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Posts posted by JoyDenver
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Would anyone be willing to share their procedure for performing periodic BB frig alarm checks with the TempTrak monitoring system? I am the new Lab director at facilities that uses this system and we currently do not have an actual procedure for performing these checks. It is my understanding that you cannot effectively cool or heat the sensor to activate the alarm like you would for a traditional manual alarm check. Thanks
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I told the lab just that and they will immediately implement using a fetal screen for their ONeg moms with Rh Pos babies. It's always a good feeling that I can come into a small rural hospital to educate them on their BB practices to better serve their community. I feel I've done my job as a COLA Accreditation Surveyor!
- tricore, AMcCord and Malcolm Needs
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As a COLA Surveyor I inspect many small rural hospital Blood Banks and I have never run across a procedure like this: "If the post-partum Rh test on the mother is mixed fieldpositive, a sample of the mother's blood is sent to the reference lab at the blood center for quantiation of the FMH by KB stain". The Lab uses Ortho gel for their ABORh testing. I have always thought routine Anti-D reagents are not manufactured for this purpose (detecting FMH) and a Fetal Screen must be performed because the Anti-D in the FS kit is modified and FDA approved to detect smaller quantities of fetal blood that may be in Mom's circulation. What is the best explaination I can give this Lab to convince them their paractice may be unsafe.
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In all my years performing lab inspections, I never really thought of this...
Most labs will QC their MTS IgG cards using the IAT method (QC serum w/ antibodies and screening cells) of course, but I don't see labs performing QC with the direct AHG method using IgG coated cells. And, of course the maunfacturer's instructions are vague. What are others doing and how have other accreditation agencies (I'm with COLA) interpreted the QC requirements for the IgG cards for indirect and direct AHG testing?
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I'm a cola surveyor and their BB specialist. You determine the acceptable range of your refrigerator as 1-6C but if you store reagents in the same frig as your blood products, then the range must be 2-6C in order to have a range that is acceptable to everything that is stored in the frig.
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Since many of the newer refrigerators have an elecronic alarm check system that simulates the temperature change, does anyone still do the manual checks with cold and warm water? Does AABB and CAP accept the simulated alarm checks? It is my understanding that the simulated checks will not record the temp changes on the chart; is this right? and is that a problem with inspectors? I am a Surveyor with COLA and I am in the process of revising our criteria for Transfusion Services. Out in the field I still have my clients perform the manual checks at least quarterly. Am I being too harsh?
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I'd like to RSVP
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I'm a surveyor for COLA and Transfusion service facilitator and have been given the task to revise our criteria. I would like to be sure COLA is up to date with AABB and CAP so if there is a spreadsheet out there ( I know there is) I won't have to reinvent the wheel.
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Does anyone have a chart or spread sheet that compares the regulatory criteria for FDA, CAP, AABB, TJC they would be willing to share. Or if anyone knows a good place to look...Thanks
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Other than Bonfils (who I know are not hiring right now) University of Co Hospital and Children's Hospital uses only dedicated BBer's. There are also two hospitals that have openings for BB supervisors Lutheran Med center and Aurora Med center.
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Even though the CA Surveyor position is filled, keep trying...there are always openings since COLA is expanding their Surveyor base
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In our lab we have some areas, like Micro, that use the LIS in this way to record proficiency results. Mostly we do not bother, as we already have to enter it online to submit results, and adding the step of ordering faux tests and resulting them on the LIS is redundant. Why do you feel a need to use the LIS at all?
Scott
As a COLA Surveyor, I always recommend the Blood Banks I inspect to create Proficiency testing patient files and rbc files into their LIS so that it can be used as a very comprehensive competency assessment. Not only are you assessing the performance of the test, but computer entry skills.
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My first guess is that the dad is not the father
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Another reason to go back to tubes for ABORh is time. I never thought taking 10-15 min to do a blood type was very efficient, and the sensitivity is not sacrified.
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If you have a series of mistakes do you record each mistake in the process separately or do you treat them all as one event. Let's say someone omits entering a BB armband # in the BBIS. Someone else crossmatches the units for a remote site. Someone at the remote site tags the units. Then someone else issues them. No one catches the missing band number. Is this tracked as one error or 4? My error tracking system includes an estimate of how likely the problem is to recur and I find that I would give different estimates for different mistakes in the event. I find the likelihood measure useful in assessing risk but I don't really want to look at only how often all of the mistakes would line up together again. I use a homemade system so I can change it all I want.
The first two occurrences happened at your facility the other 2 at the remote location. So your QA incident accessment should only track those errors
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I agree that you do not want to irradiate twice, but why discard the unit? Please consider transfusing it to a patient who does not require irradiated products.
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As long as you have a policy/procedure in place that ensures the appripriate dispense of RhIg it doesn't matter which department controls the product. Absolutely the BB has the expertise in determining the quantity appropriate that a pharmacy doesn't have. Some places will send the RhIg workup to the BB who then relays the calculated dose to both the care givers and the Pharm for the Pharm to dipense, but you run the risk of missing doses, especially in the outpatient setting unless you have an effective hospital wide IS system that is effective in communicating to all departments. I have seen too many cases of HDN resulting in very expensive care because of this.
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Terri, We will also be imlementing Epic HIS. I would be interested in yor progess and how it is working.
We are not due to convert for 3 years, but any issues that come up for other users would be gratfully appreciated.
Joy
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We were notified of a lot recall due to particulate matter in the indicator cells. Immucor is busy restructuring their QA dept. so it will be interesting to see if they come up with a different reason for the false pos's with their FS kit.
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CAP website has webbased compentencies and you have the ability to customize your competencies on the site.
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Our Donor Center is about a 7min walk from the Transfusion Service and I am validating new coleman coolers to transport the components from the Donor Center to the Tranfusion Service. Once products are transported the Transfusion Service, staff can't always unpack and place the products in permanent storage right away so I'm vallidating the coolers for a max of 6 hrs.
My question is: Is there a standand out there or any reference as to how much dry ice to use to keep the temp of frozen plasma <-18c? the maximum number of FFP that will easily fit in my cooler is 20. Can I use a specified amout of dry ice no matter what the quantity of FFP? or do I specify: "use 1 lb of dry ice for greater than 10 units and 1/2 lb for coolers with less than 10 units...." I want to keep this simple.
Any thoughts?
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We have just implemented our Echo last week. What I have observed with D teating on the Echo is the Series 4 will be negative and the Series 5 positive. I wonder if this is an indication of Partial D. We use Series 4 in our tube testing through weak D to confirm, but interpret on an individual basis (calling the Patient D neg and the Donor D pos). The Echo REALLY likes to find RhIg. Even if we repeat a screen or panel with PEG, the tube method is neg; we report the ab screen as neg in these cases. It's hard to convice our bench techs to love the Echo with these quirks just yet
(they, like most other Blood Bankers expect perfection) but, it won't take long for them to realize that the sensitivity is better than our manual method, and the bigger point, our manual teating will be reduced significantly reducing stress in our busy blood bank.
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We are validating our new Echo and are having trouble with the bidirectional interface to/from Cerner Classic. Patient information goes across, but test information does not. We're thinking our problem has to do with Echo's use of lower case letters and Cerner use of all capital letters. Is there anyone out there that has their interfaces working properly and willing to share?
Thanks
Thanks
Retired MLS SBB looking for remote opportunities
in Introductions
Posted
I am a recently retired Lab Manager, former COLA Surveyor, and Transfusion Specialist in Denver, CO. Ready to get back into the workforce in a remote capacity. I have extensive experience with various LIS vendors most recently with Softlab. If anyone has any leads or suggestions, I deeply appreciate it.