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Dansket

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Everything posted by Dansket

  1. We use the ALBA-Q-Check QC vials. We add 40ul of ORTHO BioClone Anti-D to vial #4 to cause a positive DAT and a positive result in the Rh control test. See attached document of our daily QC results from ProVue. Our QC is designed to produce a positive and negative test result for each gel column in the A/B/D/R Monoclonal and Reverse Grouping card, the Anti-IgG Gel card, the A/B/D Monoclonal Grouping card, Buffered Gel card, SELECTOGEN, AFFIRMAGEN, MTS Diluent 2, and MTS Diluent 2+. We do all our testing in ProVue including Type and Screen, Donor Unit Confirmations, Cord Blood testing, Weak D testing and both IgG and Buffered gel crossmatching and Antibody Identification. ProVue Daily QC batch listing report.pdf
  2. This flowchart represents our requirements for handling blood components returned unused by Nursing. There are three (3) basic elements: 1) Appearance, 2)Temperature, and 3) Time out of storage. If the visual inspection of the component does not reveal any unusual observation(s) and the component is within acceptable temperature limits and the component has not be out of storage for more than 30 minutes then the blood component may be reissued for transfusion. 1. Blood component is discarded if the container is spiked or outlet port(s) opened (regardless of temperature or time out of storage). 2. Blood component is discarded if the container contents are abnormal in color or appearance (regardless of temperature or time out of storage). 3. Blood component is discarded if the temperature of the blood component has exceed acceptable limits (regardless of appearance or time out of storage). 4. Blood component is discarded if more than 30 minutes has elapsed since removal from storage (regardless of appearance, temperature or time out of storage). We do not issue in coolers. If any of the four (4) numbered statements above is/are true, component may not be reissued for transfusion and is immediately discarded into the biohazard trash. No exceptions. The BBK CLS who receives a returned unit is required to complete this form and use a colored highlighter to trace his/her pathway from the starting point to a termination point. The completed form is reviewed by the supervisor and filed. My understanding of the "30-minute" rule is that the temperature of component is ignored if the component has been out of storage for less than 30 minutes. We do not ignore temperature. There was an article in the AABB News several years ago that debunked the "30-minute" rule. We borrowed our 30 minute time limit out of storage from the old rule, but did not validate. We assume that a blood component returned unused with a normal appearance, within temperature and within 30 minutes of issue may be reasonably returned to storage for reissue. This process is intended to limit the number of decisions required to be made by a generalist.
  3. The labels are standard address labels from Avery and we did do our own validation.
  4. Vial is labeled with a barcoded label that is readable by ProVue.
  5. We have been doing Weak D testing on ProVue for over 10 years using ORTHO BioClone Anti-D (vialed liquid antiserum).
  6. Did you attend ORTHO's very first ProVue training session?
  7. The was a white paper written by John Judd many years ago regarding 2 versus 3 cell screens. In this study, he observed that technique (tube testing) was a far greater variable affecting test tube reaction strength than the number of cells in the antibody screen. Since 3 cell screens are configured with more double-dose cells than 2-cell screens, it might mitigate the weaker reactions found by some individuals.
  8. 3-cell screen might mitigate the poor technique of non-blood bankers who do tube testing, but not necessary for manual or automated gel testing. All our testing is done on ProVue with 2-cell screen.
  9. I'm not understanding how performing an antibody screen determines whether or not "the woman is not known to be actively immunized to the D antigen" meets the AABB requirement. If I understand correctly you perform and antibody screen and do antibody identification, and if anti-D is identified (in the absence of a record of recent RhIG injection) you ignore that finding and give RhoGAM. In our process, we do an Rh type only and if patient is Rh negative and in the absence of a record of recent RhIG injection, we issue RhoGAM. So for this hypothetical patient, we both come the same conclusion and issue RhoGAM.
  10. Blood issue cause and effect rev.pdf View File Meditech C/S ver. 5.67 offers three different blood issue routines, Emergency Release, Issue by Specimen and Issue by Patient. This fishbone diagram shows how we use the Issue by Patient routine with three barcoded documents: Blood component container label, Request for Blood Component form (presented by Nursing) and Report of Blood Transfusion form (attached to blood container). Submitter Dansket Submitted 03/23/2017 Category Educational Materials
  11. If a positive antibody screen is detected per your protocol and anti-D is identified in the "pre-partum" blood sample, how do you determine if the anti-D identified represents "active immunization to the D antigen" or "passive immunization due to a recent RhIg injection" in the absence of any record of recent RhIg injection. I'm not aware of any serological test that all experts agree will definitively differentiate between active and passive immunization in all situations. If there is such a publication I would like the reference. Malcolm please advise.
  12. Do all feel that performing/charging for an ABO type on the mother as part of an antepartum or postpartum RhoGAM work-up is pertinent information and justifiable?
  13. Version 1.0.0

