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Teristella

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Everything posted by Teristella

  1. We have never done correlations between manufacturers. It's a qualitative test and we perform QC every time we use it, never had any issues with inspectors. Is there a certain standard you are looking at?
  2. We have used the Immucor Self-Cheks and their other products and enjoyed them. A rep let us try the Quotient competency kit (serum only) which I froze, and they've continued to react well about six months later. Some of them are pretty simple antibodies but you can always mix if you want multiples. I think they make one kit a month.
  3. Teristella

    TEG

    Haemonetics supplied us the codes, IIRC. The ones I found in the dictionary are 85347, 85384, 85576, and 85390 which are for R, K, MA and LY30 (angle is a derived value so I assume that is why there is no code for it). Did not build this myself, so I do not know specifics. If you do platelet mapping, our ADP and AA MA use 85576-91. Not sure about POC, we only have the TEG 5000.
  4. Well, in short, we do whatever we can to avoid sticking the patient a second time. If you can get your OR to go alone with it, a second sample the day of surgery would be great, but it sounds like you are shipping blood to other facilities. Would you really want to wait for a second sample before you ship the blood over, or would you be shipping the blood over on the condition that they get you a confirm tube? What would you then do if they don't match? In our case, we do not re-stick the patient the day of surgery (or floor patients, but that's another story) except in specific circumstances. Our policy is written to allow us to give 'universal' group blood products if a confirm is not drawn, as the whole point of the new standard is to prevent ABO mismatch due to misidentification... we get around it by saying that no one is getting anything but group O products without a confirm, and nothing but AB plasma. For the most part we may 'waste' 2 to 4 O pos units a week on patients who are other blood types, but the staff here are not particularly cooperative with us and it's a small price to pay for ease of workflow. Most patients are O pos or A pos so we do not really hesitate to set up a couple of O pos. In the event the patient is Rh negative we do try to get a confirm tube the day of surgery if blood products are requested. If they aren't, we don't bother confirming the patient. In any case, if the patient is continuing to use beyond the initially ordered products and we haven't confirmed, we generally bug the OR to get us some kind of sample. If the patient is bleeding more than they anticipate they usually are ordering TEG testing from us anyway so we just confirm off those tubes.
  5. We are trying to get away from tags too, but we have issues with compliance entering vitals etc. that we are trying to work through first. I made tags for downtime in Excel that allows techs to scan the product's barcodes to enter data; hopefully it will cut down on a lot of errors. There are two tags on half a page, one for us to keep and one for nursing to keep, and all the information is mirrored from one half to the other so it doesn't have to be typed twice. Our most recent downtime was almost 40 hours and keeping track of everything was a significant issue. Haven't had occasion to use the new tags yet, we'll see how they work.
  6. No personal experience, but our maximum blood orders for surgical procedures document suggests only a type and screen for both 'laryngectomy simple' and 'with radical neck' cases.
  7. 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.
  8. Are you going to be printing a copy? The temp data from those is pretty lengthy... our charts have stuck or been bumped out of calibration a few times and required printing it. We prefer the charts over paper.
  9. Our techs would go insane if they had to manually add crossmatches to the correct requisition. Seems like a lot of extra work with the way we do things here.
  10. Unfortunately I don't have dictionary access in our system. I've done a bit of work helping my supervisor but we were never really trained and figure a lot of things out by trial and error. I'd ask Dansket or goodchild perhaps, if you can't find it by poking around in TEST. I'd imagine this is a Product Group parameter, because Meditech should add the XM to whatever req it places the products on. If you wanted other orderable tests your providers use to also tack on to the most recent req, you'd have to change those individual test parameters too. There may also be a parameter in your type and screen profile limiting Meditech from adding tests to the specimen, so you might have to check there.
  11. We use Meditech and the units are automatically added to the most recent, current blood bank specimen. In this case it would be a current type and screen. We do not repeat type and screens if it is a new provider, as the provider is recorded in Meditech.
