TreeMoss

I have attached the screen shots of the set up of the Order Group and Test in Meditech. Type Reflex.docx

We use MobiLab and do not have a separate Blood Bank wristband. We love MobiLab! We are able to use hematology specimens if they are labeled with a patient wristband label at the time of collection. Our specimens are collected by phlebs, ER folks, and L&D nurses. If the patient ID band is removed and not immediately replaced in a different location, we require a new specimen to be collected and tested. We also have Temporary ID bands (TID) from Biologics that we use in times of computer downtime.

We actually have two history questions on the result screen. The original Type History question is the one that a "No" reflexes the re-type specimen. There is also a "Previous History Check" that was added when we went up on BCTA (Bar-code Transfusion Administration). The We have four possible answers for the previous history check question -- No history, Yes hemolytic reaction, Yes non-hemolytic reaction, and Yes no reaction. There is no reflex order from this question.

We do perform in parallel if we have a previous specimen from the same pregnancy.

We have a "History" (Y or N) question on our result screen. If there is no history, a patient retype (forward type only) reflex orders on a new requisition, so the specimen can be collected. You just need to set it up like any other reflex order. Our L&D nurses draw most of the specimens from their patients. They also draw the extra tube for our retypes, but we often wonder when the labels are printed just 1-2 minutes apart. Everyone we ask verifies that the specimens were collected at separate times. I see that we're not the only ones with that concern.

We accept specimens drawn at the oncologists' office and labeled with Temporary ID band labels with the TID band placed on the patient's limb. Otherwise, all patient specimens are collected at our facility with the armband being placed on the patient at the time of specimen collection.

We follow the AABB guideline and test only in tube method.

We also have empty blood bags returned to the blood bank. We keep them for 7 days following transfusion. We keep the bags in the morgue where there is room for storage. We decided this was the easiest way to keep what we needed in case of delayed reactions, especially since we don't have many of these called. We thought this was easier than having to pull segments off of the units and store. We have a special door below the Blood Bank window where the nurses or volunteer can drop of the units into a biohazard bag. We just fill up the bag, label with in and out dates, and take to the morgue. Pretty painless!

They do this occasionally at our facility. The specimen(s) are labeled at the time of collection with a label made by scanning the infant's identification band. We also do not use cord blood specimens for crossmatching/transfusion purposes. This source is also often used for chromosome testing due to the larger volume that is needed. They will not use placental blood when twins are delivered.

Where do these inspectors come up with these things? We have never had this difficulty. When we issue the aliquot, we point out the AO, BO, etc. at the bottom of the new label. If you use a sterile welder to make your aliquot, I suppose you could show that paperwork to prove that it is a closed system. I'm curious to see if anyone knows the answer to this one.

Our result includes "Candidate?" where we result "yes" or "no". This documentation helps the nurses know right away whether the mom needs RhIG or not. We credit the patient account for any testing not performed but resulted.

Our facility currently has a consent for transfusion that is good for 30 days after which a new consent has to be signed. Our NICU staff would like to have a transfusion consent that is good for the length of stay since their patients can stay for up to 4 months if not longer. We are inspected by The Joint Commission and CAP. Is anyone aware of specific guidelines that apply to these consents? Thank you

We dilute up some anti-D and use an aliquot of that to crosscheck the newly received antibody screening cells with the screening cells currently in use. When the cells are put into use, we check all three cells using anti-D or anti-c diluted up so that we are testing all cells for something positive.

We listened to an ARC sponsored reimbursement webinar a few years ago where we were told that we could charge for all crossmatches and antigen typings performed, within reason. We will also crossmatch first and then antigen type the compatible units if the antibody is showing -- to conserve that expensive antisera.

We are using EXM on Meditech 5.6.7 and love it. I was able to get the building and testing information from ATLAS and just followed that information. You will begin by having changes made to the LIS Parameters and then will just build what is needed. The whole process went well with that information.