kirkaw
Content Type
Store
Profiles
Forums
Blogs
Events
Frequently Asked Questions
Gallery
Downloads
Glossary
Links Directory
Questions
Jobs
Vendors
Everything posted by kirkaw
-
YAASSSSS! Dr. Issitt said that to me many times when I worked under his direction at Duke.
-
Greetings! After >10 years, we are updating our transfusion guidelines. (YAY!). Does anyone have a bibliography that they'd be willing to share, of articles from journals from specific medical disciplines, that advocate restrictive transfusion therapy? I'm looking for some kind of updated data akin to the TRICC trials. I think there have been recommendations from professional organizations such as anesthesia, critical care, cardiovascular and neurosugery, but I don't have the resources to do a full literature search. If you have ANY literature citations handy, I would be SO grateful for the input.
-
I would say, no because you have to verify electronic crossmatch per site. (This is according to Joint Commission.) I would also be wary of allowing them to store blood products there. You would certainly have to ensure appropriate monitoring.
-
This small hospital has been acquired by my hospital system. Would we still need a contract if they are part of the same hospital organization? Thanks.
-
I have learned that the small hospital we acquired has it's own CLIA number, so I am wondering how that will affect our decision. They are not going to have an ER but will be doing minor procedures. In envision the facility being much like a surgical center. And I know for a fact, that the other surgical center in our community does not have a blood bank/transfusion service.
-
Scott, Which Joint Commission Standards are you referring to and which CLIA regs? Thanks, Amelia
-
I love what I bought from ThermoScientific.
-
Greetings, We have acquired a very small hospital for which there will be limited services. The VP wants to terminate their full service transfusion service and only offer either 1) units for emergency release or 2) do all the pre-transfusion testing (including crossmatching) at our hospital and then transport crossmatched units to the smaller site or 3) both. I am curious to hear if any others have dealt with any of these scenarios and if so, point me towards the regulatory requirements for such a set-up. Thanks, Amelia
-
I have 2 related questions to this topic: Does anyone use and automated cooler validation kit, such as the Val-A-Sure kit? If so, how do you like it? How frequently do you validate your coolers? As an aside, we have deemed our coolers 'blood storage', as blood is likely to sit in them for hours in the OR without going anywhere. That seems more 'storage' than 'transport' to me.
-
Do you document the unit's temp when it is returned or is it assumed that if you indicate the the visual inspection is OK (or whatever 'check' your computer system requires) that the temp is <10?
-
I'd like to know how many people are using temp indicator devices on their blood units. We are currently using the HemoTemp II stickers on units that are put in coolers for the OR, but for all other 'routine' transfusions, we just have the '30 min rule', meaning that blood can only be out of the blood bank for 30 min. I have been approached by multiple vendors lately regarding temperature monitoring devices that attache to units, namely Saf-T-Vue and Blood Temp 10. What are people's experience with any of these devices? Do you apply them to all (blood) units or only those that are in a blood transport container like a cooler? Thanks.
-
Goodchild, we keep all the same reagents that you do except the Resolve panel C. Do you do adsorptions? We have a lot of warm-auto patients and that is the one thing we consistently have to send out. We keep an EGA kit too.
-
I like your thinking David. How long ago did you work at the smaller facility where you did all your own serology? I too, worked in a hospital where we did all that stuff, but it was the late 80's and early 90's before healthcare reimbursement went down the tubes. I really think I'm going to be asked to do a full scale cost analysis on this before attempting to bring all that testing in-house, and I was hoping someone else had done that in the past 5 years and could give me some ballpark estimates.
-
As I'm sure everyone else is doing, we are trying to find ways to cut costs. We are a medium sized hospital (<400 beds) in a rural setting without a trauma designation. Annually, I look at supplier contracts including reference lab testing. We currently do our own antigen typing and primary and secondary antibody ID panels but do not keep an enzyme panel nor do we do adsorptions, although we do perform elutions. Most of my staff are generalists and at least half of them are MLT's. I am curious to know the size of your institution and how much, if any, of your serology you send to a reference lab. We are seeing more complex patients (in volume, not necessarily complexity) and I am considering bringing in enzymes and adsorptions. Please give me your thoughts. Thanks!
