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Auntie-D

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Everything posted by Auntie-D

  1. Does anyone know of a scanner that is good for scanning request forms (including the flimsy multi-copy ones)? And also software that will identify if two sheets are being taken through together and also direct the form to the patient record. I've used Dart in the past which was OK but I'm wondering if there is anything better out there?
  2. Does anyone have a calibration policy for equipment before I go off and write one from scratch? Sorry to be super cheeky...
  3. My two pennies worth... I did measurement of uncertainty on KB - 47%. Shocking sensitivity... We changed our policy that any foetal cells required follow up by flowm while we were addressing the issue. We solved it by requiring all staff to take part in each EQA session and following up any discrepancy of >10%. We also introduced scoring for our controls and required all staff to do a count before moving onto the patient ones. Any discrepancies in the control scoring or EQA resulted in retraining. What actually happened was that because staff were required to do an actual count, rather than an eyeball, for every kleihauer, they organically became more proficient. We also were able to identify the staff member who was counting lymphocytes as foetal cells... For anyone who is interested - there is a modified KB that I have developed (sadly I never published before leaving the labs) that has a counter stain for the white cells - makes the foetal cells ping
  4. Not for anyone Rh neg - the instance is only 1% of the population. My uncle isn't allowed to work in China as he has a high-risk job and is O-Neg Edit - The ranking of ABO blood groups phenotypic distribution in China is O > A > B > AB. The proportions of A, B, O and AB type in China population are 28.72%, 28.17%, 34.20%, and 8.91%, respectively.
  5. Hey - not all of us are like that. I operate a 'good enough' system, but one which means people aren't guessing and messing
  6. I think they're probably thinking down the TACO route - which is highly unlikely in an MHP situation. If TACO happens when the MHP is triggered, then it likely wasn't an MHP...
  7. I have issued 148 units of products to a guy who was cycle vs car massive haemorrhage - he survived. I have issues 120ish units on an obstetric massive haemorrhage (as well as 20 6-packs on the twins) - all 3 survived. I've issued similar on AAA (with eventual bypass) - survival. I think the key is to use TEG to see whether the clotting is screwed - if they are clotting then keep going... In the grand scheme of things blood is cheap
  8. Less is more - don't overcomplicate things
  9. Quality knobhead here - details are required on reports, not SOPs. ISO 15189 states that docuements need to have: a) All documents are identified to include: — a title; — a unique identifier on each page; — the date of the current edition and/or edition number; — page number to total number of pages (e.g. "Page 1 of 5," "Page 2 of 5,"); — authority for issue. Information for users (ie lab handbook) The laboratory shall have information available for patients and users of the laboratory services. The information shall include as appropriate: a) the location of the laboratory; b) types of clinical services offered by the laboratory including examinations referred to other laboratories; c) opening hours of the laboratory; d) the examinations offered by the laboratory including, as appropriate, information concerning samples required, primary sample volumes, special precautions, turnaround time, (which may also be provided in general categories or for groups of examinations), biological reference intervals, and clinical decision values; e) instructions for completion of the request form; f) instruction for preparation of the patient; g) instructions for patient-collected samples; h) instructions for transportation of samples, including any special handling needs; i) any requirements for patient consent (e.g. consent to disclose clinical information and family history to relevant healthcare professionals, where referral is needed); j) the laboratory’s criteria for accepting and rejecting samples; k) a list of factors known to significantly affect the performance of the examination or the interpretation of the results; I) availability of clinical advice on ordering of examinations and on interpretation of examination results; m) the laboratory’s policy on protection of personal information; n) the laboratory’s complaint procedure. o) The laboratory shall have information available for patients and users that includes an explanation of the clinical procedure to be performed to enable informed consent. Importance of provision of patient and family information, where relevant (e.g. for interpreting genetic examination results), shall be explained to the patient and user. Reports however need to include: a) a clear, unambiguous identification of the examination including, where appropriate, the examination procedure; b) the identification of the laboratory that issued the report; c) identification of all examinations that have been performed by a referral laboratory; d) patient identification and patient location on each page; e) name or other unique identifier of the requester and the requester’s contact details; f) date of primary sample collection (and time, when available and relevant to patient care); g) type of primary sample; h) measurement procedure, where appropriate; i) examination results reported in SI units, units traceable to SI units, or other applicable units; j) biological reference intervals, clinical decision values, or diagrams/nomograms supporting clinical decision values, where applicable; k) interpretation of results, where appropriate; l) other comments such as cautionary or explanatory notes (e.g. quality or adequacy of the primary sample which may have compromised the result, results/interpretations from referral laboratories, use of developmental procedure); m) identification of examinations undertaken as part of a research or development programme and for which no specific claims on measurement performance are available; n) identification of the person(s) reviewing the results and authorizing the release of the report (if not contained in the report, readily available when needed); o) date of the report, and time of release (if not contained in the report, readily available when needed); p) page number to total number of pages (e.g. “Page 1 of 5", "Page 2 of 5”, etc.). These are the basic ISO requirements - Other standards may require further info ie JACIE/CLIA
  10. We also wouldn't as we keep 6 packs for our NICU babies to reduce donor exposure (and also the amount of work needed for us when there are maternal antibodies) - Irradiation would mean we would need to recrossmatch every week
  11. That's a low cutoff (speaking as someone who is 45 and trying to conceive). Do you include the risk to future pregnancies in your consent? We only recently moved from 60+ to 50+ - having it at 45 may affect women who are late starting a family or starting a second family.
  12. Sorry I misunderstood. We would record them the same way as a rejected sample - there was a code for 'stored' that had been historically in there from when we used to do frozen G&S (shock horror) and it was repurposed.
  13. To split combined forname and surname into separate columns View File Does it drive you insane when CSV files generate lists of names that the forname and surname is in one cell (yes Q-Pulse I am shaming you!). Be annoyed no more - copy and paste into this and it will separate them for you Submitter Auntie-D Submitted 12/01/2022 Category Forms  
  14. Auntie-D

