JClausen

When doing a documentation audit for blood administration, you might also consider the Joint Commission guidelines in determining how many to look at...the term "cases" below, could be applied to number of patients transfused or number of products transfused. My hospital QA department gave me the following TJC guideline for audits: The TJC recommendations state: For a population size of fewer than 30 cases, sample 100% of available cases For a population size of 30-100 cases, sample 30 cases For a population size of 101-500 cases, sample 50 cases For a population size of greater than 500 cases, sample 70 cases This is taken directly out of the HAS( Hospital Accreditation Standards manual) page 11 under sample size.

We have had problems with the newer IEC labeled cell washers leaving more saline on the cell button than we were seeing with the older equipment. (From Thermo, just labeled IEC instead of Sorval). We purchased 2 in 2008. We sent the first one back for replacement 2 times before getting one that had a little less saline left on the cell button. The second one was not ideal, but at least "matched" our 3rd one in saline retention. Unfortunately, this on was already on order before we determined the 1st one was not meeting our qualification. Like you, we are concerned about too much saline diluting the antihuman globulin. On extensive investigation by our biomedical technician, it was determined that the computer chip in this newer equipment is pre-programmed to do a 4 second decant cycle...the older equipment was programmed for 6 seconds. (from the Thermo/IEC service department). This most likely accounts for more saline being left on the cell button. The company seems unwilling and unable to fix this by sending properly programmed chips for replacement.

Thanks for the reference, I did not remember that there was information on pH testing methodology in that guidance.

Thanks for the response. I just heard from my local FDA contact and was told that the FDA did not allow use of pH strips...I have asked for documentation. In the meantime, we have decided to "appropriate" the old pH meter from chemistry and test in the BB.

We are a hospital based Donor Center and up until now, have had our monthly Q.C. testing for platelet apheresis product pH performed on equipment in the chemistry department. Last year a software update to the patient testing equipment resulted in not being able to result a pH when the value was close to the minimum 6.2 required. So, we reverted to the old pH meter method. At this time, this equipment is being taken out of service in the Chemistry department, as it is only used for us. We can move the equipment to the Blood Bank and QC our own products, and keep control material available, but for less than 20 tests per month, I am wondering if it is possible to use pH strips of some sort to do this testing. Are any of the donor centers on this forum using pH strips? If so, which strips and may I get a copy of your procedure? Does anyone use an I-Stat to do this Q.C. testing? Thanks

We recently purchased several new serologic cell washers. During validation testing, we have found that the cell button is not as "dry" as on our previous equipment from the same manufacturer (IEC). We are on our 3rd replacement of the new washer. The first one received had several drops of saline left on the cells which was absolutely unacceptable. This last replacement leaves a very small amount of saline on the red cell button, but is easily seen as different than our other washers. What is a good guideline for acceptability or definition of a good decant on the cell button?

Is anyone successfully using the Hematrax TCP/IP software with Meditech Client/Server to enable printing of modified component labels via Meditech? I need to ask some setup and implementation questions. We are on CS version 5.55 Thanks

Yes, the tubes are supposed to be crystal clear and yes the question relates to the testing, not collection. Well, I just received a batch of these tubes, and they are clear, but many scratches which I think can interfere with tibe reading and resuspension, but will try them out.

Does anyone have experience in the use of plastic tubes for ABORh, antibody screen, crossmatches, etc...or how to validate the change to a different tube? Thanks.

What will you be doing to satisfy the new CAP checklist item? We also do the PT testing, etc, but the new standard says to calibrate for the higher counts. We spoke with our Sysmex technical rep and were told that a calibrator in that range is not available any where. They also do not recommend calibrating with a higher count material as it could adversely affect our patient counts. I have sent this information to the CAP but have not yet heard from them. The issue is that the checklist item specifies "calibration" rather than linearity, PT testing, etc. We could use dilution to get the apheresis counts into the calibrated range, but it does not make sense to add error due to dilution if the system is linear at the higher counts. Thanks

What are facilities doing to meet the following checklist item? Can anyone recommend a source for calibration material? We are a hospital based donor service and our apheresis platelets are tested undiluted in the hematology department on a Sysmex. The Sysmex was shown to be linear for the undiluted apheresis product samples. Thanks TRM.44925 Phase I Are platelet counts on platelet components determined, when required, using a method that has been calibrated in the expected concentration range? NOTE: Automated whole blood hematology analyzers may yield inaccurate, non-linear results in the range of platelet counts encountered in platelet components (generally 1-2,000,000/μL). Predilution of samples from components, alone, may not avoid this problem. The entire method used for determining platelet concentrations in platelet components (including any manual manipulations in addition to the automated instrument's functions) should be calibrated periodically using a preparation of known concentration (such as provided commercially or determined through a reference method).

We are considering the installation of walk-in refrigerators for our blood inventory. Would like to hear from anyone with experience as to vendors of equipment for blood bank and pros/cons of going away from traditional blood storage equipment. Thanks.

We routinely print the list each month and take on all the drives. There will be an additional check in the computer when the donation is recorded.

Our healthcare system (multiple facilities) has adopted the Studer plan for excellence which includes the "pillars" of Quality, People, Service, Growth, & Cost...all major departments (for instance the entire Laboratory) are responsible for an indicator for each pillar. Each department within the lab has been asked to concentrate on the pillars for service and quality with a specific indicator that will tie in to employee performance appraisals. The reference is Quint Studer's book "Hardwiring Excellence" which is worth the "read". Quality was easy as we have indicators in place for Blood Bank....

I have been asked to come up with an indicator for the next year that would relate to "service" for the transfusion lab staff. The outcome is part of their annual performance appraisals. Other than customer surveys and turn-around-times, does anyone have an indicator they have used? Does anyone have a transfusion customer survey they would share?