    52 downloads

    Meditech C/S ver. 5.67 offers three different blood issue routines, Emergency Release, Issue by Specimen and Issue by Patient. This fishbone diagram shows how we use the Issue by Patient routine with three barcoded documents: Blood component container label, Request for Blood Component form (presented by Nursing) and Report of Blood Transfusion form (attached to blood container).
  14. AABB Standards only apply to AABB accredited facilities. Is there a standardized protocol provided by the AABB to determine whether or not a woman is actively immunized to the D antigen then anti-D is identified in her blood sample?
  15. We don't require an antibody screen test result prior to or after issuing RhoGAM.
  16. We don't perform an antibody screen for either the Antepartum RhoGAM protocol or the Postpartum RhoGAM protocol. We don't issue RhoGAM without an Rh type done on a current blood sample for either protocol.
  17. Blood returned unused.pdf View File This flow chart represents our SOP for handling blood components issued to Nursing but returned unused Submitter Dansket Submitted 03/19/2017 Category SOPs
  18. Version 1.0.0

    58 downloads

    This flow chart represents our SOP for handling blood components issued to Nursing but returned unused
  19. Our cord blood samples are collected in red tops. They arrive in BBK usually with one giant clot. We remove the clot, centrifuge and test on ProVue. We stopped using EDTA samples because they usually had numerous small clots that were very time consuming to remove.
  20. The Report of Blood Transfusion form (with detachable labels) is printed immediately after crossmatch results entry. Blood components (Report of Blood Transfusion form is attached prior to storage) are retrieved from storage when RN arrives with Request for Blood Component form.
  21. We stick a label on the donor tubing (permanent) and also attach the form (temporary) from which the label was detached.
  22. I would change the process. I don't see any reason to leave any refrigerator door opened for an extended period of time (over one minute) to the extent it causes an over-temp in the storage unit. Load the shipment into the refrigerator in batches so that it can recover between each batch.
  23. Try www.helmerinc.com. They have solutions for both refrigerator and freezer.
  24. What automation platform do you use? ProVue What LIS? Meditech C/S version 5.67 Do you use middleware? No, ProVue is not interfaced to Meditech Do you use positive patient identification? Yes, Typenex Blood Recipient Identification System To get a second blood group, by retesting the sample (i.e. PPI) do you: Generate a new specimen number and re-label or aliquot? No, a new specimen number is generated and a new blood sample is collected if original blood sample was agglutinated by anti-A,B (manual tube test). Generate new tests for the same specimen number. If so, will the analyzer retest that same sample with the new tests and generate a second ABO/Rh? No Do you use history from another site (like Clinical Connect here in Southern Ontario or other Electronic Health Record) as a historical result? No If so, have you created a new test that your LIS will use as a second group to use for Computer XM? Yes, depending on results of testing with anti-A,B, CONFIRM or CONFIRMO. Do all your samples expire after 96 hours? Or do you have a pre-op policy that allows for more time as long as the patient has not been transfused/pregnant. We have a 28 day policy. All samples expire at 2359 on the third calendar day (day sample collected counted as day zero) Any other brilliant ideas or thoughts? By retesting the same blood sample, you won't detect specimen collection errors.
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