goodchild

Brenda, I have one question in relationship to the sensitivity of the camera on the analyzer. Do you occasionally see specs towards the bottom (i.e. no clean delineation of the unagglutinated pellet at the bottom of the well) and have your techs expressed concerns regarding manual interpretation using the image on the screen versus the card in hand? I've heard of issues with the new analyzers and their high definition cameras.

Very useful posts. Thanks for sharing.

Beautifully written.

I would contact the saline manufacturer for more information.

Glad I'm not the only cynic in blood bank!

In addition to current editions of AABB Standards and Technical Manual, we have Modern Blood Banking and Transfusion Practices 6th edition, Human Blood Groups 3rd edition, The Blood Group Antigen FactsBook 3rd edition, Mollison's Blood Transfusion in Clinical Medicine 12th edition, and Practical Guide to Transfusion Medicine 2nd edition. I also have a copy of The Quality Toolbox 2nd edition in my office.

Following this thread to review with greater detail when I get back from vacation. I'll also post some of my own fun ones!

Am I being obtuse? What are you using the scope for?

This is also what we did to QC our ProVue.

We want them on the front, unless it's not possible. On the back it would be a challenge to do the product label to assignment label comparison. We designed the label to be pretty narrow. 3.5"x1".

We finally implemented label technology for crossmatch/assignment tags. Datamax O'Neil E4205A Mark III printers with FDA approved labels manufactured by Zebra. We're on Meditech 5.67 C/S. Nurses and techs love it. Amazing improvement to the workflow (we're transitioning away from a track fed dot matrix printer). We're lucky that 90% of transfusion documentation is electronic (TAR).

I wasn't involved in the validation of our ProVue but from my recollection of the repercussions (and my own subsequent review) it wasn't a great study. When the analyzer 'went live' it was used to perform type and screens, antibody id panels, polyspecific DATs, cord blood evaluations, crossmatches (IS & IAT), donor unit processing - the works. Fast forward to today, where we perform only type and screens.

Our reference lab provides an itemized invoice of testing performed and the associated CPT codes. We have "charge only" tests that we add to the requisition of the original test request based on the invoice. We do a similar process for in-house antibody identifications. All workups are reviewed the next business day, we note the different tests/method counts at the bottom of the AB ID worksheet, and add the appropriate charge only tests to the requisition based on the actual tests performed.

I think what you refer to in regard to the pipettor/camera would be encapsulated by the clinical engineer who conducts the OQ (operational qualification) portion of the validation. My discussion was in reference to PQ (performance qualification). i.e. We know the analyzer is FDA approved and functional but specifically how does the equipment and results it churns out compare to the current results/procedures? Does it meet our expectations? Do we need to modify our expectations/procedures/etc? From my own experience, despite the fact that they use the same reagents, manual gel and ProVue gel can often provide very different results. I think it's important to have context from validation to support the use of the analyzer in its future operation.

I've always found it odd that many institutions do low-powered validations in blood bank, 20% of a month sounds about right to me. When performing a validation I feel that you should provide opportunities for success/failure. With an assumed 5% positive screen rate, performing 40 tests, that would give about 2 opportunities for failure. Even if neither opportunity failed, statistically that would provide less than 90% confidence that 95% of future antibody screens would meet expectations.

We interpret this to mean 96 hours from the specimen's collect time. We also issue up to the expiration time. Similar concept with blood product expiration. If they start transfusing platelets at 23:30 that expire at 23:59, they don't have to stop the transfusion at 00:00.

I can see your point @mpmiola, if the box is validated to keep the blood product at the appropriate temperature for thirty minutes, it stands to reason that it should be acceptable to use for transport to patient care area for immediate transfusion, or during a brief pause (up to 30 min) at the patient's bedside while the nurses prepare for the transfusion. On the other hand, what mechanism prevents this box from being used to store blood at the patient's bedside for longer than 30 minutes?

Congrats on your go-live! Thank you for posting your experiences.

Exactly what I needed, another distraction at work!

When we log incoming RBCs into Meditech it orders a donor unit retype. We save our segments when we pull off segments to do the retype. They go in a biohazard bag labeled for the day they were performed and keep that bag for seven weeks. This process has worked for us for quite a while.

AABB 5.11.4 CAP TRM.41800 You've never encountered a delayed transfusion reaction?

I'm going through the proposal now for my Erytra. Pysched!

Dansket, those screenshots make me feel like an idiot. I felt like I had a good handle on BBK Dictionary development until just now. I don't think I have a clue what's going on there!

We're seeing a lot of question marks on screening cell 3 when it's in well 6 of the anti-IgG cards (ProVue). Manual read is clear negative. Visual inspection of reagents (which we've all done to the nth degree now) hasn't identified a problem with cards or cells. ProVue service came out and everything seems good. Frustrating situation for blood bankers.

Yes!