Moncada

Att All: On behalf of pathologists and laboratory professionals, ASCP is urging the laboratory community and other interested individuals to Sign the Petition urging the Centers for Medicare & Medicaid Services (CMS) to reconsider its position that nursing is a biological science for purposes of performing laboratory testing. We ask that you forward this petition to all of your colleagues. http://cqrcengage.com/ascpath/app/sign-petition?0&engagementId=239813 Here is the link to sign this important petition!

(Also, it opens up a several new departments in the hospital where they can stick a RN in as a director!). This is actually happening! My facility is a large university medical center. During a recent administrative re-organization, our Laboratory Director (18 yr employee, SBB, MPA, 8 yrs in current position) had to re-apply for her position. She was replaced by an RN whose previous position was the manager in charge of the lactation program. TRUE! Evidently the career ladder for Medical Technology stops a little shorter than it used to:)

We subscribe to CAP surveys and have Cerner Millennium LIS. We would like to treat all PT surveys the same as patient samples by registering them in Cerner and documenting results electronically using barcoded accession labels. (we currently only do this for the electronic crossmatch portion) However, we have a satelite lab in another building that has a separate CLIA registration. They get the same survey, share the same SOPS and same computer system as the main blood bank. My question is, how can we both do this and still satisfy the requirement of "not sharing" results? We can both see each others results in our LIS. Anyone have a solution to this dilemma?

Also curious about the frequency column, assuming this is the freq. of compatilbe units, I think k(cellano) and Kpb frequencies are in error. The frequency listed for these 2 antibodies reflects the "incompatible" rates.

Is anyone out there reconstituing platelets? We currently do this occasionally for neonates when ABO compatible platelets are not available. What do you use to reconstitute? Saline?

The E codes above are for plasma reduced platelets. We transfuse 2 separate products; plasma reduced platelets and reconstituted platelets, both from plateletpheresis products. Since we can't use the same E code for two different products (unless one is an aliquot of the original) we are looking for an E code to use with the reconstituted platelets. If you are using the above E codes for reconsituted products, what do you use for plasma reduced platelets that are not reconstituted with saline (is a product you offer)?

For those of you that are currently ISBT: 1. What do you use to reconstitute platelets.....saline or plasmalyte, or ??? 2. What ISBT product code do you use? Thanks!

Per the most recent edition of the "Circular of Information" (recognized by FDA) Edition dated December 2009, p.5 13. "Transfusion should be started before component expiration and completed within 4 hours." This was a revision from the previous edition, which required the product to be infused prior to the expiration.

[ATTACH=CONFIG]650[/ATTACH]We consulted with our ARC supplier about the expiration of 5 unit pre-pooled Cryo. Per their guidance and the attached ARC official Brochure, we assign this product a 4 hour expiration post thaw. Refer to the following on the attached ARC brochure: * Shelf life is one-year in frozen state; four hours after thawing

We also put stickers on our CRYO and platelets (same exact color....flourescent green!). We still get an occasional unit back in a cooler. For all blood products wasted (especially avoidable wastage!), I send an e-mail to the nurse manager and their Director about the details. Sometimes I will include the actual cost to our facility. This was instituted some years ago by the Blood Utilization Committee. At first it was just sent to the Nurse Managers, but the Service Line Directors were added as well. For wastage in the OR, the head of the anesthesia department gets a notification because they are the responsible parties in the OR. This has actually seemed to improve our wastage numbers. It is also a great forum for educating the nursing staff about the importance of following protocols and not requesting blood until all their ducks are in a row (informed consent, IV, premeds, pre-transfusion vitals, etc). While I don't always get a response, sometimes I do get "the rest of the story" which helps the blood bank to understand about why some wastage is unavoidable. It has actually been a positive communication tool with good outcomes. It has even helped to disperse the "30 minute" myth that still seems to live on outside the walls of the transfusion service! Good Luck!

To my knowledge, the FDA and AABB do not have an official view about this "yet", but the test is called Verax Platelet PGD Test. The salesman was also in our facility. While in theory, this may increase the comfort level of platelet transfusion, in reality it would be crippling to our facility's operation. We often transfuse 35+ pheresis daily, many dispensed urgently to trauma and OR. The test takes approximately 30 minutes to complete on each one; time that both the patient and the tech, unfortunately don't have. Even with the large volume of pheresis that we transfuse annually, we have only had one case of contaminated platelets being transfused, and that was prior to the 24 hour testing performed by our supplier. It is hard to justify the added cost and lag time based on at least our statistics. Unfortunately, it would take either a sentinel event or a regulatory requirement for this to make any sense at our facility.

Our tube system validation involved measuring the temp of the transported blood products. All were within AABB standards for transport, including platelets at room temp range. We use the "secure send" feature of our system...i.e. a pin# unique to the individual is required to "receive" the tube. If a valid pin is not entered within 2 minutes, the tube returns to the blood bank, again with an alarm and a pin # required. Any tubes sent via secure send take "STAT" priority.The biomed department can track deliveries and provide us with the names of the nurses that remove the products from the system. All products are heat sealed in plastic bags to contain any leaks (which are very very rare). Yes, there is a procedure to "decontaminate" the tube system, but is rarely needed. Our tube system works great with only an occasional lost unit. Most of your concerns are addressed and solved:D

If a physician orders pooled CRYO5 for a patient, but does not transfuse, we bill the patient for a "thaw fee" X 5 and a "pool fee" X 1. You cannot bill for the productif the patient does not receive it, but you can recover the preparation charges. We do not bill for unused FFP (we give all our FFP a 5-day expiration and label as "thawed plasma"). We waste very little that way.

Is an FDA variance needed to label a product as "Thawed Plasma" with a 5 day expiration? The label does not say "fresh" anywhere on the unit

I have just finished my MBA-Healthcare Management at Western Governor's University (an on-line, totally self-paced program). They used skillsoft extensively. At least in this program, I found the textbooks a much better use of my time and efforts. ( I completed the entire program in 10 months!) Skillsoft is very time consuming and sometimes very elementary. I am not familiar with their capability to program customized material. Good Luck.