Jump to content
April 2024 Challenge

Maureen

Members - Bounced Email
 View Profile  See their activity

  • Posts

    60

  • Joined

  • Last visited

  • Days Won

    3

  • Country

    United States

 Content Type 

Everything posted by Maureen

  1. Maureen
    I would expect serious complaints and pushback for suggesting shortening the time frame, whether to 29 days or 3, from presurgical staff, surgical staff, physicians, patients and their representatives. There is a lot of pressure to make our OR run smoothly and on time. If you make it less convenient for pre-surgical blood work you invite same day T&S, with the risk of delaying the start of surgery.
  2. Maureen
    We use 21 days if not pregnant or transfused within 3 months. We are occasionally asked to extend it beyond the 21 days, but I ask them to request a physician override of our P&P, so it hasn't happened yet. One recurring issue is that the patient does not return with the ID band provided at the time of specimen collection, so the T&S must be repeated on the day of surgery. Another issue, although infrequent, is a name change.
  3. Maureen
    To ensure compliance with AABB Standard 5.16.2.2 if you use an electronic crossmatch you need to perform both front and back types (AABB 5.14.1).
  4. Maureen
    Our donor center will fax a list of their LR RBC inventory - listing the ABO/Rh of the unit, and the antibody(s) for each. We can request any of these units, if we can use them and avoid wastage. We have a test protocol, the patient must be negative for the corresponding antigen, and a full crossmatch is required.
  5. Maureen
    We do not require a transfusion consent for RhIG.
  6. Maureen

    Echo Problem

    Maureen replied to L106's topic in Equipment

    We've seen the same issues since December 2014, and found thorough cleaning of the probe block helpful, sometimes cleaning the washer manifold &/or changing the indicator cells &/or changing the screening cells helpful also. Immucor has become more helpful and efficient at shipping replacement reagents quickly. I find the Echo Report for Strip Performance or Reagent Performance helpful. As the percentage of equivocal reactions rises to 2% you need to intervene or take action. Once it exceeds 2%, and you've done the maintenance the reagents are readily replaced.
  7. Maureen
    We entered the pertinent info from our card files into our LIS for each patient we could match, which covered 99% of them. Each card was verified at a later date, then discarded.
  8. Maureen
    We are a 350 bed hospital with some outreach labs - and have used the Immucor Echo ~ 6 years - and it works well for us.
  9. Maureen
    Our pathologists do not review, comment or report on patient antibodies. My prior Transfusion Medicine Medical Director, at a large academic medical center, did review new antibody identifications, and issue a formal pathology report.
  10. Maureen
    Be aware - if you use the Sorvall cellwasher Plus (CW2 plus) the manufacturer requires quarterly speed and timer checks. We didn't catch this change during installation - but our AABB/CAP assessor did.
  11. Maureen
    We're using myweigh Palmscale 7 – Advance 200 – was $48.90 ~ 1 year ago.
  12. Maureen
    Our lab has used the Echo for 5 years. Immucor Technical Communication cc-09-042-02 (Nov 2009) recommends 'you perform a visual verification of negative reactions before final release...' due to false negative interpretations. There is nothing (I can find) in the manufacturer's package insert or Operator's Manual which requires this step. We still follow this recommendation, as we find instances where the interpretation is a false negative. Our experience shows these may or may not be resolved as a clinically significant antibody. An Echo panel is usually run, or PEG screen/selected cells. We do full crossmatches on the Echo. This is sometimes quite a bit of work to identify something unimportant, but in other cases we clearly id anti-E, anti-Jka or b or others prior to transfusing.
  13. Maureen
    We see this situation often, performing the antibody screen/ID with solid phase (Immucor Echo Capture) obtaining signficant reactivity, but finding the antibody is 'below titerable levels' performing the CAP Uniform Procedure. In the lab I worked previously the Antibody titers were done using Ortho gel - there were no issues. I expect the change from tube to gel was validated, but before I worked there. I also expect that the validation results required some explanation in the documentation - as gel (like solid phase) can detect IgG antibodies at lower levels.
  14. Maureen

