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April 2024 Challenge

Susan Betler

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Everything posted by Susan Betler

  1. Susan Betler
    Hello Noel. It is the size of the tube that is the issue in the configured D rack in the TANGO infinity from Bio-Rad. We have contacted tech support. But in these trying times no solution for my facility at this time. We have poured off the donor sample into a smaller tube and while not an ideal solution it does work. We like to work directly with the specimen as received. It would not be prudent to ask for one facility to have a change in your manufacturing guidelines for future donor specimens for proficiency testing. Thanks for your help however. Susan
  2. Susan Betler
    I believe it is a 100 x 75 ml tube
  3. Susan Betler
    Donor cells ADR-01
  4. Susan Betler
    Sorry tango optimo
  5. Susan Betler
    Any suggestions for placing the donor unit on the D rack for tango infinity? Ours is configured to accept small tubes (12x75). Unfortunately during install we never thought about a survey sample. Really do not want to ‘pour off’. Not an issue with the tango option. Any suggestions would be greatly appreciated. ThAnks Susan
  6. Susan Betler
    Can anyone offer suggestions for validation of new ISBT printer as compared to current printer. Used essentially for labeling thawed plasma
  7. Susan Betler
    Thanks. They are not helpful. That is the timeframe that we are stuck with for specimen expiration.
  8. Susan Betler
    I just answered this question. My Score FAIL
  9. Susan Betler
    An RN reports symptoms to an MD during a transfusion and the MD states that this is not a "reaction " and wants the transfusion to continue. Other than urticaria, medical staff is pondering letting blood be collected, basic workup completed for evaluation and if "negative " continue the transfusion. There would be no physical clerical check. I am against this potential protocol. RNs feel that the MD has the final say and blood bank does not need notified at all. Guidance please and thanks.
  10. Susan Betler
    How do you apply verbal orders for uncrossmatched RBC's? We have meditech and there is no order set placed in the EMR by a physician just a phone call and it can come from anyone in the ED.
  11. Susan Betler
    Hello and thank you all. Just found out we will be getting a pp next Wednesday that will have the pop up box at issue for bar coding the DIN, product code, blood type and expiration. Barcoding is a must (no typing). That should handle the issue problem for selecting the correct product for issuing apheresis units. Will train to add a unit tag comment related to container 1, container 2 etc. as another check.
  12. Susan Betler
    How are you able to differentiate AT ISSUE the same DIN, SAME Volume but different product codes (container 1, container 2)? Unit entry is no problem. Assignment for compatibility testing is no problem as long as the tech chooses the correct product (again container 1 or container 2). Unit Issue is another story as our unit tag only contains the DIN and no mention of ISBT product code. When issuing both DINs will display but there is the probability that the issuing tech can select the wrong product. Any help would be appreciated. As always MT is not helping. Thank you in advance. Susan
  13. Susan Betler
    Can anyone with meditech experience provide me with a rule that will have a patient sample expiration date be 3 days from sample collection at 2359 (per AABB). Meditech has only been able to assist (?) me with an expiration date/time of 3 days at 2301 since we went live in 2009. Thank you.
  14. Susan Betler
    In your facility, who is permitted to record vitals signs during a transfusion? RN must record initial and 15 minutes (along with remaining with patients). Any vital signs recorded after those time frames my facility wants to utilize nurse's aides and nurse interns (hired for summer not completed in nursing school). Question arose in regards to recognizing adverse effects to transfusion. Thank you.
  15. Susan Betler
    if you are using BBK Specimen Internal Inquiry,which is what we use on our pending log to see what is "coming" into the department, there are a lot of headers on the left side. Example ORD PRODS: followed by ORD TESTS: followed by COMMENTS: which can be rather large and many pages if you have test view group, etc, followed by QUERIES: MARKERS: COL BATCH: ORDER SITE: RCV SITE: PERFORM SITE: RPT AUDIT: AND THEN FINALLY HX COMMENTS are printed. I have had 2 techs think that this is new meditech and there is nothing that needs to be looked at or investigated....hmmmmmm.
  16. Susan Betler
    Hello: We just had an upgrade (?) and discovered that the HX Comments, if they are more than 4 lines, are printing NOT in the Patient Demographic AREA but after queries and reasons, etc. Techs will have to scroll through pages to find the HC Comments. My laboratory is a generalist lab with techs floating between 3 departments. I put many "helpful" hints, etc in the patient HX Comments field. Any comments for those with version 5.67? Thanks
  17. Susan Betler
    Since this is a "one time" per day charge, regardless of how many products the patient receives, how do they keep tract? I doubt if this would be a viable option at my facility. thanks
  18. Susan Betler
    With ICD-10 codes coming very soon, fiscal department wants Blood Bank to figure out a way to charge a patient for CPT 36430 when they receive any number of blood products on the day of service. This code is billed on a per service basis and not on the number of units of blood products transfused per day. Has anyone encountered this request and developed a "rule" for this billing code? This rule would be used for both inpatients and outpatients. There has been no valid response from Meditech---looking for "key words"???? Thank you.
  19. Susan Betler
    This is one thing that does work in Meditech for Blood Bank. Once patient is "mapped" to the test code for your "coombs crossmatch", any RBC order that is placed with have the "coombs crossmatch" associated with it. Meditech version 5.66
  20. Susan Betler
    Has anyone, using the TANGO, experienced "carry-over" to another patient from strong positive antibody screen? Today, we have 2 patient samples running consecutively on the TANGO. Both samples gave similar results with the antibody screen---Screen I and II positive (3-4+), Screen III-negative. First sample tested is 92yo female who is O Negative. The second patient is 19yo pregnant female who is O Positive. The 92yo female's antibody ID panel (I-8) appears to be anti-D + anti-C. The 19 year old was just at another facility on 7/30/15 and results were O Rh Positive with a negative antibody screen using gel. We purposely run our solidscreen controls to detect carry-over and have never had false positive results with the controls? I have looked at the troubleshooting guide...... Any comments?? Thanks
  21. Susan Betler
    By the way, the rule outs were done with indated panel cells (based on all the discussion about QC on outdated panels)!!
  22. Susan Betler
    Today we had a patient who had an undetectable anti S (previously detected by another facility) who made an anti M. The anti M was not detectable with LISS or PEG when performing rule outs. The patient delivered on July 7 at another facility. We made the decision to screen units for transfusion for S and M. Any comments in regards to the clinical significance of the anti M?
  23. Susan Betler
    Thanks for the insight. I was also contacted by tech support and can't wait until this lot number for the screening cells is done!
  24. Susan Betler
    The decision was made (among others) to go with TANGO solid phase because this method had much less unexpected reactions than the ECHO. We did expect "unexpected" reactivity to occur with the solid phase method. Unfortunately, there is no resolution with these patients, so far.
  25. Susan Betler
    Does anyone utilize flowcharts to assist with TANGO antibody issues that do not make sense and would be willing to share? My facility is fairly new with the TANGO. 3 patients recently that have had positive TANGO antibody screens (one with one cell 2+; one with 2 screening cells-2+; one with all 3 screening cells 2+). TANGO panels (panel I-8 and panel 11+) on first 2 patients were negative. TANGO panel (I-8) on the third patient reacted 2+ with 5 out of 8 cells---no specificity. Crossmatches on all patients were compatible by TANGO and manual tube using LISS. I am leaning to the fact that if manual tube testing (still the gold standard) is negative and units are compatible, the TANGO reactivity is non-specific.
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