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Everything posted by DFields
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I would like to obtain a "poll" from other centers as to the following: 1. At what time after collection do you take the sample for bacterial detection? 2. Is this time calculated from START or from STOP time of the collection? 3. If using the culture method, how long after inoculation is the product made available to inventory? Thank you in advance for your responses. Please just list as 1.-, 2.-, 3.-
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New National Patient Safety Goal 2009 should help you fix the problem of nurses not wanting to comply: NPSG.01.03.01 Eliminate transfusion errors related to [patient] misidentification go to JC website for details: with 2 persons required at bedside or 1 person and a computer (automated ID such as barcoding)!
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So if the FBS is + and the KB is NOT negative, you only give 1 dose of RhIg as long as the KB shows less than 15 ml <whole blood) of feto-maternal hemorrhage??
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:cries:Are you asking about transfusion history as well as pregnancy history? Are your poicies for mitigating risk in platelet donors the same as for plasma products? If the female has a history of one pregnancy are you treating her the same as if there were multiple pregnancies? What about previous platelet donors who are female and multiparous but no problems have been reported in recipients of their platelets, can the Blood Bank Medical Director allow them to continue to donate?
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Please share how your facility decides if events are "near miss"? If caught prior to distribution (such as at the issue window) and this is part of your process, do you consider that a near miss? Processing errors, if caught prior to distribution, would they be "near miss" events?
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Is there any type of label (with barcode) for "NOT FOR TRANSFUSION" in ISBT (to parallel the grey/white overlay that went in place of the SBO-Rh label in Codabar)? There was also an emergency (untested) Codabar overlay, I believe it had spaces to fill in what tests had not been done on the unit. Is there something equivalent to that for ISBT?
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Having been a blood banker for MANY years I like anti-A,B for both "confirming" the front type (old school) but I assure you it does still (albeit rarely) pick up subgroups much more strongly than the anti-A.. Last week we had a patient type as an O front and reverse with gel (A1 cells were 1+) whereas with tube reagents the anti-A forward was weakly pos, the anti-A,B was 2+.........the reverse showed and anti-A1
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What if the + screen is found due to RhIg anti-D or cold antibody (not clin. significant)- do you allow I.S. crossmatch? Do you do T&S conversion and xm units for those + screens? If using electronic xm would it let you do that if clin. insignif. antibody is identified??
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What timing device do you use for arm scrubs? Do you calibrate/QC the timing device? If wrist watch is used is it checked for accuracy? If wall clock with second hand is used is that checked/how often? An external auditor is asking us (we had never been asked that before).
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Of those who run liquid controls, do you run them at "home base" or after you get to the mobile collection site?
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What are others doing for calibration of manual blood pressure cuffs? What about calibrating vital signs monitors (electronic)?
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Poll: Do you require a second tube (drawn at a different time) to confirm the ABO/Rh of any new patient prior to transfusion (with other than group O red cells)? Yes No
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Has there been a recent poll as to how many Transfusion Services are now requiring a second tube to confirm ABO/Rh for new patients?
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How do other Transfusion Services and Blood Centers categorize and track NEAR MISS EVENTS? We are looking for some benchmarks. Any suggestions?
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Unresolved issue, how are others handling + sickle donors? 1. do you send notification letter, if so what do you say? 2. do you allow them to continue to donate? 3. if unit goes through filter and leukoreduces how can we be sure the wbcs are effectively removed (per literature) without counting each product? 4. do you put the donor on some sort of flag or surveillance in case they come back? THANK YOU!
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Does your institution allow nurses to collect extra tubes (such as ER or L&D) in case the pysician orders tests (or more tests) at a later time? Is collection of extra samples permitted? Are there time frames for holding and storage? Where are they stored and held for possible orders? This is a problem for the Lab as a whole at our instituion and we are trying to find out what other facilities are doing/requiring.
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Does your blood center allow the donor to "refresh at the bedside" or only under certain circumstances (for example giving juice or water if they feel weak or lightheaded during donation, or have a reaction? Is it against OSHA for the donor to be drinking (or eating) during blood collection/in the collection area? Is there any difference between whole blood collection and apheresis collection for your "rules" on this at your blood center (such as since apheresis is longer to you allow that donor to drink liquids)? THANK YOU VERY MUCH, I do not want this to just be "my opinion" I want to find out what others are doing, whether there are regs and whether anyone has been cited. Would it be acceptable as long as not during initiation and conclusion of the procedure (when risk of contamination)-which is the feeling of some blood bankers I have talked to?
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Who performs therapeutic apheresis?
DFields replied to bmarotto's topic in Donor Services and Donor Recruitment
What are the regs for an on-board BB Med Director/pathologist during a therap. apheresis procedure--do they have to be within a certain number of minutes from the facility? Does it vary by type of ther apheresis (different for plasma than for red cell exchanges or for platelet or wbc reductions??) :confused: -
If a donor had a pos CMV antibody, then NEG,NEG,NEG would anyone suspect a false POS? How would you label subsequent donations, based on current test results? Is there a requirement to check test results vs. previous? DO any computer systems do that?
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Do your computer systems check current CMV (antibody) test results vs. prior (for platelet apheresis donors especially)? If not, do you check manually as far as keep a file on each donor? Have you ever had discrepant test results, such as back and forth NEG,NEG,POS, NEG,NEG,NEG,POS, etc.?? If you had a POS result and then the donor tested NEG for multiple donations after that, would you label the products CMV NEG or not (as precaution due to prior POS result)??
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How do Donor Centers comply with CAP requirements as far as the rest of the lab for checking new lots vs. old prior to use? Also do you set your own ranges for controls for donor testing equipment (Hemocue, pH)?
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How are other Blood Banks addressing the CAP lot to lot comparison requirement which other areas of the lab comply with?
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What about recording the temp every 4 hours since the cooler is used for storage? Do you use temp indicators? What do you do to revalidate every 6 months? Do you do a trial on each cooler in use or summarize data from the 6 month period?
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What do you do when you happen upon a donor with a +DAT ? What type of letter do you send and what type of deferral? Do you allow future donation and retest the DAT prior to release?
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Does anyone know of any studies regarding PLATELETS and the effect (in vivo) of tubing them? Are the platelets affected in any way??? Are other facilities allowing platelets to be tubed ?--
