amym1586
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Posts posted by amym1586
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yay! We've got Biomed trying to figure out a way to hang our bags for us. But we tested it today and one person just held the bag and we got almost to 500g today! So, I'm feeling better about these bags now.
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I just read over the instructions again and it does say to suspend the bag 30 cm below the patients arm.
We are laying to down close to the floor on a scale and occasionally rocking it . Could that be our problem ?
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It's on an electronic scale below the venipuncture site.
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On 3/31/2016 at 6:04 AM, David Saikin said:
I don't know what to tell you about this. Interesting phenomenon but I have yet to see it. Are you using a big enough needle? I use 19g and can usually fill the bag right up . . .
Yeah, We've tried 19G and 18G.
I don't know what the deal is.
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So I've been trying out the MacoPharma bags. And every time the bag stops flowing at about 296 grams. Different patients/ different phlebotomist. Any tips ?
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If they chose to do it on paper then they also fill out this form to go with the unit.
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On 3/23/2016 at 7:56 AM, richj said:
Amym1586
What information is initially in your downtime book? Do you place a sticker there as well and what time are you aiming for? Do you have product ID Tags for the units ready to go and if so what do you call them ie Trauma ONEG or Trauma OPOS
Down time book consists of basically everything we would go over at issue: Patient, Blood type, Medical record number, BB wrist band #. Unit number, blood type, visual inspection, Date, Time, Tech that signs it out and the nurse that signs it out. We have uncrossmatched stickers to put on them. We average 1-2 Emergency Releases a month. I'm not sure we would benefit from pre labeling.
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We're in a similar boat with HBB. Almost everyone has completely given up using the computer and going back to paper method.
For us the worst part comes after we've issued the units. The steps to follow are a pain and confusing for the techs to follow.
A lot of times they make a photo copy of the unit. Have the nurse sign the downtime book. And give them an emergency release form for the doctor to sign. Then they'll use the photo copy to sign out the unit.
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That's great Terri !
Right now I've got. Red M&M's for Guess the #RBC's
Gummy worms Guess the #parasites
I'm collecting funny looking RBC's and WBC's that like other things. Like one that looks like a cat and they'll get to name the cell. Most creative will win.
Guess the cost of lab supplies.
Everyone gave me their blood type So I'm going to incorporate a game with that along with some Killer questions Malcolm gave me.
Someone else is asking for things no one knows about each person and putting together a game.
And I'm making a Pin the needle on the vein game!
I think we'll have a good week if I can get it all together!
- Malcolm Needs and tbostock
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Gotcha! We don't spit units here. There's a small paragraph about prevention in the Technical manual guess I'll put something like that in there. Thanks for putting me on the right track!
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Could anyone help me out with this AABB standard 5.19.7 for Transfusion Associated Circulatory overload (TACO)
BB shall have a policy for responding to request for products for patients identified by the ordering physician or other authorized health professional as being increased risk for TACO.
I'm drawing a blank as to what a BB policy would need to say for that
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Cool. Since we are gearing up for an upgrade from Version 3.8 to 3.11 Quite a big jump and I never got trained on the guts of this BB system they are going to ask to have someone from a build team come and help us. So I'm definitely going to see if I can incorporate QC !
- Maureen, tbostock and John C. Staley
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3 hours ago, Dansket said:
Are you sure? A test name, a lot number and an expiration date is not much different than a test result!
I'll definitely ask. We are getting ready for an upgrade on the system. So I'll bring it up to see if it's an option.
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3 hours ago, John C. Staley said:
I am curious, has any of your staff provided a rational reason for this dereliction of duties beyond, "I forgot". While not condoning what they are doing maybe the current system is cumbersome and difficult or at least very inconvenient. Another question, is it wide spread, say more than 3 staff members, or are there some that actually comply? If it is the majority of the staff who are having problems, this might be an opportunity to get them involved in fixing a perceived problem. Stress the need for the documentation and ask them to come up with a system that will ensure it getting done accurately and at the time of testing. I found over the years that if the staff come up with solutions to problems they are much more likely to comply, and quite often came up with something much better than I could have. On the other hand, their solutions are not always acceptable but should at least be considered and if rejected an explanation of why should be forth coming.
There you go, a little more philosophical drivel!
That's a great idea. When our previous supervisor left a few months ago (putting me in charge) he said that the as needed QC was something he wasn't focused on and suggested I try to get more involved in it. So Im guessing they've all be very lax about doing over the last few years.
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17 minutes ago, Dansket said:
amym1586,
Depending on your BBK computer system, you can create a polydat test that cannot be resulted without QC (make the QC results entry part of the test results entry).
Currently, I don't think there's a way. We have our fetal screen set up to put in the positive/negative/ patient at entry. But there's no way for Lot numbers and things like that. So they are having to also go to the LIS and enter the Lot number and QC.
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Speaking of Poly DAT....
Our current Positive and Negative control for the poly qc is :
Positive control add 1 drop Poly IgG to one drop of Coombs control spin and read.
For the negative control Add 1 drop of A1 cells to 2 drops and Anti-D. Incubate tubes for 15 minutes and centrifuge, wash 3 times with saline and add 2 drops of Poly specific coombs reagent. Spin and read (verbatim)
Our manufactures instructions
Drections for Use
Bring reagent to room temperature (25°C ± 5°C) prior to use.
Direct Antiglobulin Test
1. Prepare a 3% to 5% suspension in isotonic saline of the red blood cells to be tested.
2. With a clean Pasteur pipette, add one drop of the prepared cell suspension to a small test tube.
3. Fill the tube with fresh isotonic saline; centrifuge at high speed and decant. Perform this washing a minimum
of three times.
4. Decant completely after the last washing. (CAUTION: Do not reintroduce human serum components after
washing procedure.)
5. Add two drops of Anti-Human Globulin BioClone.
6. Mix well and centrifuge immediately.
Suggested centrifugation: Approximately 15 seconds at 3400 rpm (900-1000 rcf) or 1 minute at
1000 rpm (100-125 rcf).*
7. Resuspend the red blood cells by gentle agitation and examine immediately for macroscopic agglutination.
8. Examine negative tests with an optical aid
Do I need to change our procedure??
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Thanks for the advice !
Time for hardball. I really don't mind it as much as I thought it would. I get a lot more work done when people are mad at me!
I'll start with a full on in service. My boss said after that if they still miss it print it out and make them sign it. Then he said he would get involved with a written warning, a verbal warning and you're gonna wish you put in that QC warning.
- Maureen, jayinsat, David Saikin and 3 others
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Well I know the daily QC is getting done at least 5 days a week because I do it
It's the as needed QC I can't get anyone to enter like Poly DAT. They say they are doing it but they forget to put it into the computer.
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I can not get our techs to enter QC into the computer. If I had to guess they aren't even doing the QC.
I'm just fuming right now. That I can't get grown up techs to think. Just THINK. This isn't rocket surgery!
Should I take away computer PRN QC and take it back to paper?
I feel like I've followed all the steps to get them to cooperate.. Emails, verbal communication. Nothing is working.
daily quality control
in Transfusion Services
Posted
ORTHO QC Data Sheet bb.f..qc.2.odt