    To do list

    Post it notes getting out of hand, losing track of pages in your notebook? Organise your to-do lists in here. Can anyone work out how to remove the completed tasks without actually deleting them (so they count in the numbers)? The 7-day thing seems to include complete stuff too and I can't make it stop To Do List Template.xlsx
  15. Version 1.0.0

    2 downloads

    Does it drive you insane when CSV files generate lists of names that the forname and surname is in one cell (yes Q-Pulse I am shaming you!). Be annoyed no more - copy and paste into this and it will separate them for you
  16. The first question before switching should always be 'can the patient tolerate a low hb until D Neg become available?'. If the patient is in bed and asymptomatic having their hb a bit low for a while is probably the easier option. Give them iron and epo and let them make their own
  17. Irradiation is not required unless the neonate has been transfused in utero
  18. LIMS validation checklist - - that it won't let you issue ABO incompatible units - that it alerts you if you are issuing ABOD discrepant units - your antibody flags alterts - that it won't let you electronic issue if the patient has antibodies (it would issue as uncrossmatched not EI) - that it won't let you issue expired units - that it wont let you issue on one sample - that it wont let you issue on an expired sample Much of this may already be in place but will need revalidating specifically to the electronic issue process. If any of these fail, or are not possible on your system them you shouldn't electronically issue.
  19. I'm out of the lab now, but we wouldn't test them unless the current sample was going to expire in the next 24 hours and the Hb was low. We would record them on the system as a spare so we could use them if needed.
  20. It's a recommendation rather than a requirement but I don't envy you - I've been there!
  21. Ours are reviewed annually as some of the standards we work towards says 'Review shall not exceed 2 years' - and we all know how long it can take to get a document revised and approved. Our staff get issued with new revisions to acknowledge but are not required to re-acknowledge old ones unless there is an issue with competency. Any case where someone has a CAPA raised against them would be an automatic reissue of the SOP to read and acknowledge, regardless of the root cause.
  22. This is Shrodingers D - Treat the mum as if the baby is D+, treat the baby as if they are D-
  23. I worked in a lab where we had no access to AB plasma for nearly a year - everyone got group A plasma in emergency situations except under 18s
  24. I've come across a new one so I thought I would ask you kind people for advice. I am working for a company that generates fit-to-work certifcates. What is the minimum information that would be acceptable in a footer for the template? I'm tempted by just document number and version but is that actually enough?
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