COTTONBALL

Thanks so much for the input, but they are years away from computer crossmatching. They are hardworking, intelligent techs who have been short-changed for quite some time now. They don't know, what they don't know. I worked so hard with them these past 18 months, and they were actually beginning to like and appreciate my position on quality, and giving our patients the very best experience possible. I pray the buy-in sticks with them. This is the first for-profit organization I have worked for in my 25 years, and what a difference. Nursing is big on quality and for the most part knows the state of the lab. I have resigned my position on principle, and really hated leaving my wonderful coworkers. My core values in always doing the right thing, especially for patients well-being, I cannot trade in. I reported my concerns to upper management before leaving. Have two job offers already, but will take the next few weeks to get some sleep and hopefully grow some hair back Regards, Connie

Wow! I guess I am getting too old in the business (25 years). In the old days we use to work exclusively in Blood Bank, however I know the culture has changed to cross-training in multiple areas of the labs. Still, this is a highly specialized area, and we must be seriously confident in our PPPs and techs. If performed correctly, an immediate spin Major crossmatch will capture ABO incompatibility. Further, it takes under a minute to perform a history check, and EVERY single time you crossmatch, add-on, or assign a blood product, you need to know your patient. Respectfully, Cottonball, MT(ASCP)SBB

Hi Mabel, when you say "if you are not inspected by JC..." do you mean the lab or the organization? The reason I am asking(naively) is because I have never had a JC inspector visit the Transfusion Service department at the JC-inspected hospitals where I have worked in the past. Regards, Connie

:cries:HELP! I am wondering if you all will update me on current standards or best practices in reference to a process for Blood Bank work review. I manage 30 techs (most are generalist) and have been performing daily reviews of their work. Along with review of Meditech exception reports and override reports I find lots of errors, as you can imagine the deviations and FDA/CBER reports are plentiful. This fast-paced level II trauma center needs fast-paced competent techs. I have been in the business for 25 yrs (only 18 months here). Turnover rates and rushed training sessions (two weeks) contribute to substandard lab practices. The problem is a Director who does not understand Transfusion Medicine and the potential harm we can bring to our patients (he only sees numbers). If I could list the errors here, you may also lose sleep tonight. :angered:He called CAP and asked if we needed to review 100% results. He wants to change to reviewing only 5% daily . To me this is unethical, unsafe and an accident waiting to happen. I am seriously concerned for the patients, so I turned in my resignation. All input, comments, and suggestions welcomed. No spell checks please. Sincerely, Cottonball, MT (ASCP)SBB

Hi Malcolm, Thanks for the generous amount of information and a very good antigen structure review. Interesting case that you have, and so I am thinking when you say your patient was M+N-, this means serologically, and normal "N" antigen by molecular or other test. In your line of work, "seldom" should be used with caution . Can't wait to read your story. Thanks for all that you do. Regards, Connie Cottman, MT(ASCP)SBBCM

Greetings fellow BBkers, Need to know your stories/cases on Anti-N. I know quite a few things about antibodies and I have seen Anti-N at least three times in my 20 years, so would like to hear REAL cases that you have experienced. Because some techs have never seen certain antibodies, they believe for example, an Anit-N is not possible. Everything has been ruled out, plus antigrams/panel cells reactions fit Anti-N, perfectly on more than one hospital visit. Father's sample is not available, plus we are not trying to do any additional work, as Anti-N is usually insignificant, not implicated in HDN, and patient has delivered. Your input is most appreciated. Kind regards, Connie Cottman, MT(ASCP)SBBCM

At least keep them up to ring in the brand New Year! Sad to say, but breaking them makes me happy:)

Are you kidding me? I am sitting here at work breaking all of the christmas bulbs. I can't even explain the fun that I am having. Thanx so much for the snow flakes as well:)

I agree with L106. As you know, you have to scope it to confirm the "stacks of coins" and so, to take a peak at it (microscopically) after saline replacement, should not do any harm. Some weak reacting, cold antibodies, plus Anti-A1 (reverse typing)may be lurking. I would follow my written procedures.

"Electronic issue" = logic, but ya gotta let some things go Mr. Malcolm:)

While spending a year in Waco, I learned about their Dr. Pepper soda. Rhode Island... Pepper popular?? I always imagine a nice, quiet place, now add to that, "harvesting peppers".

RE: Cottonball Thanks a bunch, L106, and Doc. Is that Dr.Pepper of Waco,TX?

aakupaku, you are probably correct. If I were new to the business, there would be no mad rush to SBB certification and I probably would have gone to SBB school. Also, there is no subsitute for Hospital and Reference lab experience(s). As you stated, 20 years plus Lead/Supervisory experience(s), we have seen quite a bit, and still growing.

Thanks tbostock, RR1, and LaraT23. And yes Lara, I will be around contributing my two cents, hopefully for a very long time. There is so much more to learn, plus it's fun.

Hey, thanks you guys. And Angela, Congrats! to you as well.

Hi jmphil4, I did not attend SBB school and passed the exam on first try, yesterday. However, I attended the SBB weekend review in Houston, studied the Technical manual, Standards, Denise Harmening's 15th ed. from cover to cover, and stayed plugged-in to this site. There is a lot of education material at this site. The questions on the exam are not Blood Bank 101 so you really need to know what to study. I was happy to see a question about the GATA-1 mutation and the Duffy system (I got that one). But with another question, knowing aspirin inactivates platelets was not enough, they wanted to know the exact mechanism- COX.... If you have serious study habits and time, and know what to study/learn, you can do it. I strongly recommend attending the Review in Houston. It covered a lot of material and it is a very good start.

Hello to all of my BB friends around the world- London, Hong Kong, Amsterdam (a few of my favorite visits). I found this site over a year ago, and just like a good book, could not put it down. I consider myself a pretty sharp BBur, but the knowledge and wisdom at this site makes me "much mo smarter":D I took the SBB review in Houston (hosted by Clara Wong); studied my but off for about 9 months and passed the exam on first try, yesterday. Just wanted to thank you all for the enormous information flowing through these chats. I appreciate all of you. And Mr. Malcolm Needs (across the pond), you are infectious. Please continue to do what you do. Please, no spell checks today. Kind regards, Connie Cottman MT (ASCP) SBB

This is just a test.