs here (NOT being used for C&S screening), we do micros about 1/3 of the time. The problem is with our UA/culture screens. We have to do a micro on each one to assess WBC and bacteria/yeast. So besides doing a lot of extra cultures, we do a lot of extra micros as well. This is our main problem (in my opinion) -- our screening protocol is too conservative. Next year we will be getting a Urisys or equivalent. Our protocols are going to have too change. Scott

I was wondering what protocols others are using for urine culture screening. Currently we have two ways to order a UA: Urinalysis, and Urinalysis w Screen for Culture. (We also have a straight urine C&S order -- we just do those without scrteening. If the latter is ordered, we look at the following from a UA: Esterase, Nitrite, and on microscopic: WBCs, and Yeast and/or bacteria. If any of these four things is positive or present, we do a C&S. If they are all negative, we cancel the C&S as "void per protocol". Almost all of our UA orders now are Urinalysis w Screen for Culture. The presence of bacteria (or something that looks like bacteria) causes the C&S to be done, We get a lot of negative urine C&S s with this system. Thanks,Scott

Any master's degree (including business and public health) is going to set you up for management and/or administrative positions, if that is where you want to end up. Scott