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Testing Standards (Pt. Retypes and DATs)


n.peters

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I was just trying to get an idea of what everyone is doing out there:

1. Do you retype a specimen everytime it is touched. For example if day shift does the crossmatch and you come later and do a add-on do you retype the specimne? If so is it documented?

2. If you are doing this are you also doing some sort of documented second type?

3. Do you do a DAT on all crossmatch specimens?

4. What sort of facility are you?

Thanks!

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If an additional order is received and a second tech is doing the testing, the second tech repeats the ABO&Rh but not the antibody detection.

We haven't done DAT's or auto controls with T&Cs for many years.

We are 325 bed hospital in the Mid West.

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Because we have 2 types on all patients who are transfusion candidates it is not mandatory to repeat such, but I never stop a tech from doing it if it makes them feel more comfortable. We do document these retypes. We stopped performing an auto ct when we switched to gel antibody screens but we do run an auto if and when we perform an antibody id. We do not do DATs with xms. We are a 40 bed facility with an active transfusion and reference service.

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I was just trying to get an idea of what everyone is doing out there:

1. Do you retype a specimen everytime it is touched. For example if day shift does the crossmatch and you come later and do a add-on do you retype the specimne? If so is it documented? No we donot retype our specimen. Our old timers used to do that but they are gone now.

2. If you are doing this are you also doing some sort of documented second type? All our patient without historical type at our facility gets second type done by 2nd tech(do not charge the patient).

3. Do you do a DAT on all crossmatch specimens? No.

4. What sort of facility are you? 400 bed hospital with very active transfusion services.

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For retypes, if a patient does not have a verified blood type on file, a second specimen is drawn after testing of the first specimen is complete. This re-draw is done, preferably by a second phlebotomist, at a different time. Anything else, other than a second draw at a second time, is pointless if you want to verify a patient's ABO/Rh.

DAT's are only run on patients that have been transfused within the previous three months, positive antibody screens, or patients with a previous antibody history.

We're a 295 bed facility in upstate NY with no maternity but an active OP and dialysis dept.

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We just do a quick back type on the patient if more units are added on at a later date and the tube is within the 72-hour time limit. And yes it is documneted.

We only do DATs and autos for 'problem' patients: + antibody screen workups, colds, etc

We are a 220-bed hospital, issuing about 250 units of red cells a month.

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1. Do you retype a specimen everytime it is touched. For example if day shift does the crossmatch and you come later and do a add-on do you retype the specimne? If so is it documented? Currently yes, with the new computer system we are installing NO.

2. If you are doing this are you also doing some sort of documented second type? No

3. Do you do a DAT on all crossmatch specimens? NO!!!!

4. What sort of facility are you? 300 - 350 beds, level 2 trauma center with full service for just about everything but transplants.

:fingerscr

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We do a retype if an order for added units is received for the same specimen, though no repeat on the antibody screen. Yes, we document it but we do not charge for it.

We have a retype policy, but that is a separate issue in our minds and applies to the original crossmatch order for patients with no previous record.

We do not do a DAT routinely with crossmatches. We do require a DAT and/or auto with antibody ID workups. We have a couple of physicians (oncologists) that ask about the auto on some of their patients when they transfuse them, but I simply tell them that they have to order that test if they want it. I will not start doing it on all (or even some) crossmatches again - no way!

We are a 186 bed hospital in the Great Plains and transfuse approx 165 units a month to a broad range of patients.

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We do a re-type when a specimen is added on to by another Tech. Yes-it is documented in the computer as a re-type. (This is a totally separate issue from the possible solution to the new CAP requirement of positive patient identification which can be accomplished by performing a second type on a second phlebotomy.) We only perform DAT's when we get a positive screen and are doing an ABID. We are a 350 bed hospital with active ED and Maternity.

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Hope this helps...

1. Do you retype a specimen everytime it is touched. For example if day shift does the crossmatch and you come later and do a add-on do you retype the specimne? If so is it documented? If a 2nd tech does the crossmatch then a retype is done. On the other hand if the same tech that did the original type and screen also does the crossmatch then the second type is omitted.

2. If you are doing this are you also doing some sort of documented second type?An internal order is generated and resulted in the computer. The patient is not charged and the test does not appear on the patient's chart.

3. Do you do a DAT on all crossmatch specimens? No.

4. What sort of facility are you? We are a 700+ bed hospital.

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We don't repeat types for add-on orders, but our policy requires checking that the band number and patient ID match for specimen currently used and specimen on record. Also our computer keeps all add-ons on the same specimen number for the life of the specimen (3 days) so it is easy to make sure we are using the same specimen.

We do a DAT or Auto control only with Ab IDs, not screens.

We are an independent lab serving 2 hospitals that total about 150 beds.

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We do a retype with a second cell suspension (same sample) done by a second tech if possible. No charge to pt, does not appear on chart.

Autocontrol done with a panel, DAT (poly, then IgG, then complement) if AC is pos and pt has been tx in last 21 days.

350 bed, level II trauma center in suburban St. Louis, MO

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For patients with no historical blood type we require a 2nd specimen to retype. This type is documented. For add on units, if a tech wants to recheck the type they are free to do so but it is not documented nor required. We only perform an auto control on panels when the screens are positive. If the auto control is positive we will do a DAT if the patient has been recently transfused. I am from a hospital in Louisiana that is a 500 bed hospital and is a level 1 trauma center.

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