R1R2

No it doesn't. It also does not require you to test an example of each possible result, for example a positive weak D or positive fetal screen etc.

I have used both types of specimens - real and fake. I prefer the fake (expired unit of red cells and plasma). I can make up a lot of fake specimen and can use one for each associate. By using a fake specimen, the answers are known and will be the same for each tech (I don't have to remember what the results should be if using a different patient sample for each tech). All DOs are done with the fake specimen. Results are recorded in LIS and on any worksheets. Any instrument maintenance is included in the testing DO. A test is included for each test system. I am sure there are so many other ways to accomplish competency. I have attached a CMS document that I have found very helpful. how-lab-personnel-competency-assessments-041316.pdf

Yes and we charge for autologous no used too.

I would be curious if the reactions would go away if saline technique was used instead of gel?

What a good excuse not to pool the plasma. Yes it is easy for the therapeutic operators but a pain for the blood bank. Also, if for some reason, the exchange was cancelled or cut short, you would have a useless pooled product on your hands. If the procedure was cut short, you have exposed your patient to many donors needlessly. My 2 cents

What enhancement media are you using for your screen/antibody ID?

Yes, you need to save the panel sheets, hard copy or scan. You could develop a new policy for suspected RHIG workups to minimize paperwork. I don't know how many panel sheets you are saving now but you could probably reduce to one.

I don't know of any regulation that would require this. I think your current process is sufficient. I would ignore the recommendation.

You may want to rethink sending prelabeled tubes to the patient care area. I can think of at least 3 regulatory agencies that require samples to be labeled in the presence of the patient.

You can use correlation samples with nice, strong reactions to get around this problem.

Can I ask how many RBC units are actually transfused at these small hospitals?

we dropped C/T monitoring after we went to electronic crossmatch

hemoglobin

This is one technique that I would not want to validate in gel. Gel will enhance reactions and will pick up strong, direct agglutinins. A microscopic reaction (negative) in tube could be a 1-2+ (positive) in gel. I don't want to take the chance of enhancing unwanted reactions and would opt tube testing in this case. I am interested if others have done this and their success or failure.

I have seen this numerous times and is most likely due to the A antigen not being completely developed on newborn RBCs. I have seen a fetomaternal hemorrhage do this once in my career but it was detected in the D tube test. Can you look up mom's HGB pre and post delivery?

Having done both crossmatches for years, I can tell you that the IS crossmatch is more susceptible to human and technical error. IS crossmatch has its place in BB but not for routine everyday testing to get the blood out the door IMO. And like Malcolm said, tell him about the money.

Just curious, do you have the option of implementing electronic crossmatch?

I have seen some very serious patient safety events with cooler use too so they are no safer than fridges IMO. The JC sentinel report listed a single fridge holding multiple patients' blood products as one of the root causes identified. Perhaps you can have multiple refrigerators if you have a large trauma center so each Trauma bay has it's own fridge (this was identified as a possible solution in JC report). IF you want a fridge in the Trauma unit then make sure you have put into place policies/procedures that include receipt, storage and return. You should audit the process too.

This would be horrible, if in fact, they were using the test in lieu of a rosette test. All I can think about is he possibility that some moms did not get the required amount of RhIG.

Hi all, Our respiratory department, that performs non waived testing, was cited by the state for not having the technical consultant assess competency. A respiratory therapist with an associate’s degree assessed competency. I have thought about modifying the lab director delegation form to include the respiratory therapist, however the respiratory therapist does not have the required educational background required by CLIA. I know our department is not the only one in this boat and was wondering how others have solved this problem. Thanks in advance, CAROL N

Hi all, Can you let me know what you do for lot to lot for Hemochron ACT PLUS and Avox 1000E. Thanks in advance

Hi all, I need ideas for pre, analytic, post monitors for POC. Also, whom do you report these monitors - lab, hospital or both?

Although not data loggers, our system records temp about every 10 minutes.

I have seen this and it was the pathologist that thought this was a good idea. I reminded him that there is no literature on double filtered products and no one in the whole world does this (I guess I was wrong about that second part). Anyway, perhaps the reason they think it works in reducing transfusion reactions is that they are premedicating everyone. You may want to look at the cost of those filters and how much you will save when you discontinue the practice. I would send out some education to the docs with your pathologist's approval and discontinue this practice. Do you have a Transfusion Committee?

One word - shipping. It is complicated, time consuming, fraught with error. And I agree with all that David wrote.