mrdth5

I’ve done some internal research and we haven’t had an analyzer retic flag we couldn’t clear in over five years. We have little to no sickle cell population in my area. With the complication in keeping staff competent- it may be more cost effective to send out a manual retic, if needed on these rare occasions.

We never had a problem with the API samples for the screen; we don’t do the quantitative testing.

We use a WBC simulator offered though Media Lab. It allows the techs to test their competency against a variety of different cell types against the experts. Once a diff is completed, the experts discuss each cell type and identify characteristics of why they called it XYZ cell. The techs love it and they can do it whenever they have down time. The website will let you try a demo version if you ask.

We have two Sysmex analyzers that offer the automated retic count so one is always the back-up to the other and we perform the analyzer to analyzer correlation twice per year. We are rarely performing manual retic counts except for surveys, so we’re having a tough time keeping the techs competent. I want to discontinue doing this test but the former Hem supervisor has convinced staff that it’s a CAP requirement to correlate the analyzers retic count against the manual method at least once per year. I am unable to locate such a requirement. We don’t verify other automated counts (WBC, RBC, etc.) against a manual method. I would love to hear form anyone else who has encountered this dilemma. Thank you.

Is a microwave thawer the quickest plasma thaw technology currently on the market? Is Tropitronics, Inc. the only vendor of this technology in the U.S.? Thank you.

Apparently the use of a buffy coat smear to detect malaria came from a 2011 study that was published in the Asian Pacific Journal of Tropical Biomedicine. I does state however that a larger and more complete study should be performed before implementing this into common practice. Here is the link if you’re interested. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609286/

There seems to be a lot of variation among local users and those on this forum regarding this issue. Some run the QC after each rgt change (same lot#), whereas others will use various versions of patient control or XbarM. I think I’ll keep our current practice until I have time to dig deeper into IQCP, which could change everything. We’ll see.

At our laboratory, we have a policy to run 2 levels of QC after each reagent change, even if it’s same lot number. I can see if it’s a new lot and Sysmex has provided documentation on that, but with every, same lot # change seems excessive to me. Does anyone else do this? Is this required by any accrediting agency? I’m a newbie Hematology supervisor so I’m looking at things with a fresh set of eyes, albeit a little rusty in Hem so I need the community help. Thanks for your response.

The CDC does have good information and makes no mention of using a buffy coat smear for malaria. I can't figure out why this was required in our procedure but I'll be talking to our pathologist about removing this step.

Is anyone using a buffy coat smear to confirm negative thick and thin smears for malaria and other parasites? I cannot find a reference to do this other than in our procedure.

This is very common with solid phase and from what I've read, gel as well. In our experience, it's almost always a "solid-phase antibody" or a strong cold. Seen many a cold antibody identified by the reference lab that was 3-4+ on Echo. Immucor does not agree but I have to go with the reference lab on these. I suggest that you and your medical director develop a workflow on how you want techs to handle these scenarios, either very conservative or liberal, institution variable. I did and it stopped all the off-shift confusion.

We have used it for over 2 years without a problem. We validate the temperature annually against a NIST thermometer and it has always matched.

I have several but my biggest issue right now is that I need to know if alpha/numerical MRN (patient IDs) can be data converted from my current BB LIS into SQ BB GUI when that time comes. We no longer use alpha/numerical MRNs, but several historical records have this type of MRN and include important transfusion data that needs to be retained. If this can be done, then my next question is: If/when a patient with a historical alpha/numerical MRN comes back and is registered with a new MRN, will we be able to merge these records? Any insight here is appreciated.

I would think so since the training for nurses is already much more than transporting.

Does anyone have recent experience with Sunquest GUI BB module? We’re heading in that direction (like it or not) and I’m concerned with the sales support, or lack thereof, in getting some of my questions answered. I’d love to get some recent feedback from users. Thank you.

Based on these responses, I’m working with nursing at the moment to draft a competency checklist for the transport of blood. Nursing is already doing an annual competency for the administration of blood, but they feel that this transport training could be done once at orientation with records retained. I’m torn on the frequency for this and the CAP standard does not guide us here. Is there a reference that can be cited to have this done annually?

Can you please share how you satisfy this portion of the requirement? Transporters of blood components and tissue should be trained and competent in prompt delivery. Do you maintain competency records for blood transporter personnel? If so, what frequency does you asses the competency? Once at orientation, yearly, etc. Thanks.

We've decided to pursue a "fake" MRN and DOB to retain the historically relevant information for those who are not deceased. We understand that the records are not completely reliable with only the patient’s name is many cases but we will error on the side of caution if this situation arises. We're already through the letter "C" in our card file! Thanks for the many great suggestions and encouragement.

I should start my mentioning that my hospital has been using a BB LIS since 1992, however we've also been duplicating our efforts by creating and maintaining a paper card file for each patient as well. Crazy, right? So all cards since 1992 are a duplicate of the data already stored in the LIS, so that’s easy to deal with. Even some of the pre-1992 cards can be manually entered in to the LIS ( a lot of work but not too bad-small hospital). Problem: It’s the pre-1992 cards which contain historically relevant transfusion information (antibodies, requirements, etc.) that I cannot enter manually into the LIS because the cards lack a medical record number and D.O.B. 30+ years ago the hospital used a patient name and wristbands as the identifiers. Has anyone had a similar experience with this dilemma and could offer some suggestions? I’d really like to not keep a separate file that techs would need to search. Thank you.

My local reference lab did not make a recommendation whether to give e negative units or not, rather they deferred to the blood bank medical director. The reference lab did mention during a phone conversation that transfusing e negative blood would greatly increase the risk of this patient developing an allo anti- E in the future which seems logical. My MD decided not to screen for e but give AHG compatible units, or least incompatible. I was wondering what others would give in this situation?

We use a manual process with designated O Negs that have the paperwork 90% pre-completed so the blood can be out the door rapidly (usually less than 5 minutes from initial phone call). We then use the paper to EI the blood in HCLL. The EI in HCLL took too long for our traumas.

At our last CAP inspection we were found deficient in this standard because our LIS has a limitation on the number of characters it can print on a specimen label. When the patient name exceeds this limit, the system prints a "+" sign to indicate there are more characters. Strictly speaking, this label would not match the requisition which contains the complete name. We require staff to look up the complete name and write in the missing characters on the label. This is messy and often gets missed. Please share how you deal with truncated patient names at your institution. Acceptable or not?

While this was not the answer I was hoping for, I thank you very much for this reply and pointing me in the direction of this document.

My blood supplier is telling me that if we divide red blood cells in an open system(aka not using a sterile docking device to attach a satellite bag), the Product Description code must change as well as the Division code. This is to reflect that the product is now OPEN supposedly. I cannot find any mention of this in the literature I've read and Mediware support tells me that dividing red blood cells is hard coded to change only the Division code. Is there anyone who can verify or disprove that the Product Description code must change if dividing red blood cells in an open system?