-
We are a 4-hospital system with the same HIS but 3 of the 4 hospitals have different MRN's and all hospitals issue their own encounter # for each visit. We do have a unique blood bank identifier # that prints on the patient's armband that is the same across facilities and across visits. However, each time a patient is transferred to a different facility, we require that the receiving facility get a new type and screen specimen. The only time this is not true is for preadmit/pre-surgical patients. If a patient wants to have their blood drawn at a sister hospital because it's closer to their home, they can do so, but the specimen is collected and labeled with a handwritten label and the order is a paper requisition. Both of these items are delivered to the facility where the patient will have their surgery, a new encounter is registered, the type and screen ordered and the testing performed. The specimen remains at the testing facility where the patient is having surgery.
-
I have a Vista Ovation but my staff doesn't like it. Plus, the QC and calibration is a nightmare.
-
I agree with Mabel's assessment. I am in the market to replace my Provue and my preference is the Erytra. The main downfall is that the Erytra is not a tabletop analyzer so space is a concern. Also, the capital expenditure is greater than for the Vision. I love that the Erytra is true random access. The Erytra's capacity is greater and the time to process is slightly faster. Although I was impressed with the Bio-Rad IH1000, that analyzer is HUGE and as far as I know, it's not FDA cleared yet. One of the reasons that I'm looking to switch vendors is that I feel that Ortho's customer service has deteriorated substantially over the past 2 years. Additionally, whereas Grifols manufacturers the Erytra and Wadiana, Ortho contracted Grifols to make the Provue (it's actually a Wadiana under a different name) and the Tecan to make the Vision.
-
Blood warmers have come up in our Joint Commission inspection. I know this string is old, but I am wondering if folks still have different practices on who maintains blood warmers. Our JC inspector feels that blood warmers should be under the jurisdiction of BB/TS, but I disagree. Although I understand the concept that the Transfusion Medical director has oversight over all things having to do with the blood products, as a tech and blood bank supervisor, I do not feel that I should be responsible for aspects of the infusion process. The JC standard states that 'All blood warmers must have a warning system to detect malfunctions and prevent damage to cellular components. This system should be checked per manufacturers' specifications.' The AABB standard states: Warming devices shall be equipped with a temperature-sensing device and a warning system to detect malfunctions and prevent hemolysis or other damage to blood or blood components. Neither standard dictates WHO should be checking these devices nor at what frequency, other that ensuring that it comply with the manufacturers' recommendations, which for ours, states annually.
-
Scott, that's how we've viewed these cases. That's how we treat warm autos too.
-
2 questions: For those going the DTT route, from whom do you buy this? Do you follow the 'recipe' for reconstitution outlined in the Technical manual? Is anyone going only the route of giving phenotypically matched red cells for these patients and not using DTT treated reagent cells for the serologic workup? (This assumes that you can get a good sample for pheno/gentoyping prior to the 1st daratumumab).
-
Mabel, so what's your assessment of the Grifol's manual gel workstation? Do you like it better than the MTS gel workstation? I am sore at Ortho for not including tube incubation wells in the new manual gel workstation.
-
David, how did your Grifols presentation go last year? My sales rep came to see me yesterday and wants me to go to Virginia to see the Erytra in action in March.
-
I'm pretty sure both the Erytra and the Wadiana would do an IS XM. But it would probably be faster to do it in tube.
-
This therapy has come to my hospital. Thankfully, our oncologist gave me a heads up. Apparently, the drug manufacturer is strongly suggesting that prescribing doctors communicate with their transfusion services. They even provide cards for the docs to give the patients, that can be presented, should the patient go to a different hospital (I'm envisioning something like a card from the Red Cross that details what antibodies a patient has). Anywho....since I do not routinely stock DTT, and haven't used it in 20 years, my 'frontline' strategy has been to get a complete phenotype on the patient before he gets his 1st daratumumab treatment this afternoon. I am simultaneously trying to find a supplier and pricing for DTT (anyone, anyone?) to determine if this is something we want to undertake or do we want to send these specimens to our reference lab every time.
-
I just got notified by one of our oncologists today, that she has a patient that will begin treatment on this drug next week. I am thinking that we are going to go the way of ChrisW. We don't typically stock DTT but I am amenable to doing that but have not had a chance to do a cost analysis.
