cthherbal

Our policy is to repeat screen by gel and do a panel before determining if we are calling screen Neg or Pos. We are strict with this because antibodies have been missed in the past. We had one sample yesterday weak on SC2, tech thought it was visually negative but on ficin panel was a clear anti-E.

Same as David (gel)

I don't know anyone who is using them, yet.

Huh I have never seen that on a unit label. I thought a hemochromatosis unit could be labeled like any other unit as long as donor met criteria and donor center had an FDA variance.

Could it be anti-i?

Thanks, Sandy L. So, if our antibody ID system is gel, then QC is performed daily.

Yay

Antie D: It's a quick, easy test to detect FMH. Much easier than KB especially as far as competency.

Yes I noticed a weaker positive QC than on prior lots as well.

Need more information to accurately comment. I have some questions- Do you put results in a LIS or on paper? If LIS, is the LIS a blood bank system or do you just put type and screen interpretations in? Does the LIS QA check previous results- for example, if someone was previously entered as O pos and on this admission is A pos, will there be a hard stop/warning? If only on paper, have a second tech review the work and perform a 2nd blood type on another sample before any crossmatching takes place. This is critical to prevent mis-transfusions.

I have worked in 7 hospitals over my career (US) and only 1 of 7 hospitals ran a K+/K- panel cell (with anti-K antisera) upon receipt. We do not QC panel cells- here is my rationale: Antibody detection (screening cells) are QC'd daily. Antibody Identification (Panel cells) are essentially QC'd each time you perform a panel (your patient sera/plasma serves as your QC) as you typically have positive and negative cells for rule in/rule out. Any patients reacting with all panel cells we send to a reference laboratory for ID. If you truly QC'd panel cells you would have to do each antigen (pos and neg) to prove all panel cells are viable for any patient that may come along, with any antibody specificity, within that 4-6 week period that the cells are being used. We do not carry all the antisera in our inventory. Does anyone has the time (or resources) for this? An exception is if you use expired panel cells (for rule outs), pos and neg cells (again patient or antisera can be used) must be tested per CAP to prove panel cells are still working properly for that particular antibody. -Colleen Hinrichsen

We do forward and reverse- required if you use electronic crossmatching.

Interesting discussion, thanks all. I am taking a look at our MTP now and possibly making changes for Peds. We only use blood warmers for RBCs and no other components.

Thanks for bringing this topic to light, Mabel. This relates to a Joint Commission Patient Safety goal: 2014 NPSG.03.05.01 Thank you for sharing the links, Terri.

There was a recent CAP survey (J) that touched on this topic. The summary report was sent to participating sites.

We participated for almost a year but it was a lot of work and it didn't prove to be very useful so we stopped reporting. We do about 4K transfusions a year.

We do same as Dr Pepper. We use the 1-6C purple ones.

Revcos are reliable.

Michaele we use >/= 95% compliance rate of completed slips.

We QC each day of use like Clarest mentions.

chill: We have a required question built into the HIS whenever blood is ordered: Does your patient have sickle cell disease? If the answer is yes, we give C, E, K, and Hgb S negative units (and honor any other antibodies the patient has ever made). We are a community hospital ~200 beds. This information also crosses to our blood bank system automatically to the patient history. We have a similar question for transplant patients. If it's an error (they answer Yes but it's really No), we can fix it in our blood bank system (we use SoftBank).

No Terri

There was also an interesting video presentation on this topic a month or so on OCDs Transfusion News.

I agree with David and Terri. Can not wait for electronic transfusions, hopefully by the end of this year! Terri: Will yours be hospital-wide? I'm thinking OR and outpatients which is manual and ER which uses different software then hospital. Perhaps they will stay on paper...

Yes we do the same as Terri and bxcall1.