Dansket

HFAP headquarters determined that we do meet the intent of the standard.  So no deficiency cited or on record.  Thanks for you replies!!

From experience let me tell you that staffing is much more of a justification for automation than numbers of tests.  A small rural hospital that is staffed with only one or two techs at a given time would find automation invaluable regardless of the number of type and screens they perform.  Automation can literally be life saving under short staffing situations and I'm referring to patient lives not staff!   

We use flowcharts if the electronic P/P is not available.

We use flowcharts if the electronic P/P is not available.

Sending a prelabeled tube for nursing to collect would make me really nervous

When performing tube testing, tubes are read for the presence/absence of agglutination.  Results of these observations are documented in computer/on paper.  Tubes are discarded.  At that point, what direct proof do you have that the tubes were graded correctly and results entered correctly in computer/on paper?
The only proof was in the contents of the test tube and it is gone!
When an audible alarm system is tested, the only proof is the brief sounding of the alarm and then it's gone too!
 

If you observe your chemistry, hematology and coagulation departments that use automation, you will commonly see that automated instruments have automated instruments as back-up.  Consider this as you move forward with automation.

We keep 4 A liquid plasma in rotation.  We got that approved with the Trauma Committee for emergency release as well as Massive Transfusion Protocol, citing several studies.  It's easier to keep on hand than AB liquid plasma.  Doctors can't order it, we just substitute it as necessary.  When the expiration date is close, we will use it on in or out patients as compatible units.

If you observe your chemistry, hematology and coagulation departments that use automation, you will commonly see that automated instruments have automated instruments as back-up.  Consider this as you move forward with automation.

If you observe your chemistry, hematology and coagulation departments that use automation, you will commonly see that automated instruments have automated instruments as back-up.  Consider this as you move forward with automation.

If you observe your chemistry, hematology and coagulation departments that use automation, you will commonly see that automated instruments have automated instruments as back-up.  Consider this as you move forward with automation.

We are less than 100 beds and have 2 ProVues,  We do not do any manual testing, gel or tube.  Transfuse 100-130 RBC/month.   ORTHO will be replacing the ProVue with the VISION in April 2015.

We had a custom report created by Iatrics for Meditech C/S 5.6x that prints the form that we attach to the unit for emergency release.  The program requires only 3 inputs, patient name, unit number and MD name.  This gets the RN out of blood bank as quickly as possible.  Then we made a second entry using the Meditech Emergency Release routine at our leisure.

Validated transport coolers for storage up to 24 hours.  Standard blood bank refrigerator with remote alarms.  Helmer has mobile blood bank refrigerator.  HemoSafe blood storage/issue refrigerator.  These are some of your options.

Validated transport coolers for storage up to 24 hours.  Standard blood bank refrigerator with remote alarms.  Helmer has mobile blood bank refrigerator.  HemoSafe blood storage/issue refrigerator.  These are some of your options.

If using a paper results entry system, then I would the same methodology for immediate-spin crossmatch as the ABO plasma grouping test.  If using a computer results entry system (properly configured), I would enter initial immediate-spin crossmatch results obtained without enhancement..  A properly configured computer system will not allow crossmatch of ABO incompatible rbc unit (regardless of whether or not electronic crossmatch is available)!
In my world, your patient would be electronically crossmatched after all required pretransfusion compatibility testing requirements had been met.  We see such patients routinely where the expected anti-A and/or anti-B is not detected in ABO Plasma grouping test done in gel.  To enhance detectability of the missing antibody, we do immediate-spin tube test with 3% A1 and/or B cells which resolves 80% of this type of ABO grouping discrepancy.

My bad,  I intended to state, "If the Weak D test is positive on a newborn, we report the patient to be Rh Positive, if the Weak D test is negative, we report the patient to be Rh Negative.

If using a paper results entry system, then I would the same methodology for immediate-spin crossmatch as the ABO plasma grouping test.  If using a computer results entry system (properly configured), I would enter initial immediate-spin crossmatch results obtained without enhancement..  A properly configured computer system will not allow crossmatch of ABO incompatible rbc unit (regardless of whether or not electronic crossmatch is available)!
In my world, your patient would be electronically crossmatched after all required pretransfusion compatibility testing requirements had been met.  We see such patients routinely where the expected anti-A and/or anti-B is not detected in ABO Plasma grouping test done in gel.  To enhance detectability of the missing antibody, we do immediate-spin tube test with 3% A1 and/or B cells which resolves 80% of this type of ABO grouping discrepancy.

They don't. Clinical staff enter orders for products, not associated testing; Meditech adds the product to the newest BB specimen that is not expired (if it's going to expire in a matter of an hour or so, I believe it always generates a new one).
Crossmatches are reflexed testing.

Are you sure?  A test name, a lot number and an expiration date is not much different than a test result!

amym1586,
Depending on your BBK computer system, you can create a polydat test that cannot be resulted without QC (make the QC results entry part of the test results entry).

Ah yes, but, being a pedant, these things are important to me!

Yes, quite right. ProVue uses manufactured reagent red blood cells for reverse grouping, antibody screen and antibody identification.  However, fresh cell suspension are made from each test sample.

We only stock anti-IgG cards.

I am fairly certain there is no requirement for a backup method. On the other hand, most blood bankers I know suffer from a level of paranoia that requires they have at least one back up method if not two or three.  I think determining the need for a back up method would balance on the size of your facility and how much of an impact your only method being down would have and how long being down would likely be.  My guess is that instead of an entirely different method you would be better served by have backup for any critical equipment like the centrifuge required for the gel technology.  
The other aspect of a back up method is it's use in working out problem patients.  Again, if you have a reference facility within a reasonable turn around time then you would probably be better served by utilizing their expertise instead of attempting to maintaining competency in multiple methods within your staff.  
Just my 2 cents worth.