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SMILLER

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Everything posted by SMILLER

  1. 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
  2. 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
  3. We still use it for certain patients -- like those who produce atypical antibodies and need to have a AHG crossmatch. Scott
  4. 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
  5. ! Thanks for the head's up! Scott
  6. 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
  7. Yay! But see CFR 493.1256 (d) (3) (ii) and get back to me on what you think that means. Scott
  8. Besides at the start and at 15 mins, we document every hour, at the end, and 1 hour post. Scott
  9. 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
  10. Ah! Then the MLTs are getting screwed, and the facility may be breaking the law!
  11. 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
  12. 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
  13. 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
  14. 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
  15. 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
  16. The FDA is one thing. But in the US, you have to also follow the CLIA regs. Your inspection agency must, at a minimum, satisfy those in their standards. See the CFR for QC, and review your inspection agency's' standards. You will see what I mean. Scott
  17. In the US, a MLS is the professional certification for a Medical laboratory Scientist. Besides a board exam, it first requires a B.S. in an accredited program. Is this what you mean? Scorr
  18. I don't think that is correct about dumbing down to manufacturer's recommendations. I believe the regs read that at a minimum, manufacturer's requirements for things like QC be followed. CLIA/JCAHO/CAP regulations are often much more strict than what a particular manufacturer may suggest for their product. If you choose to not run a pos and neg control, you better have a better reason than, "the manufacturer said it was OK." Scott
  19. We get a couple a year here. The difference is, for our records, as to whether to document it as a cold anti-M or a NSC. I just wondered what these are when they react as a M and the patient is M antigen positive. Some kind of auto-antibody I guess. Scott
  20. A recent thread about homo- and hetero-zygous expression of the M antigen reminded me of something I have wondered about... Why do so many Non Specific Cold antibodies, when tested with common antibody ID panels, "mimic" anti-M? Apparently there is some moiety present on RBCs that react with a NSC from patients that are often otherwise positive for the M antigen. Yet, the pattern ofr these looks like a M reacting antibody. These seem to be always only cold reacting (IgM), and not significant, but I just wondered what is going on here. Thanks, Scott
  21. If documentation of proper blood handling for transfusion is not appropriate, I am pretty sure that the inspectors will not care whether it's happening in the Blood Bank in the Lab or in OR. This is healthcare, after all, and this is my hospital. I do think it is worthwhile to try to correct deficiencies. It make seem like a sisyphean task at times, but one cannot just give up on this stuff just because we "are at the mercy of human beings". (We should all be used to that by now!) I do think that efforts should be concentrated on making things as simple as possible, not only for ourselves, but for those other humans in all the other departments that we work with everyday. I do think its worth the effort. Scott
  22. Generally during the same patient stay. Scott
  23. We do not have units in a fridge in OR (or anywhere else for that matter besides the BB). Our BB is just down the hall from OR, so our OR units are kept in the BB until needed for a specific patient Then they are issued in a cooler. Presumably the correct ID and read-back is done in the OR for each unit. Scott
  24. Hmmm. Here in Michigan, we are indeed doing negative controls for reverse cells (we just use albumin). We are FDA and JCAHO inspected. Scott
  25. That caveat is used for inpatients who have a continuous stay. We cannot take the patient's word for it if they have been away from our facility. However, we have an exception for pre-admit testing, which we will allow up to 10 days before the procedure IF the patient gives us info regarding pregnancy, transfusions and other hospital stays. Also, in a similar vein, we generally will not repeat an eluate on a positive DAT if it has been worked up recently and the strength has not changed. Scott
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