BenchTech

I am hoping that some of you out there can help me, like every blood bank in every hospital we have a fair amount of specimens that we reject because they do not meet our policy. We have been asked to present our quality data at an up coming QA meeting and also to justify our policy. People are frustrated that they have to have a separate patient ID band (Typenex) for blood bank and are using the excuse that they are to busy. Personally I would be embarrassed to use the excuse I am to busy to do my job correctly but the administration wants to review the need for the extra bands. We are looking for data on how our % of mislabeled/rejected specimens measures up to other facilities of all sizes. If any of you have the data you would be willing to share we would much appreciate it. We are looking for number of transfusion specimens in a yearr or month, and the number rejected for mislabeling and the amount rejected for hemolysis if you have that as well. Thank you in advance.!

Our OR has used TEG testing for the last 4-5 years at our hospital to get an idea of what the total platelet inhibition in all the cases is. Over that time there was a noticeable decrease in the use of FFP, Plts and Cryo. I don't know if any of you are familiar with this testing but it's really cool.

Hopefully by talking to your provider you will get the answers that you need, if not try calling the blood bank at the hospital you will be delivering at and speaking to the supervisor about getting the pathologist at that hospital involved. The pathologist should be a good resource for your provider should they have questions about the possible implications of Anti-Cw. Just out of curiosity where are you located?

That's a great point GilTphoto, but often times we would have a neonate receive multiple plt transfusions over the course of a couple days. We would try and keep them on one single plt as long as we could to decrease the donor exposure. We were lucky and had the luxury of ordering one AB plt to have on hand for just neonate use.

I don’t know a single tech that enjoys doing a Kleihauer Betke in fact I can’t think of a test that I hate more. Unfortunately if the majority of your orders are on patients who have fallen or have been in accidents having the results can be extremely important to have turned around as quickly as possible. Where the test is done can really depend on the facility. If you work a large specialized medical center where all techs are only blood bankers or hematologists I have found that the test is generally performed in hematology as it is more similar to what they generally do than what the blood bankers do. If the majority of your techs are generalists as in most hospitals, then it is not asking too much to have the blood bankers do the test. Any where I have ever been we have always done it as a STAT test, 1-2 hr turn around on all shifts. In order to keep competency we would routinely make up “test” cases for people to review. One of the cases would generally be a patient with a really high WBC count spiked with some cord blood so people could get used to seeing the cells side by side. As for generalists having a fit, they always have fits when stuff changes especially if you are adding work when they already feel overwork. Most of the time they are just nervous that they will be expected to do more with out receiving the additional training and support that they need. As long as you make the transition with out pushing someone who is uncomfortable with the test into it to fast you should be okay.

When I worked at a place that transfused to neonates, the docs would order in MLs and we would sterilely aliquot type AB plts only in to a syringe.