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CellSaver quality indicators


RRay

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Our cell saver machines are in the OR. Only surgery techs/personnel are allowed to use it.  I never seen one in action but I hear good things. Attached are some guidelines, best practices, and indications for use.  Good luck. 

 

 

cell_saver1.pdf cell_saver2.pdf Guideline_IntraoperativeCellSalvage.pdf Poster_Abstract_Fatreduction.pdf US-Cell-Saver-Elite-Owner's-Manual-120859-AC.pdf

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Thank you for that information, but I'm looking for quality indicators for monitoring/tracking cell saver use.  I feel like I have seen a hct of reinfused product being used before.

Some sort of data review is part of a CAP requirement:

TRM.41550 X 2 Intraoperative/Perioperative Safety and Efficacy The intraoperative and perioperative blood recovery program ensures the safety and efficacy of the recovered blood components. NOTE: Safety and efficacy of recovered products can be measured through various mechanisms, such as through the review of data by institutional committees and monitoring of the intraoperative/perioperative transfusion practices. Evidence of Compliance:  
     
   *  Review of intraoperative/perioperative blood recovery and reinfusion program records AND/OR meeting minutes of institutional meetings

 

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I suggest reaching out to your director of the O.R. and to your Biomed Director. Start a conversation with them showing them the CAP standard and ask them how they are measuring the safety and efficacy of recovered products. Ask them to provide you a copy of their data to include in your records. Also, since your medical director has to actively participate in the program, they may need to officially report to them as well. Perhaps this could be covered in your transfusion committee, if you have one.

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1 hour ago, RRay said:

Yup!  I have all that in place.  Our committee just wants to know what quality indicators other locations are using.  

My guess is we are all like you. We are not actively involved in their use and monitoring and kinda leave it to them. The only thing I have truly monitored is that they are being properly maintained by biomed. I get a copy of their report. Your post here has me thinking we need to implement a quality measure though. <_<

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For those interested, this is what we have settled on for now unless it comes out that other locations are tracking something else useful:

-Post-wash total Hbg >15 (Hct>45) to indicate good wash quality

-effluent line clear or not

-Also found post-wash heparin concentration of >0.5IU/mL as indicator of poor wash quality, but not sure if this is feasible to test anti-Xa levels... this one is to be continued.

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17 hours ago, David Saikin said:

IF you are not responsible for the operation the only standard I recall is that your medical director is supposed to be involved in setting up the quality aspect in collaboration with those responsible.

CAP recently revised these standards. It seems the new revisions are pushing towards more active monitoring of quality metrics and review of the same by medical directors which can be part of a transfusion committee.

The new checklist items read:

·         TRM.41550 Intraoperative/Perioperative Safety and Efficacy. Phase II
The intraoperative and perioperative blood recovery program ensures the safety and efficacy of the recovered blood components. 
NOTE: Safety and efficacy of recovered products can be measured through various mechanisms, such as through the review of data by institutional committees and monitoring of the intraoperative/perioperative transfusion practices.

Evidence of Compliance: ✓ Review of intraoperative/perioperative blood recovery and reinfusion program records AND/ OR meeting minutes of institutional meetings

·         TRM.41600 Intraoperative/Perioperative Program Involvement. Phase II
The transfusion service medical director is involved in establishing standard operating policies and procedures related to intra- and perioperative collection and reinfusion procedures. NOTE: When the laboratory is not responsible for the standard operating procedure manual for intraoperative/perioperative services, the transfusion service medical director's involvement can be achieved through review of such procedures or through meeting minutes of institutional transfusion committee meetings. The transfusion service medical director must be aware of standard operating policies and procedures to help the institution ensure efficacy and patient safety.

Evidence of Compliance: ✓ Review of intraoperative/perioperative blood recovery and reinfusion program records AND/ OR meeting minutes of institutional meetings.

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Yeah.  More oversight.  CAP's days are numbered at my facility, and I'm pretty sure ACHC doesn't get into blood salvage any deeper than equipment maintenance at best.

Luckily we have all of the CAP standards in place, except adding formal reporting to a committee that the TMMD reviews.  It was just in documented for OR use.  So they tasked me with seeing what other facilities track for QI since there isn't set requirements.  I think the metrics we settled on will be fine, but it's always nice to know where we are amongst our peers.

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1 hour ago, cthherbal said:

We contract the service to an outside vendor, but we review their compliance reports at transfusion committee meetings quarterly. Very low usage here (4 collections in 2022 with no blood returned to patients).

Did the 4 collections use a cell saver? If not, what process or instrument was used for collection?  Thank you 

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  • 1 month later...

We have tried various things over time.  With the current machines, we just measure that the Hct achieves at least what the manufacturer says it should.  We in BB don't operate them but used to years ago.  That is probably why we still have an oversight function.  Tradition!!!!!!

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