nziegler
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Everything posted by nziegler
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we run "qc" once every 30 days (more accurately, whenever we get a normal patient - seeing as how we only test 3-5 patients per month). we also qc a new lot number. we'll draw a co-worker that we know works if need be.
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We have no rules set up for our hematology qc. I do look at the levy-jennings to identify shifts or trends, but generally speaking rules like 10x or 4,1s aren't very helpful. In the world of hematology, being part of a qc pool is the most important tool (for Beckman users, it's IQAP). Comparison of your values to the "pool" is much more important than package insert means. Having multiple instruments is also helpful for comparison. We run a patient check once a day - i have 3 instruments, so at any given time, between IQAP reports and patient check numbers i can figure out which instrument is showing a problem. Because our standards in NY require at least one level of control every 8 hours, +/- 15 minutes(!) we have taken to running one level of control every 6 hours - it is actually saving a lot of money (we were running 2 levels every 8 hours). If there's ever a problem with the one level of control, they can run the other levels as a troubleshooting measure. Hope that helps!
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I don't use that particular product, but for any of my low volume special tests, that is what i do.
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I'm wondering what sort of statistical analysis any of you use for correlating white cell differentials between methods. Regular old linear regression analysis works fine for segs and lymphs - but nothing else. I've also tried truth tables. The only thing i've found that seems to really work is the Rumke scale.
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Manual Differential agreement with Auto Diffs
nziegler replied to LG53's topic in Accrediting Agencies
we run one patient check per day to "verify" the auto diff vs manual diff. all other differentials are just put into the computer. we used to write the results on the instrument printouts as well, but no longer do that. there is no regulation stating you need to. i have a feeling that may have started "back in the day" when differentials could not be done with keystroke directly into the computer. the printout would have served as an "intermediate worksheet" and clerical errors would have to be checked. as far as saving the printouts, we only save ours for a week. the only exception is when the auto diff is released, in NYS those histograms need to be saved for 6 months. -
i got the articles from my sales rep - so i'm pretty sure it has more to do with trying to sell us their silica clotting time assay (seeing as how that package insert pdf was also included in the email i originally got).
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[ATTACH]684[/ATTACH][ATTACH]685[/ATTACH] i have no idea if those attachments worked. if they didn't, you can email me at nziegler@chsbuffalo.org
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We use IL product here - we report a normalized ratio based on screen and confirm results. I know the ISTH is now recommending negative DRVVT tests be confirmed with a more sensitive test - like the hexagonal phase. We have not changed any of our practices.
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What do you use as a cut-off point for an aPTT to reflex to a mixing study? Our current policy is to perform a mixing study on every pre-surgical patient with an "elevated" PTT. Elevated = anything above the normal cutoff. So with 36 seconds being our high end of normal, a 36.1 is reflexing a mixing study. I haven't had much luck finding what other's are doing.....
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We've been running with the 800's for over 2 years now and they are a great improvement over the 750's. We run 500+ samples per day (with 3 instruments). The only problem I can really complain about: the slowness of the software. It also doesn't flag when there is a large percentage of bands present. Not a problem for most, but we do report out bands. We even use them for body fluid analysis.
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is anyone currently using the cellavision to perform white cell differentials? we are currently working one up and are curious as to how it is interfaced (we use SoftLab), how it fits into the workflow, etc....
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CLSI document H56 "Body Fluid Analysis for Cellular Composition; Approved Guideline" states for pleural, pericardial, and peritoneal fluids that the red cell count is of little diagnostic value. (pp32-33)
