Pailloz

In a large urban hospital, I had a nurse franticly call and tell me she needed blood on a code and somone was coming forpatient : Betty Levin. We looked her up..no patient , no specimen, as we preped uncrossmatched for pickup, the nurse swore she had sent specimens. Look under Elizabeth, Liz, a variation of Spelling in so many ways.(of course she had not other identifiers) When nurse arrived: pickup slip stated BED 11 not Betty Levin!!! Since my name is Elizabeth I always got a kick out of that one!!

WHile we would love to keep to a less than 7 ot 10 day old protocol. It is just not possible with the inventory. Generally the NICU kids and Docs with keep the Dedicated donor after the 7th /10 day....no washing The Cardiac docs evaluate it on a case by case basis. Sone tinys can tolerate the K ...others can not. MD decides. With teh tiny SIcklers/Dialysis/Leukemias/ transplants etc. you can see why we couldnt keep the 7 day inventory rule. As for ISBT, alliquots are quite a challenge. and I agree with the posts clarifying that the parent bag ceases to exist and alliqouts can not be made after the 2nd generation (Aa or Ba) level, but must proceed to CO or DO...etc. Lastly, has any PEDS site addresses the complications of double product units like Single Donor Plats or Double Red cells that have the same ID #, going into the 1st or 2nd generation? Meaning have you define each alliqout AO BO Aa Ba etc for each antigoaculant and its particular "E" code.

Oh, yes the stand alone software....that must be approved thru the budget of most hopspitals thru the IT departments. IT departments that generally absolutely DO NOT WANT any stand alone software in the hospital when there is fully intergrated Sunquest promising the same capabilities FREE in a few months.... That sure did sound like the blues didn't it?

I do agree that 2nd draws are preferable to repeat testing on the initial specimen. Due to the tight volume restrictions placed on PEDS patients , it would be very difficult to force 2nd specimens from our patients. Any repeat collections must be approved by the MD prior. In the absence of 2nd specimens, ER/ trauma patients with no history all get O rbcs and AB ffp.

I was wondering if anyone is using any sort of standardized programs to collect data on the various internal events/varience/incidents/situations (whatever you call them) ? Most of this data is Blood Bank specific and internal: does not really fit into the hospitals definitions of risk events/incidents. Anyone heard of the MIDAS system? or is anyone using anything else to track and trend internal variences?

Do you allow staff to use unit identification stickers on manual logs or forms?? Has anyone heard of any citations or regs on this?

What an issue here at this hospital...no pun intended!! OR & Cardiac each have their own OR refrigerators. One is very compliant, the other is NOT. You guess which is which. One doesnt care about forms, locks, safet vue, whatever it takes to achieve compliant . The other is adamant againt all of them:we are causing them undo delay . Administration would like us to somehow keep both frigs open for issue but whatever I implement for one will be opposed by the other. I fear I am in for a compliance nightmare. One option would be to forget the frigs altogether and issue to coolers at time of OR but this option is not at all popular here since BB was deliberately redesigned and relocated to be smack in the middle of the 2 Main OR complexes primarily for easy blood availability 24/7.

Recently during an inspection process, the inspector was unsatisfied with our level of records/documentation of blood issued to the OR refrigerator. Our BB staff deliver to the OR site and OR staff have access to retrieve as needed. As I evaluate improving records of who and when the units were removed from the OR frig ,I am faced with some challenges. I am rather sure a great many folks still issue blood to OR site , correct? How have you addressed this documentation challenge? I am very reluctant to complicate documentation via manual logs of Refrig access for OR staff but this is one option. I will concede that issuing blood in coolers for specific cases is very appealing to me but will open up a political nightmare within my institution. BUT has anyone been challenged to the documentation of the cooler access? I mean... who goes in and out of the cooler is similar to who goes in and out of the Frig....right? I would love to hear ideas both in public forum and private email

I would have to evaluate the prior performance issues of that employee and evaluate your patient history check procedure. I agree this decision is VERY dependant on the computer system versus a manual system. If you had a computer system AND the tech blew pass repeated flags for "antigen not tested" & f"ull crossmatch not completed" AND there was documented evidence of prior poor technique by this tech then I may side with the manager. The tech is dangerous. IF, on the other hand, (as I beilieve) you have a manual CARD system & the tech just didn't find or SEE the Kell AND he was following routine procedure otherwise, I would do the root cause analysis with the tech as part of an educational development project. I may go so far as a documented verbal warning if that is HR's first step of deicipinary action. Sometimes those techs that make the mistakes can be the front line for turning around a weak system and developing a better one.....ie COMPUTER!!

Thank you to everyone who has given me valuable information. While my pathologist is clearly out there, the higher ups have listened to me in the absurdity of his request. In good part due to the feedback and emails you have provided her, i brought to them much data supporting my proposed of Wyndgate. Hopefully it will be approved on the 2006 buget!! thank you to all

Please do not laugh. After recently being shot down by finance for my bugeted proposal WYdgate system, my pathologist would like ME to BUILD a blood bank system on an excell or access frame. He is dead serious. After almost laughing in his face, and explaining the vast compexities that have to do with Blood Bank computer systems, he is still relentless. While I am flattered to know he thinks I am that smart, I need to get him some heavy duty CBEr, FDA, regulations, links,......ANYTHING. to explain what these system involve. ANd that this home grown idea is just not a reality. ANy idea would be greatly appreciated Right now we are still usualy manual record, logs, carbon paper, etc. and while this old fashion method is slow and tedious, I am truly afraid of what his imaginary:eek: Blood Bank system may look like. Elizabeth