goodchild

That's exactly why I was curious to see some screen captures. The image quality on the new analyzers (GD Erytra and Ortho VISION) is TOO good.

Mabel, would you be willing to post images of some of the problems you're encountering with specks above the button? I'm very curious. Is the analyzer reporting these as "?" or as negative?

This is a very good/loaded question. See also 42 CFR 493.1256 "Standard - Control Procedures": (d) Unless CMS approves a procedure, specified in Appendix C of the State Operations Manual (CMS Pub. 7), that provides equivalent quality testing, the laboratory must— (7) Over time, rotate control material testing among all operators who perform the test. After my interpretation of the CAP standard and the related CFR, I implemented a rotation of QC across all shifts. It was the bane of our day shift technologists (previously night shift did rack QC and evening shift did ProVue QC), but on the other end, we've virtually eliminated FDA biological product deviation reports related to routine QC problems and everyone seems to have a better handle on QC as a whole. I am in the camp that disagrees that 'regular' or 'over time' can be interpreted as "when we need them to do QC for annual competency assessment."

I can't agree more, with both of your posts.

Recent scenario we had, I thought was relevant: Patient with newly positive antibody screen, ordered for transfusion of two RBCs. Had been admitted for about a month; now diagnosed with numerous medical problems that were previously unknown to the patient. Patient was transfused a total of six RBCs with the last transfusion five days prior. The bench technologist wasn't able to determine a specificity with plasma testing but the autocontrol was positive. (Recent grad, a more seasoned technologist might have suspected the specificity based on pattern of positivity.) DAT was positive with polyspecific AHG and anti-C3. Our procedure indicates to proceed with elution in this case if the patient was transfused in the last 45 days. Eluate testing clearly identified anti-Jka.

I am very interested in how you handle this setup in Meditech.

We don't revalidate either.

There is a Replace BBK Crossmatch Test routine, which can swap the IS XM mnemonic to your IAT XM test mnemonic.

Anytime I suspect weird interactions with reagent cells, I recommend grabbing a few units from the shelf and seeing what those results look like.

That's a very good thing to keep in mind, thank you for posting that.

anti-D presumably due to RhIg, antibodies which fall into our bucket of "cold antibody", and Knops system/Ch/Rg/Cost antibodies. We may have another look at it before it's published to live and procedures updated.

It's interesting that you posted this because the supervisor and I reviewed our Meditech Antibody and Antigen dictionaries just recently. It hadn't been done in many years and whoever set it up previously configured antigen warnings and IAT XM for every antibody, so review/revision was a long time coming! One difference from the discussion here that we decided upon was to retain the requirement of IAT XM for antibody of undetermined specificity (INC).

Yes.

We've enabled edits of specimen expiration, the issue is that we have the product safeguards in place (Product dictionary, page 6, B for Type and B for antibody screen). When a patient comes in through an outpatient area they get a clinic account. The Oncology transfusion or surgery is on a completely different account, so if blood is ordered, it can't be crossmatched without the blood type and antibody screen results. Sure, in the requisition desktop you can move the type and screen from the clinic account but that's actually out of compliance from a billing perspective.

How does everyone with Meditech C/S handle outpatient Type and Screens which need to be used for Oncology or inpatient transfusion? I would love to hear some solutions.

This may shock anyone using Meditech TAR at their hospital but we have successfully implemented TAR in ED and OR (i.e. anesthesiologists) this year !

Where did FDA address transport containers (coolers) as storage?

After that laundry list what's left to love? I do like the user interface. . .

Also curious about this topic.

Is this Client Server or Magic? What version number?

I'm not a JC assessor but I think referencing the current edition technical manual as a supporting document for a procedure makes sense. If you cite the AABB technical manual for a specific guideline/verbiage/bit of info, then it doesn't make sense (to me) to state current edition, because the cited information could change.

Following this with curiosity.

Perhaps check with your LIS analyst to see if they can create a separate antibody in the dictionary that would represent RhIg and set the clinical significance of the antibody to 'no.'

@amurphy Wow, someone from Meditech! Sending you a PM about an unrelated issue so I don't hijack the thread.

You can never charge two HCPCs codes for a single transfusion. You also can't individually charge testing/processing CPT codes if there's a bundled HCPCs code that describes it best.