JasonS

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Our LIS prints out a requisition for the Cord whenever a baby is born. This requisition contains the mother's type and screen results.(Conveniently our LIS connects the Mother & Baby's accounts. We have Meditech and I'm not exactly sure how they do so.) The technologist then looks at the printout of every cord we get and automatically does the ABO/DAT if the mother is Rh negative. We have a comment in the mother's specimen(if she is RH negative and giving birth) that needs to be filled after the baby ABO/DAT is finished, so it will show up on our pending board until the baby specimen is done and the results added to the mom's specimen. We do not automatically test the cords if the mother is group O. In these cases it has to be requested by the floor or as reflex from the baby's bilirubin threshold. We will also do it for positive antibody screens.

I know some hospitals where it is done in Hematology, though here it is done in Blood Bank. I agree with Malcolm on this issue. Your calculation uses the total #counted and # of fetal cells. This is a ratio and so the calculation shouldn't change(other than you changing it to the correct number of total cells counted)

Yes, we do that here.

Our blood bank addon printouts are formatted a bit differently than those for the rest of the core lab. There is a text entry prompt for additional requirements such as Irradiated and CMV negative. This defaults as NONE.

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Is the problem that they can't add a PC onto a submitted type and screen? Or is it when they initially order a type and screen + 2 packed cells it makes 2 requisitions? We have packed cells as an option for the clinician when making a requisition for a type/screen, if they want 2 packed cells when ordering they can simply change it the count to 2. This works similar to adding onto any chemistry test in a requisition except there's a count that we can edit. Once the order is placed though, only the blood bank has the option to add/remove units. The floor can ask for more units via addons which works similarly to addons for the chemistry module where we get a printout and manually change the unit count to whatever is requested.

No, we don't run any controls with it.

We still use the IS crossmatch. (No electronic crossmatching here yet ) If the sample is not on the bench(we put it away) we would also perform RA/RB to confirm the group on the sample. I believe we are moving towards the 2 sample policy and can then bring in electronic XM. Until then I will spend my time doing all these IS crossmatches.

In our system the physician can either order a screen only, culture only, or a screen + culture. The lab does not reflex culture based off of the results when only a screen is ordered, so it is up to the physician to request an addon for a culture after viewing the results. If a culture is ordered it is worked up regardless of negative results for the UA. Cultures are probably ordered preemptively and thus worked up on > 70% of urines, but it really depends on the physician. I would be curious as to what our stats are for urine culture growth rates. On a side note, how often do your hospitals perform urine microscopics? Ours are not order-able by physicians, but reflex off of any positive for PRO, NIT, WBC, BLOOD. As a result we read dozens a shift.

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I was wondering this too.

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We also do this.

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