Jump to content
May 2024 Challenge

adiescast

Members
 View Profile  See their activity

  • Posts

    1,038

  • Joined

  • Last visited

  • Days Won

    4

  • Country

    United States

 Content Type 

Everything posted by adiescast

  1. adiescast
    I would have to wonder whether this is the same patient. Does she report having been at your hospital in 2002 and 2004? What was the strength of your A typing? Any possibility she was a subgroup? Did she get transfused recently (possibly with type O blood)?
  2. adiescast
    The point is to check for new antibodies, not to reidentify the one you already know about, as gkloc says. I do usually include one cell for the known antibody (or separate cells for multiples) just to see which ones are still demonstrating. It may be overkill, but I don't like to report out "Anti-X present" on an antibody identification if I haven't demonstrated it currently.
  3. adiescast
    When you say "Do you document that you received the form back for every issued product and that it is completed accurately?" are you thinking about an audit to be sure that the form is produced accurately each time it is required? I do think we overkill on the documentation, but sometimes it is like pulling teeth to actually get people to produce the required forms, completed properly, at the required checkpoints. Having audit results that show whether they are complying or not can help spur them to actually do it.
  4. adiescast
    Learned from the master!
  5. adiescast
    Ah, so the "cross" came from doing both major and minor? Just wondered... "Match" is still appropriate to what the computer does before you issue the unit. "Issue" does not refer to matching the types and determining if the unit is acceptable for transfusion. How's that for pedantic?
  6. adiescast
    And you are very good at it! The term comes from the idea that the unit and the patient are matched by the computer and determined to be "compatible" blood types. Wherever did we come up with the term "crossmatch" to begin with?
  7. adiescast
    I wonder if the 24 hours was just intended to be a lead time recommendation, not a sample expiration recommendation. It would be good to have some lead time (when possible) to work up a sample with antibodies before they require the transfusion.
  8. adiescast
    We have a multidisciplinary committee. We have nurses, a perfusionist, doctors, myself, the hematology supervisor, the blood bank medical director, the lab director, the blood conservation coordinator, and someone from QA. We used to have someone from the blood center and I would like to do that again. It is hard to get the physicians to come. They didn't even come when we were feeding them.
  9. adiescast
    If you are using irradiation indicators, what type are you using, how do you perform quality control on them, and how do you document your quality control? Thanks!
  10. adiescast
    The Direct Coombs would only be useful if the mother had anti-D and the fetal cells were coated. The weak D test was determined to not be sensitive enough to detect the level of fetal-maternal bleed that could result in sensitization. The only methods that currently are able to detect that level of bleed are the fetal screen (rosette), the Kleihauer Betke, and the flow cytometry.
  11. adiescast
    I had the same experience in 2006. The form I have now is a variation on that form that no one ever used. We have electronic forms that the nursing staff can print out with the patient information already on it and they still don't use it. It is going to take the Med Exec Committee mandating it to get them to use it.
  12. adiescast
    Attached is the "pick up" slip I designed for sending blood in the tube system. I stole from many sources, so I won't try to give credit here... Our process is the floor sends the pick up slip through the tube. We send the blood and the slip to them (we use the secure feature in the tube system). They sign the slip and return it to us. If we don't get the signed slip back in 10 minutes, we call to find out what happened to the blood. This is a very new process for us and we are only using it in a very low volume area right now, so I won't make any claims about its success rate. Pick up forms 090110.xls
  13. adiescast
    We have a similar process to Deny's. Our emergency release form allows up to 12 unit numbers to be recorded on it. We do put the same bag tag and sticker on the unit as for a routine crossmatch, but we have a stamp for uncorssmatched and emergency released so that doesn't have to be written (or printed). If we can get the nurses to bring patient ID stickers, we use those instead of writing patient information on the tag. Anything that shortens the time it takes to get everything together!
  14. adiescast
    CAP required at some point that the medical director's name be on reports, but I don't think that ever encompassed unit tags. It is not currently in the Lab General Checklist (as of 6/17/2010).
  15. adiescast
    We transitioned to using the actual temperature of the unit for determining its suitability for re-use after return, but we did not change the nursing procedure. The nurses still use the 30 minute rule for returning blood. It was easier than trying to determine when the blood would exceed temperature for all areas of the hospital, doctor's offices, etc. We have a separate policy for the trauma bay. The trauma bay is kept at 96 F ambient temperature. We did a study and determined that it takes less than 7 minutes for a unit sitting on the counter in the trauma bay to exceed 10 C. We do not accept returned units from the trauma bay for reissue. We also require units to be transfused within 4 hours. We tell the nurses to start the transfusion as soon as possible after issue or return the blood to us until they are ready, but we do not have a policy for a required time frame to start the transfusion.
  16. adiescast
    FDA doesn't like refrigerators outside the blood bank either. They say you are not in control of the blood. When they saw our system, the FDA inspectors were impressed and felt that we did retain control. JC has never commented on our system in the several inspections we have had since its installation.
  17. adiescast
    No, my plant ops guys found the locks and the release buttons. They installed them and it works great! The release buttons even have a light that indicates when the door is open.
  18. adiescast
    The biggest problem with thawed plasma is that it is often warmer than 10 C when you issue it because it just came out of the thawer. So if you take the temperature on its return and it is > 10 C, what does that tell you if you don't know what temperature it was when it left the blood bank? This is not a question that I have resolved for myself. Our plasma is thawed and kept for 5 days, so it is usually at 1-6 before it leaves the blood bank. The temperature can be taken and is an accurate indicator of whether the temperature requirements have been exceeded. We do not take the temperature when recently thawed plasma leaves the blood bank. (We are usually throwing it out the door as fast as we can at that point!)
  19. adiescast
    Apparently our institution has had great success with requiring a form for insulin ordering from the Pharmacy, so my administrator expects the same level of success in mandating a form for ordering routine transfusion. We shall see if he is right. First we have to get the Med Exec Comm to "bless" it.
  20. adiescast
    Some people have procedures in place for converting the product to a 5 day product after the 24 hours is up. They may use it for tracking purposes. You are not required to relabel the product code of a thawed ffp with a 24 hour outdate.
  21. adiescast
    We currently use a pick up slip and require the nurses to check the transfusion order and consent and document on the transfusion record. We are preparing to require the physicians to use a transfusion order set that has check boxes for the reason for transfusion. We are hoping to capture a picture of appropriate use in this fashion. The form is designed so that it can be computerised when physician order entry is implemented (at some unstated VERY future time). Is anyone else using a system like this to capture appropriateness of use data?
  22. adiescast
    If you have a central monitoring system regularly logging the temperature, you are not required to have a chart recorder also. You do need to have a back up plan in case your central monitoring system is down. We plan to keep our charts because then no one has to remember to take 4 hour temperatures or run put a chart on equipment when the central system is down. On the other hand, the system is not down often, so you may prefer to avoid the expense of the charts and risk the staff forgetting the temperatures on the rare down occasions.
  23. adiescast
    My understanding is that if the label is in direct contact with the bag plastic, it must meet the FDA glue standards. Otherwise, it just has to work for your purpose.
  24. adiescast
    You could also install a magnetic lock on the refrigerator door that can only be opened by pressing a button in blood bank. It works well for us. They come get it in blood bank and take it to the refrigerator. They call us, identify themselves and the blood they are placing in the refrigerato, and we open the lock and document the time they placed it. When they want to use it, they call us, identify themselves and the patient, we push the button, and they read us the unit number(s) they are taking. They know their ability to have a refrigerator depends on following the system and that we do not do coolers if they lose their refrigerator privileges.
  25. adiescast
    You mean they aren't?
×
×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.