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milesd3

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    Med Lab tech

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  1. The issuing tech should have questioned the "O" plasma even though it was her boss. Without pathology approval (at our facility) we cannot give inappropriate units knowingly. I'm interested in what the pathologist is saying because at least at our facility, the pathologist is ultimately responsible. The "boss" at the very least should be counseled and or written up personally if this is the second blunder perhaps he should be gone. The issuing tech should at the very least receive a verbal warning. all my opinions..
  2. Yes we still do them on a rare occasion. One of those archaic nearly useless tests that some doctors can't get away from.
  3. Thanks Scott, I'd be totally fine with the old manual test but we are a small rural hospital and the night tech is alone after midnight and if he/she is in the ER or on the floor when the hour is up it would have to be remixed and the process started over again thus making the ER Dr. upset. I realize ESR is not an emergency room test but someone forgot to inform the ER Dr.s about this fact. We also do CRP's but if "our" ER Drs order a CRP they seem to want the ESR as well. In the 23 years I've been at this place, we've never had a backup for ESR and haven't ever had a need. I suppose in the event that our analyzer was down, we would just send the sample to our reference lab. If administration approves the purchase we have decided to go with the Streck mini cube. If they don't I'm going to talk to our pathologist about discontinuing the test all together.
  4. Streck is discontinuing the ESR plus sed-rate analyzer and I was wondering what everyone else is using. streck is recommending the mini-cube but I don't know any thing about the analyzer good or bad as I think it pretty new but is able to test directly from the edta tube eliminating the need for sed-rate tubes. we only do 10-15 per month so we do not need an analyzer that can test dozens of sed-rates at a time but something affordable and reliable. Thanks
  5. Is that a Sysmex instrument? You might check on their website for CLSI procedures for that particular analyzer. We have a xt2000i and that's where I got the bulk of our policy from.
  6. milesd3

    QC

    Are you saying that a specific parameter is consistently the same exact value each and every time QC is performed and for all three levels? That would be amazing. There are a couple non reportable items on our analyzer that stay pretty consistent but they are items that have to do with the operation of the instrument such as diff X and Diff Y. none of our reportable parameters are steadily the same number each time...
  7. K-CHECK Serum Controls are now available from Fisher and Fisher catalog number is NC1551709. A set consists of x 2 Negative, x2 Lo positive and x 2 Hi positives. Total of six vials (5 ml x 6)

    IMG_2626.JPG

  8. When we had the Stago we ran QC every 6 hours but it was because we were able to utilize the QC material better that way. I cannot remember how long the QC lasted (hours) maybe 24. We are on our second Sysmex and allot of us set timers so we don't forget. Occasionally though we are on the floor or ER and we end up being late. We document that we were late and why. Obviously not all the samples between the late QC and previous are suitable for retest so we look back at previous coag results on that patient if there is history and compare. State health recommended this but I'm not sure what it proves.
  9. Thanks Scott I'll take a look at comparing my data with QC ranges to see if that will help me. I talked to a guy at JCAHO and basically they can't tell you anything or maybe won't would be a better term. He did tell me though that there should be some individual limits and that our director has to decide what they are... He doesn't have a clue nor does our pathologist. The problem with sysmex is that they make claims about the correlation between the modes but they don't elaborate. On average we are aok but individually we are out on different parameters. Sysmex went as far as to tell me if I'm running controls in both modes then we don't have to do it... JCAHO said controls aren't really patient samples and we have to do the correlations with patient samples. So we just got inspected so it will be 2 years before we have to worry about it but I sure would like to know something lol thanks again..
  10. how about other instruments. Someone "has" to know ????
  11. I've been performing open vs closed comparisons on our Sysmex for a couple years but had the expected limits wrong. I was using instrument vs instrument numbers but actually found the correct data accidently searching for something else. My question is: Does each individual sample comparison have to meet Sysmex claims or is it on average. I couldn't get a straight answer from sysmex at all in fact they claimed that no one was doing that and that if we were testing controls on both modes then it was all we needed to do. I finally talked to someone that told me that the average was ok and that I should always use a normal sample for this but they could not provide any documentation on this other than what I already had ( one paragraph and a table of limits). I also spoke to JCAHO and they told me that it should meet claims on average but that there should also be some individual limits as well. When I asked him where do I get these limits he said the typical JCAHO response "you lab director must determine this". I spoke to our director as well as our pathologist and neither had a clue on where to look for this. On average we are fine both % difference and/or less than some expected actual number and the regressions all look good (even Basophils) but individually there are failures on everything platelets being the worst. What was suggested several years ago by a JCAHO inspector was to do this testing every Monday and crunch the number every 6 months. I quizzed a friend at another hospital but they use a Colter and that information is provided by Colter in their documentation which consists of running ten samples each in triplicate (averaging the triplicate results) and using that average results to crunch the numbers. What is everyone else doing along these lines. We just finished our JCAHO inspection in May and had a state health validation inspection last week but neither looked at this information this time. Thanks
  12. Cool I talked to them sometime ago and they told me their control was "not" acceptable for use with the tablet because it makes a speckled pattern on the tablet rather than the solid purple that serum does on the tablet. Have they reformulated the control?? Thanks
  13. We don't send units with the patient unless they are already hanging. We found out years ago that units sent were discarded by the destination hospital and the explanation is simply that the other hospital didn't do the work and didn't want to responsible for someone else's work. I understand the reasoning thus we don't send units...
  14. We haven't had the 2120 for 5 years but yes, unless something has changed with that analyzer, all three modes have separate pathways thus the comparison between modes is a requirement. We also had to run controls on all three modes as well. That analyzer was a bear. I hope you have better luck out of yours than we did... very needy..!!
  15. Thanks Moyer yes I read the insert and actually talked to a nice gentleman there about the same thing as the instructions in the insert basically are what the urine control would be. He told me I could experiment with different volumes of acetone in ketone free serum and develop my own control but that seems like a lot of work and extra use of the tablet. Our pathologist just said to wait and see what JCAHO said if they indeed say anything.
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