bmarotto

We order the patient retype test, result each phase with NT (not tested) and enter the historical interpretation. When the exception for the interpreation comes up, we respond with a canned message. We have a canned message called HIST which translates as "Historical Blood Type from (name of previous BBIS)". It works well for us and has not given us problems during inspections, including the FDA.

What about ABO & Rh? We do both automated and tube. The primary test is done by automated solid phase. Confirmatory blood types if there is no historical type are done by tube, albeit on a different sample. We do about 15 tube confirmatory blood types a day. It seems that we have method comparison built in to our daily workflow but will CAP see it that way? I am wondering if I need to add ABO & Rh to the twice a year comparison.

I am not familiar with Meditech but I would not forget to test some oddball scenarios to make sure the logic holds. For example, if you divide units try dividing both before and after performing EXM. If Meditech allows the user to edit/delete a unit blood type you should test that as well, especially after the EXM has been performed but before the unit is issued. What if units are electronically crossmatched on yesterdays sample and you get a new sample today and identify an antibody? If you try to issue the EXM compatible units does the system alert you? When you validate, you try to poke holes in the existing logic. The straightforward scenarios will likely validate just fine.

We are evaluating our irradiation policy and would like to know what other places do. I would appreciate answers to any of these questions if they pertain to your facility: 1. Do you provide irradiated red cell/platelet products for all acute leukemias? 2. Do you provide irradiated red cell/platelet products for myelodysplastic syndrome? 3. If you provide all irradiated red cell/platelet products, how did you set up your fee structure? Do you charge all products the fee you used for non irradiated products, the fee for irradiated products, or did you establish a new fee somewhere in between? 4. If you provide all irradiated red cell/platelet products, did your compliance department have any concerns abou this? Thanks in advance. Bev

Same here; the date of service for billing is the sample collect date.

Great stress reliever. I am going to smash those lights all weekend!

Happy Birthday, Malcolm. :hooray:

I saw the snow yesterday and thought my eye floaters were back until I checked a few other sites. I agree with Terri...I love snow that I don't have to shovel or drive in. Where are the colored lights?

This is one of those that has me seeing red. So a unit can be issued to a floor an returned at 9C and be acceptable but if it comes back in a cooler at 7C you discard it. I like your "in motion" statement. Maybe we should have things like baggage claim carousels installed to keep transporting the coolers round and round until they are used or returned.:nana:

Please clarify if the unit was originally grouped as Group A by the Tango/Techno but mislabeled as Group B (i.e. was it clerical error in the labeling of the unit or did Tango/Techno give an incorrect ABO result?). If the patient is Group B and the unit was labeled Group B (incorrectly) and the crossmatch was compatible what made you question the ABO group of the unit? You say there was no forward/reverse group discrepancy (I assume you mean the patient)...if this is the case and you did not do immediate spin crossmatch perhaps the patient's anti-A is not reacting at AHG. Try testing the patient's reverse group at AHG.

I know there are hospitals that irradiate all red cells and platelets. How did you set your charges? Assuming there may be emergencies when it is not possible to irradiate units fast enough there will have to be charge codes for both irradiated and non irradiated products. Did you set the fee the same for both?

Yes, the shielding appears to have solved the daily connectivity error problem. We have only had one in the month since the shields were applied.

Hi Denny, Here is a link to a BB Pathlab Talk thread that talked about the PEG procedure. You are correct, it was David Saikin. We have been using the procedure for a few years. It is very simple and works well for us. Bev http://www.pathlabtalk.com/forum/archive/index.php?t-2807.html

I am sorry to hear about the fire and loss of you possessions. The important thing is you are all safe. It is amazing you are finding the time to follow Blood Bank talk. Will you have to find a new home or can your place be restored? P.S. It is great to see you have not lost your sense of humor. -Bev

What we found very helpful was to have a clinician buy into the program and work with the Blood Bank director to educate all clinical staff. We were fortunate to have a new intensivist who had an interest in Blood Management. Together, they visited every clinical department to outline the program. There was also a required online learning course. Our order sets are still on paper but physicians are required to select a reason for transfusion from an approved list. There is an "other" category where they can justify why they are transfusing outside of guidelines. There is a note that "other" reasons are subject to peer review. If there is no reason indicated, we request the order to be resent. We are about four months since go-live and red cell transfusions are down significantly (approx 8%). We thought it could be the summer months but our September numbers were also down. Time will tell.....

Carefusion and CareChek are two standalone applications that are approved for blood administration.

I believe this is the item you may be looking for: http://www.wescottlabs.com/bldbnk/labaccessories/la-ttv.php I do not believe in routine microscopic readings but I do find it helpful to detect weak mixed field reactions.

We are still waiting for the ferrite noise filters to be installed. BioRad is pretty sure there is some EM interference from the new PC that was installed next to the Tango. The timing of when we started getting the connectivity problem supports this theory.

Just a guess...but microsopic reactions?

Ther error we get is "No connection to device via serial interface". Sometimes we also get "Installed version does not match the analyzer or system is turned off". We have not had any LIS interface errors. It keeps nagging at me that we never got these errors over the three months of validating and training. The only thing that changed just before the errors started was the installation of that new PC. If we turn the PC off for a few days and the errors go away then we'll have an answer....but will still need a solution!

Are you talking about the connector for the interface between Tango and your LIS? Our problem is the serial connection between the Tango and the Tango PC, causing the Tango software to freeze.

In looking back, our connectivity problems began around the time we had a new PC and monitor wall mounted next to one of the Tangos so the techs could verify exported results in the BBIS. Three months of testing, validating, and training prior to that PC being installed and there were no connectivity issues. I find this very suspicious. I have asked our BioMedical engineers if they have any kind of device for measuring electromagnetic interference. Maybe we will just turn the PC off for a few days and see if the connectivity issues dissapear.

We have been live with Tango for three weeks. We have two Tangos and have been getting connectivitiy issue on both. BioRad will be trying two things next week. 1. Placing shielding on the parallel cables to block electromagnetic interference. 2. Reinstalling the firmware. I will let you know if this helps. We did not notice a problem with false positive reactions or carryover during validation or since we have been live. That is not to say we won't see these issues in the future.

Agree.

We have also had good luck with Helmer products.