  12. That is what we do but we do not do anything special for women under a certain age. We do also confirm them first if they are O and getting plasma. EDIT: We do confirm them if possible, usually we are just grabbing a CBC from a different draw/phleb. We just do not go out of our way to get a second sample if they are O pos.
  13. Yes, we have been seeing this too. There are a couple of threads on this. Trying to get pre-treatment samples on patients who will be going on this drug has not been fun.
  14. I'm just tickled they're calling something 'least incompatible' when apparently they actually aren't the least incompatible. Wondering if we're missing something here.
  15. There should be an unsubscribe link at the bottom of it.
  16. Thanks, Cliff, for the Velcro idea! It took a few hours to get all the old labels off without alarming the poor fridge but I relabeled our shelves this week.
  17. That's how it is for us. We did a DAT, so does reference - we charge for one. We also were told we can't pass on STAT fees or other miscellaneous charges. We did finally manage to build a rare unit fee, since we get charged so much for that on occasion. Make sure you are charging for everything they do, at least as much as possible -- we commonly pass on a charge for elutions, adsorptions, chemical treatment of RBCs, red cell separation and molecular typing.
  18. Why? From my brief stint in components at a blood supplier, I remember leukoreduction methods being QC'd fairly well. Physicians should be pre-medicating patients and requesting irradiated blood as needed, not double filtering products to some unknown end. How do they even know it's doing anything qualitatively substantial?
  19. I guess I could answer the actual post! We, like Terri, tend to go with the flow, and most of it depends on staffing and workload. If we have time we'll screen for single antigens or multiples if the combo isn't too difficult. Of course we never screen for e and very, very rarely for c -- it takes about three hours for us to get antigen negative units so we would order those STAT if we needed and screen in the meantime if things were dire. We don't have stringent rules, sometimes I come in on Monday and cringe when I see techs ordered Fya neg, K neg units when it wasn't particularly busy. Maybe that's the former reference lab tech in me, I spent quite a few days doing antigen typing on donors for eight hours straight.
  20. I like this idea, but was wondering how you decide which to screen (essentially, do you pull from the 'middle' of the shelf expiration-wise) and if you segregate them afterward if they're negative, or just tag them? We use hang tags that aren't really visible if the units are on the shelf, but I don't like the idea of having another 'set' of units to worry about rotating weekly (we already rotate trauma units, liquid plasma, platelets, antigen negative units on hold, the list goes on!). Maybe we could tag these in a different manner...
  21. I, too, would be interested in any SBB material I can get my hands on... I'm not in a position to do a program now but I would really like to in the future.
  22. Ours has sections for the following: Accreditation Staffing - minimum staff available, on-call, etc. Testing Menu - including tests that can be sent to reference lab Turn Around Time -- refers to a different policy Critical Values Blood Suppliers - outlines what is available, how far away they are, etc. Blood Inventory - available and available upon special request Delays in Provision of Blood Products or Services - what might cause a delay, what we do if there is a delay in testing Transportation of Blood Products - outlines how we issue blood, includes info about coolers Blood Administration - refers to a housewide policy Consultation - how to contact blood bank for consultation with pathologist or our blood supplier's medical director.
  23. Yes, we use strips of foam sheeting that comes between the sleeves of glass tubes we get. It's about a quarter inch thick so I cut it in 1x3 strips or so and fold/roll them. After a while they loose their springy-ness so having it rolled helps. I like the thicker foam blocks better, but I haven't see anything in our lab packed with that stuff.
  24. At my previous job we had a CTM with an outside agency monitoring it; we tested one piece of equipment daily by manually bringing the probe out of temp, and did a different piece of equipment every day. Their initial response was to call the blood bank first so we logged their response time on a form. With all our storage locations each fridge, freezer, platelet rocker, etc had the sensor tested every four or five days if I remember correctly. At my current facility we don't have a CTM, although I wish we did.
  25. It just seems like if that is your argument, then you should be giving phenotypically matched units to all your patients. I do not see the difference from the position you seem to be making.
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