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maureen320

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Everything posted by maureen320

  1. Hello All, Now that Cerner has migrated from major release upgrades to incremental upgrades, how are you managing the Blood Bank validation effort? We have not yet received any guidance from Cerner and at this point we feel that we will need to make the determination to validate on our own. How are you some of you handling this? Thank you! Respectfully yours, Maureen Slackway, MS, MT(ASCP), CPHIMS, CQA, CAPM Senior Application Analyst – Laboratory Systems, Universal Health Services, Inc.
  2. Hello everyone, TRM.41350 states that if a patient has special transfusion requirements they must appear on the transfusion tag. Our facilities utilize the transfusion requirement section in various ways and many of our transfusion requirements are not associated with an attribute (for example, transfuse with group O RBC, transfusion with group AB plasma). How are you planning to achieve compliance with this CAP requirement? Will you print all active transfusion requirements on the tag or will you limit the printing to requirements associated with an attribute? Thank you in advance for your insight! Respectfully yours, Maureen Slackway, MS, MT(ASCP), CPHIMS, CQA
  3. Hello everyone, what are your thoughts about this: suppose you have phlebotomists collect the majority of your samples. One exception would be when a patient has a line--nursing must collect the sample. Suppose a phlebotomist is present at the bedside and witnesses the nurse collect the sample from the line. The phlebotomist signs and dates the tube. Is this acceptable? It is my opinion that the person physically collecting must sign and date the tube I discovered that this practice is happening where I work What are your thoughts?
  4. Thanks so much for the responses! I always feel better after posting on this forum :-)
  5. Hello everyone, It was discovered during a monthly audit that tach and timer testing was not done for our serofuges during the quarterly timeframe. The audit was done late so this omission was not discovered until about 2 months after the testing should have been done. All implicated serofuges were immediately removed from service upon discovery. Is this reportable to the FDA?
  6. Hello everyone, We have a hospital policy that states transfusions must be started within 30 minutes of receipt from the Blood Bank. I've read the posts about the 30 minute rule here but my question to all is this: what do your nursing/hospital policies say about transfusion start time? If you have a specific statement like mine, do you monitor compliance? In my opinion, if the transfusion start time is delayed (> 30 minutes in my case) and the entire transfusion event was completed within 4 hours, I do not see an issue other than non-compliance with our SOP (non compliance with SOP is something I would monitor). If the 30 minute rule is indeed outdated, I would like to suggest new verbiage but wanted to get a feel for what others have in their policies. Thanks!
  7. Hello everyone! I need to do a major overhaul of the SOPs where I work and the first one on my list is Change Management. Anyone willing to share your SOP and associated forms with me? I like to see what others are doing... Thank you in advance for your help!
  8. Hello MACWHC, I, too, have an IS background (former Mediware consultant and former EHR analyst) and the system we use is a national system with nationally established truth tables. I find this very frustrating. Our truth table is not set up to force an entry for the IS phase. You can bet I am bringing this issue to light--I just started here in my position and was not part of the initial blood bank info system implementation.
  9. Hello everyone! We employ tube testing as our primary testing method. I am new to my organization and have been told by the staff that the previous supervisor verbally stated that a reaction of 2+ or greater was required when testing with Anti-D in order to call a patient Rh positive. However, the SOP states 1+ or greater. I should also mention that the truth table in the Blood Bank information system for Rh testing is built to match the SOP. My question to all is this: if the 2+ or greater is indeed required to classify a patient as Rh positive, what is the reference? I do not see this specific grading requirement in the manufacturer's insert nor do I see in the AABB technical manual. Any help is greatly appreciated! Thank you!
  10. Hello, I just encountered this problem over the weekend. I used LISS to resolve the issue as per our protocol.
  11. Thank you goodchild you confirmed what I suspected. I am new to this facility and to this position--only been here 1 month. I asked why the IS reading was omitted and was told that the previous supervisor indicated that since the ABSC did not include a reading at IS the XM did not require it. WHAT??????????? to say that I got red in the face is an understatement. My question is then how much digging do I need to do to report this? How far back do I need to go?
  12. Hello everyone, I recently discovered that the techs are not following the SOP for crossmatching for patients with antibodies. The SOP states the following in the scope section of the SOP: A full serological crossmatch is done on all patients with currently demonstrating clinically significant antibodies or who have a history of clinically significant antibodies. The SOP states later: Perform Immediate Spin Phase when the patient has antibodies as the first phase of a complete serologic crossmatch. There is also a flow chart that clearly indicates that an IS reading is required when performing a serological crossmatch. I discovered that blood had been transfused that did not have the IS reading done. I suspect that this practice spans several years. My question to you all is this: is this reportable to the FDA as a BPD?
  13. Hello everyone, The Medical Director decided to discard the units. He is FDA-fearing
  14. I, too, fully support the BB vending machines. Our sugical schedule does not warrant one, though. We are not a high volume blood bank. I am an IT geek and love anything that technology can do to make our jobs safer.
  15. Thanks so much everyone for the feedback! I have only been at my facility for about a month now and this exact incident has not occurred or at least there is no record of it. One scenario that I can not help but toss around in my head is this: what if this missing temperature recording involved the BB refrigerator in the BB where available inventory was stored? There is no doubt in my mind that we would be finding every way possible to justify keeping the inventory. This OR situation is not much different. Yes, I agree there is the issue of how the blood is handled once in the OR's hands but that is happening every time we issue blood to that location. Do I like it? NO but it is something that I have to live with and the alternative of coolers gets me red in the face lol
  16. I am inclined to say that it would be easier to defend a final disposition of discard vs returning to general inventory...
  17. Hi Terri, Yes, the refrigerator is indeed hooked up to a remote alarm. Thanks for the reply!
  18. Hello everyone! My facility has a refrigerator in the OR. The temps are taken daily by the OR staff. The Daily temperature record is returned to the Blood Bank at the end of the month. I noticed today that temps were not documented for one day. I generated a report that indicated four (4) units of RBC had been issued to the OR and then returned to the BB later that day. Fortunately, the units are still in our inventory and have been quarantined physically and electronically. My question to you all is this: if the chart and the event log on the refrigerator are reviewed and no abnormnal events noted, can the units be released to inventory? My instinct is to discard the units but I wanted to query the group for some advice. Thank you!
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