cheru26

Finding a qualified lab tech is extremely hard in rural area.   For those who server rural area hospital laboratory how are you managing staffing issue.  Do you guys use non lab educated ( Biology, chemistry ) graduate to work as tech? 
Any comment/suggestion is welcomed 
thank you  

I am al lab manager in rural area hospital.  Have anyone tried to recruit non-traditional candidates with Bachelor's or Master's degrees in Biology or Chemistry.  According to CLIA #0e101a">A candidate with a master's or bachelor's degree in a chemical, physical, or biological is acceptable.  if any one has a successful story in recruiting and training non tradition lab?  Please share your experience.

Yes, the same unit.   once it is hung it is good for 4 hrs.    No need to use a new blood  product.    limit donor exposure. 

Yes, the same unit.   once it is hung it is good for 4 hrs.    No need to use a new blood  product.    limit donor exposure. 

Yes, the same unit.   once it is hung it is good for 4 hrs.    No need to use a new blood  product.    limit donor exposure. 

Yes, the same unit.   once it is hung it is good for 4 hrs.    No need to use a new blood  product.    limit donor exposure. 

No need to keep. We shred them right away.   

I can share ours.  Send me your email. 

We have been using Cerner Millennium Pathnet since 2005 and our amazing Lab Informatics team has set up QC entry for each test in Pathnet with parameters that we defined. Each test group has an established relationship with a QC group. When opening the result entry worksheet, an appropriate QC group for the tests being resulted must be chosen.  If the QC has not been satisfactorily resulted in the established time period, a warning displays and result/interpretation verification can not proceed until QC has been satisfied. This way we are always confident that QC is current for tests being resulted. If computer downtime is expected, we print copies of QC so we know when it has been performed and when it will expire. If unexpected downtime, we perform and record QC as indicated per procedures and enter it into Pathnet during downtime recovery. This process has served us well for the past 12 years and always satisfies AABB, CAP, FDA,  and internal auditors.

We have been doing this for years. We only only have to use the mom's IAT results if they think they might give blood products to the infant. We do not use the cord blood for baby transfusion because they could be contaminated with mom blood. They must order a specific test for the baby transfusion workup. We use a current baby hemo specimen to perform the baby ABORh off of a "clean " specimen and use the mom's IAT results. The DAT would have already been performed on the cord. Our computer is set up to enter MOM IAT results when we enter the baby's results. They baby is spared being stuck again.
Our baby transfusion population has dropped off to almost nothing in the last year or two. Any baby that might need blood is shipped off. I'm not too sorry about that either.

We do not perform antibody screens on babies, only a forward type and a IgG DAT. We use the mom's results when considering transfusion.  What is your particular concern for using one screen versus the other? If a mom has always had negative screens, never demonstrated an antibody, great, that was easy.  If the mom was previously demonstrating an antibody, even if she is negative now, you would still need to honor that antibody if transfusing mom or baby.  To me, it's no different than any other patient. Their current antibody screen is important, of course, but you still need to honor any previous antibody IDs. 
 

I can email you mine...if you send me your email address.

Perform Crossmatch using existing T&S sample.   The sample is valid and there is not enough time to develop an antibody .
 

It is ok to as long as the sample was in date when issued.   No problem at all. 
 

Per CLSI, the minimum number is 20 sample.  Make sure the Samples you select are fairly distributed in range from negative to large bleed.
 

Are you using gel, tube? We primarily use gel, tube is our back up.
Hope you will find them helpful,
Frenchie
Daily QC worksheet 2016.xls

ORTHO QC Data Sheet bb.f..qc.2.odt

Here is our QC sheet.  We have an "extra" QC sheet for each month to document lot changes during the day, or 3% screen QC.  We document it in the computer.
Daily QC Template Master.xlsx
 
Hope that helps.

Here's my tube QC. It includes only those things we use or are likely to use daily. Some other reagents like ID panels, anti-C3b, -C3d, etc. are QC'd only when used. Those results are logged on the daily worklog.
Daily Reagent QC Data Sheet ver 3 -Tube.doc

Chris H,  I would think the scenario would not be considered emergency since you have one sample history. I would issue O Rh Specific until the second sample.  I am writing our SOP to state if there is no second sample issue O Rh Specific.

We use Data Logger SmartButtons - we validated the buttons against a NIST therm at several temp ranges. Then you just program the button for the time intervals you want (1,2,3......60...240 minutes) and just put it in the cabinet. It logs temps at the interval you program. Let the cabinet run normally (closed) then stress test - load it with outdated plts, leave the doors open, alarm check, etc. Then simply download the button and print the graph. Note on the graph what was going on when temp was out of range. Note temp recovery time. Write it up, you're done. Works for any temp device in the range -40C to 85C. We use them for everything. They are inexpensive and resuable. http://www.microdaq.com/acr/smartbutton/smartbutton.php

Chris H,  I would think the scenario would not be considered emergency since you have one sample history. I would issue O Rh Specific until the second sample.  I am writing our SOP to state if there is no second sample issue O Rh Specific.

We've been live with Cerner since February 2013 and our process is the same.  We get a unit of the patient's blood type from the fridge, go into Result Entry, scan the sample accession label, scan the barcoded BBID (blood bank i.d. from the armband) on the sample, and then scan the unit (however many are ordered).  As soon as you scan a unit, the computer makes the decision that the unit is ABO compatible with the recipient and automatically fills in the interpretation field with Computer XM OK.  Don' forget to pull a segment from the unit as well as a number sticker--we affix the sticker on a 12X75 tube and place the segment inside folded so it won't fall out.  Often we will wait until a nurse comes to pick up blood and just perform a Computer Crossmatch Dispense at that time.  The only thing is you have to manually enter the BBID in the field in the save dialog box when you are dispensing so that it will print on the donor tag.  Since we do not have the sample in hand at that time, I had to figure out a way to be able to quickly find the blood bank armband i.d.  What I did was to build a BBID result field in the ABORh test so that we can quickly look in Order Result Viewer at the most recent type and screen results and see the BBID.  We can then verify it against the blood request form that the nurse brings which MUST have the BBID on it.  We type this into the BBID field during dispense, pull a segment and sticker and we're done.  We never have to handle the patient's sample again.  It took us awhile to get used to this as we went live with electronic crossmatching the same time we went live with Cerner.  Everyone loves it now and we've never looked back, including this "old timer" blood banker!

Here's mine too - if it will help anyone.  Very difficult to get everyone through and despite telling them it is THEIR responsibility - you wind up doing the lion's share of it in order to get it done.
Blood Bank Competency 2014.xls
Blood Bank Skills 2014.xls

This is the electronic tool that I use to track completion. This will give an idea of the "TEST SYSTEMs" that we have decided to evaluate annually for competency. Once an assessment is complete I drop the date in the proper cell and it calculates the completion percent automatically based on how I've set up the spreadsheet.
 
Each cell represents either a completed direct observation checklist, result entry review worksheet, reviewed copy of QC/results worksheet, blind sample testing worksheet, or graded problem solving exam.
 
I have a form document with all of the information from the spreadsheet in a condensed version for the associate/lead technologist to sign when all competency assessment events are complete.
 
Copy of cy2014 competency assessment completion.xlsx