skopti

We have been on Cerner Millennium since March 2003 and have encountered this isuue all along. The supervisor reviews the BB Review Que report, investigates and if no blood group is available a no charge ABORH is ordered and resulted.

Good Luck and best wishes.

For newly identified antibodies, our technologists report the antibody ID, then the BB pathologist enters his consult comments.

Our CAP inspection is due by 10/19/2007. SO far no CAP team has shown up (we are a multifacility organizations, 5 Hospitals and 1 core lab) a team of 22 people will be comong. not sure when....we were informed by CAP if the inspection team does not shoe up by the due date, our Accreditation will be extended until the inspection is performed.. Also, I am an AABB and CAP Assessor. I have performed few unannounced AABB and CAP coordinated inspections and had a pleasent expereince with the facilities i inspected. If you run a good blood bank you should always be ready for inspections.

The blood bank used to dispense Albumin until pharmacy took it over 6 years ago.... best move they ever did!!!

We counsider the unit to be transfused and we enter a note into the product comments indicating the estimated volume infused, 5 ml, 10, etc..... and the patient will be charged for the unit (since the unit will not be used for another patient).

In addition, AABB has a questions that facilities should have an ISBT implementation plan in place by November 2006.

AABB requires that all AABB accredited facilities be up on ISBT 128 by 5/1/2008

In 2003 we moved to a new BB computer system, we did the validation in house and it took about 12 weeks to validate. In 2005 we did an upgrade to the system and we validated the system in house and it took 3 weeks using 2 techs and 1 IST Analyst.

Cerner Millennium does support Digi-Trax ISBT 128 label printers as a standalone printers. The ME 2007 rev supports Interfaced printers. Currently we are in the middle of upgrading from ME 2004.08 to Cerner ME 2007.08 and planning on Interfacing our Blood Bank module with the Digitrax ISBT128 printers. We are a multisite facility and have 6 Blood banks on the system.

At our facility we follow same process, the policies and procedures ar in MS Word format and we password protect them. All procedures are linked to the table of contents by a hyperlink. The first page of each procedure has a header where we have a box to indicate the date of last revision, this way we know this is the most recent copy. Only 2 satff members (Supervisor and a senior tech) have access to modify the policies and procedure. P&P are posted on a shared drive and can be accessed from any PC thoughout the facility.

We place all Blood products in clear ziplock bags.

At our facility, We only perform a DAT on the pre-Transfusion sample if the Post transfusion DAT is Positive (+). IS your facility CAP Accredited?

We extend our samples to 21 days for surgeries (only patients who have not been transfused or pregnant in the past 3 months. We do not freeze them, they are kept on a special (21day samples) shelf in the fridge.

If patient was not transfused , then an autoadsorption can be done. Least incompatible units may need to be trasfused.

Unfortunately, the Colts tend to choke towards the end. Still they are one of my favorite teams, after the Bills of course.

We also issue a pool of 10 cryo.

We Replace the saline Bottles monthly every time we change the saline cubes or bottles. Giving them a 30 day expiration.

Currently we are on Millennium, but when we ran Cerner Classic we ordered separate tests on the post reaction sample and a repeat Group and screen on the pre sample. A footnote (using templates) was entered for each test to indictae if it was a pre or post sample test.

1. Albumin - Pharmacy 2. Clotting Factor concentrates - Pharmacy 3. Rh Immune Globulin-intramusular - Blood Bank 4. Rh Immube Globulin-intravenous (WinRho) - Pharmacy 5. IVIg - Pharmacy

If a historic ABO/Rh is already on file, we do not require a new sample for FFP and Plts transfusions.

In our hospital the shifts overlap. The senior or charge technologist conveys the messages to the senior technologist or charge tech on the following shift. Alos, written notes are left on the main desk for all techs to review.

It defeats the purpose of having a computer if you are going to enter ithe results on paper then in the computer. You are duplicating your work and wasting time also increasing your chances of errors. At our institution we do a direct result entry into the computer.

We use a 6% albumin control

We tag them when they are received from the supplier. If not used for the intended recipient within 12 hours they wil be given to a different patient.