    TEMP-CHECK

    Maureen replied to Eagle Eye's topic in Equipment

    We purchased the older model directly from Hampshire Controls. They had the best price, warranty and return policy. No problems validating or implementing this piece of equipment.
  15. Maureen
    If your quote is his actual text he should be a writer
  16. Maureen
    Yes - I have for several years. We have had (fingers crossed) no issues.
  17. Maureen
    Our Cerner CPOE orders were built with lab input, and include a 'Reason for the (component) order', each with a unique dropdown menu. The Reason menu options come from our hospital's Blood Usage Committee's 'Usual Indications for Transfusion...' policy. After implementation we received many requests for an option of 'Other', particularly from the unit clerks, because the reason was not documented on the order they were entering into the LIS, but our Medical Director refused to allow that option. I see a decreasing number of orders entered into the LIS by non-PCP, of the 18 orders we dispensed for on Sunday 13 were entered by the PCP, 2 were entered by phlebotomists with the reason 'Pre-op', one was Emergency Release, and only 2 entered by unit clerks.
  18. Maureen
    A great meeting is planned in Providence - a bigger vendor area this year - 48 booths committed to date - new this year - a Jobs Board - wireless available in the Exhibits area - a Vendor sponsored reception Wednesday, April 30th, at 4:30 - 5:30pm. Check out the entire program at the website ascls-cne.org.
  19. Maureen
    While I can relate to each of the negative issues associated with OR Blood Storage refrigerators I have concerns regarding the alternative - individual coolers in each OR room - with staff monitoring and documenting as required. Has anyone implemented a better solution?
  20. Maureen
    I interpret the standard to say that the alarm system check documents that it functions as expected. Since we have not set a low alarm for the freezer there is no requirement to check one.
  21. Maureen
    Cerner does 'know' when a patient is eligible for EXM, and this is flagged in both Pat. Prod Inquiry and Dispense by the designated icon. When you 'click' on it the pertinent (both inclusion and exclusion criteria) display in an informative window. With our setup the user does not need to 'order' a crossmatch. When a pickup order is presented we match it to an open Blood Product Order. When the Crossmatch order does not yet exist Cerner will create one during the Computer Crossmatch Dispense (CCD) process. There are no 'overrides' for Computer Crossmatch Dispense, if the patient is not eligible the tech must choose a different option. We do not utilize a separate BB number - so retrieving the specimen is not an issue for us. The CCD process is the same for both 'Transfuse' and 'Hold' orders in our laboratory.
  22. Maureen
    Our lab initially used E-XM at time of test results from Result Entry, which was not very different from Immediate Spin XM. We implemented E-XM Dispense via Dispense & Assign Products with other process changes in Feb 2012. We see several benefits; Expired crossmatches are not dispensed. Fewer overrides occur overall. The techs are diligent about performing ABO confirmation on a second specimen, so we avoid crossmatching O LRRBCs on non-O patients. We spend less time on inventory management. We use FIFO more consistently, with the oldest units transfused. The techs appreciate all the automated checking in this process. We've reduced mistagged components, with IS XM more than one component for a patient occasionally the tags were transposed.
  23. Maureen
    Once the flu was widespread our state DOH mandated either get the shot or wear a mask everywhere you could come within 6 feet of a patient - interestingly one tech received his first ever flu shot today - after I obtained the box of facemasks for him.
  24. Maureen
    Has anyone tried or are using a mechanical barrier - such as FinalCheck or Bloodloc - with a Bloodbank band? If so, is the system effective?
  25. Maureen
    I can agree "Cerner has a “standard” compatibility tag that is not very desirable", the font is too small. Our customization request has been on the short IT todo list for quite awhile now, but doesn't make it to the top, despite multiple issues. We print on 3 hole paper and attach the standard laser printed report with a plastic tie tag (Avery item 18800) with no issues.
×
×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.