Dee

Our facility performs an ABORh recheck on patients that do not have a historical blood type on file. We have an employee that is working in our area but is not a medical technologist. She completed nursing school but did not pass the national test. Part of her responsibilities have included ABORh rechecks of patients and donor unit check-in. Our new lab director states that due to CLIA regulations, she can not continue to perform these rechecks. Is this your interpretation?

John - There are a few articles that have been written but I don't have a list. We have been converting to 5 day Plasma for at least four years with no problems. For infants or known patients with a Factor deficiency, we use plasma thawed within the 24 hour time frame. Routine surgeries or other patients needing FFP, we use Thawed Plasma. It has really helped on decreasing product wastage.

We perform a TS on the day Pre-Admit testing is performed - up to 14 days before surgery. A form is completed inwhich the nurse asks if the patient has been transfused in the past 3 months. If yes - TX must be performed the day the patient arrives for surgery. The Pre-Op form is faxed to Holding by Blood Bank on the day of surgery so the nurse can again ask the 3 month transfusion question. The Pre Op specimen is placed in "Todays Specimen Rack" on the day of surgery to ensure availability if tr rxn is reported and an electronic xm is performed with a 3 day expiration. Patients with antibodies have antibody id performed on Pre-Admit specimen and antigen neg units are saved. The day of surgery a TX is performed and units are crossmatched. This process has really saved time on having units available for surgery and meeting regulatory requirements.

Our Nursing Administration wants to change from using Medical Record Number to Date of Birth as the primary identifier in addition to the patient name. Blood bank will still need to use the MRN to look up patient information since there are many patients with the same DOB. They are being told by a consultant that the move to DOB is a major move nationally. Are you guys seeing this?

Our understanding from an FDA standpoint is that once the blood is within the transfusion service control it is being stored and therefore must be maintained at 1-6C. We were told that the 1-10C was strictly for transport between facilities.

To me there is a discrepancy between AABB Standards and the Technical Manual. Standards state that red cells should be stored (maintained) between 1-6C. Out of refrigeration, a unit of red cells will reach >6C generally within 15 minutes. I think the 30 minute guideline should be eliminated.