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Everything posted by Jane
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I am having a problem with our plasma freezer and I was wondering if any one else has seen this type of problem. During the defrost cycle, the temperature is going up too much and is approaching the -18 mark at which time we'd have to move our plasma. Our refrigeration repairman whom we've used for a long time says that the voltage is dropping too much from the outlet and this is causing the problem. Manufacturer's specs say that the voltage should drop no more than 10% and it is dropping 20%. This in turn is causing a strain on the compressor, making the cycle last longer than it should, etc. Our facility services people say there is no problem and that anytime a motor is trying to run it will drop the power. Any advice? I've confirmed from the manufacturer that these specs are the case and that this will cause the problems I've described. Thanks, Jane
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It definitely made it easier for us when ARC went 100% leukoreduced!
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We also use Ortho gel but we do not purchase their QC kit. We just freeze our expired antisera (duffy, kidd, etc.) and then dilute it to get 1-3+. We freeze the aliquots and get out one for the week that we keep in the fridge. It stays good and we check it when we make it to make sure we get the needed reactions. We haven't had any problems with inspection.
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Our facility uses 2% and right now we just track those associated with red cell units. I read (either in the technical manual or a textbook) that if you have more than 2% there may be a problem and if you have less there may be under-reporting (or nurses not recognizing a reaction). We have just started tracking this in Blood Utilization and we are fairly close to this number. Sorry that I can't remember the exact reference! If I run across it, I'll pass it along.
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Cliff- Is there a way to sign up for a daily update on this forum? I use to get a newsletter about new posts.
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I loved David's idea of checking the weight on a calibrated scale. Our Mettler balance is calibrated and checked yearly by the company and I think I will use it to verify our weight each year. I am in the process of validating a new blood collection mixer. Do you all think that checking its weight measurement by weighing 3 bags of different weights on it and our Mettler balance say 10 times each and averaging these and calculating any difference is sufficient?? The company gives very little guidance except to say that a known weight should weigh within +/- 1 gram. I thought this same process could be repeated yearly as a calibration check. Then we will also check the calibration daily with our weight. As part of the validation, the techs will also each do a checkoff to make sure they understand the procedure and all the bells & whistles like the clamp and alarms work like they state in the user's manual.
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If anybody else has examples they are willing to share, I am still trying to gather more info to improve our process. Thanks!
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We signed on for both. I figured if we didn't we'd get slammed on our next CAP inspection.
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We are a hospital based transfusion service that only collects autologous units. It is very difficult for us because our staff has been cut (it is based on billable tests and spending an hour with a donor is only 1 billable test). I am working now to do away with this program and there are many journal articles to support this position. The patients could still donate at the American Red Cross about 1/2 hour away. There are many articles that support the position that many of the donors would not need a transfusion if they hadn't donated their own blood.
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They (Cliff) likes it when we attach the procedure here if you don't mind doing that. If you do mind- then you can send it to me at Removed e-mail address, spammers get lots of them this way, please send a private message to Jane if you want to learn her address.. Thanks!
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Would anyone be willing to provide me with their procedure for emergency release? Ours really bites! I know there has to be a better way to do it!
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Thanks for your responses! I sounds like it will be fun!!
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I have heard that my facility will begin performing interventional cardiology procedures such as placing stents and balloons. Does anyone have these procedures at their facility and what blood bank needs are involved?
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New Computer System Validation
Jane replied to Kim.Turner's topic in Computer Systems / Software / ISBT128
I would definitely agree with the outside vendor. We hired a consulting service to perform our validation. My director also wanted us to do some validating of our own. I did this in conjunction with our integrated test plan. Be sure to save screen shots of everything. Misys estimated something like 80 or 120 hours for our validation and they provide a step by step guide. The most important thing is probably validating the system like you will use it. -
Our facility's policy is just like John's. We have no set in stone number- it depends on how many units the patient has used, expected usage, our inventory, and also the supplier's inventory. For instance, if O neg units are in shorter than normal supply then the threshold will be lower than normal as well. We also need approval from the pathologist but that isn't a problem.
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I feel sure that I'm not the only one in this situation. We sign out blood to the ER with a form that all other floors use (including OR). It comes back and they haven't filled out any info on it. No signatures by the nurses that transfused it, no vitals, no nothing (except what it left here with). Their answer is "we don't have time" Maybe they don't- but to not even check that they've verified any info?? Do any of you use a different form for "trauma situations?" And how is your compliance with the form use? Thanks for any help!
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We too have been having Nursing fill in the reason for the transfusion but this is often done by the unit secretary who writes things like- anemia or hgb 9.3. This leaves the blood utilization committee to wonder if this patient couldn't have just received iron or procrit. But maybe the patient had symptoms of anemia. The chart reviews become long and drawn out trying to figure out what the doctor was thinking. So were hoping by having the doctor indicate the reason we might get a better grasp on this. And have improved utilization.
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All that I have heard about electronic crossmatch is that since you are not really doing any testing, you can't bill for a crossmatch. Maybe at some point there will be a CPT code for the electronic xm. The revenue reasons and the billable tests are why we haven't looked at it also. Our facility decides staffing by billable tests and I'm afraid I'll lose a tech if we don't have these billables any longer.
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Laura, Would you consider sharing your form with me? Thanks, Jane
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Our blood utilization committee is looking at revising the informed consent form. Currently this form lists numbers for the risk of acquiring HIV, Hepatitis B and C from a transfusion. It also mentions that there could be an undetectable mismatch, and mild and temporary reactions (fever, chills, etc.). Do any of your facilities use a brochure for patients that has this info? Also do any of your facilities require "why" to be on the form- such as why the doctor feels that patient needs a transfusion?
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What does the red dot mean beside some of the topics?
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My facility (300 beds) is considering implementing prospective review for all components. We currently do a prospective review for everything but red cells (thought it might be easier to break them in slowly). Part of the reasoning for starting this is it is hard to perform the review adequately retrospectively. Doctors do not typically write in the chart. " I gave this patient blood because . . . " If anyone else has this process in place, help! Thanks!
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Are you supporting continuing education opportunities?
Jane replied to gerhan's topic in Education / Quality
Our facility does a decent job of supporting continuing ed. I am trying to be more mindful myself of the need for bench techs to learn and keep up to date with new info in the field. We order tech sample and I just ordered check sample this year. As far as offsite meetings, our facility will pay for supervisors and above (and occasionally someone else) to go to out of state meetings. Bench techs can usually go to local meetings. They are sending me and one of my blood bankers to AABB this year! -
Here is my SOP as well. Hope this helps! Jane QC-107 F1 2004.doc QC-107 Proficiency Testing.doc
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Our facility has no experience with using the pneumatic tube to transport units of blood. We are building a new emergency room that is in another building and the question has come up. Do you have to use a certain type of pneumatic tube or will any old one work? If anyone would be willing to share their signout policy and validation protocol, I would be grateful. Thanks!