Kathy

Please tell me why, if I use my sterile connection device to attach the syringe/filter set, I have breached the sterility of the syringe, but not the original red cell unit.  It seems to me that if you breach sterility, the entire system is compromised.

I spent 24 years working in 2 pediatric hospitals with level 3 NICUs and can count on one hand the number of times I or any of my colleagues did the procedure.  I doubt there is any hospital that does a lot of them.
 
For competency, you can save up expired RBCs and FFP so that you can do a direct observation. Make sure their final product has the target hematocrit. I would also make a thorough written quiz for assessment of problem solving skills. 

There are no cost effective disposable temperature monitors for platelets that you can stick on the units that I am aware of.  I know that Berlinger makes something that you could have custom made for the 20-24 degree range...cheapest would be about $10 each (Q-Tag, I think), so a bit pricey. 
 
I think the best option is to validate coolers for platelets - you can beef up a standard cooler with Styrofoam, room temp gel packs, etc. and then use a temperature datalogger in the cooler - preferably with an alarm.  I like the Traceable Memory-Loc ones because you can transfer the temp data on USB if needed.  I want the platelets back ASAP... CAP says something about not being agitated for up to 24 hours is acceptable, so you will want to define how long it is OK to be out of the blood bank in your SOP. 

Thanks. We are having a problem with our new LIS company not including the hospital name on their standard tags, which forces us to pay to have them customized so that we have our name and address on them.  We are trying to make a case that that should be standard because it is required.

I agree that this is a very daunting task and I don't know where I'm going to find the time to do the direct observation on all tests for everyone, especially with a new computer system validation and launch coming up soon. I have a few techs on the evening shift who have Florida blood bank supervisor's licenses, so I am going to see if I can delegate some of those tasks to them, after I do the direct observation on them.  I have competency files on all of my techs and whenever I just so happen to observe them doing anything, I write it down in their files. That saves me a little time.  I have made a customized course (quiz) on the CAP website, which assesses their knowledge of our policies and procedures.  I have the AABB publication that has observation checklists and competency assessments, so I will use them as a starting point. 
 
I really don't understand what intermediate worksheets are. If someone could clarify, I would appreciate it.

This job is slowly driving me bonkers.  Every day I find things that the techs have missed such as forgetting to return units in the computer, not logging them into the computer, not changing the current lot number of reagents in the computer, putting the units on the wrong shelf, not cleaning up, leaving paperwork out....I could go on and on.  I am getting frustrated and am beginning to think that maybe this isn't the best position for me to be in. I'm not sure if I am an ineffective leader or if I am just dealing with a normal problem that is part of this job.  I do talk to the techs, and it doesn't look like it is the same tech making the same mistake all of the time.  My techs are mostly generalists. I know that the blood bank is a very complicated department and if you don't work there all of the time, it is easy to forget the details. 
 
The problem I struggle with is the fact that we have rules that must be followed.  There are A LOT of rules.  Is it reasonable to expect a generalist to remember all of those rules?  Is there a way to simplify things for them (checklist, charts, etc?).

I made up a few custom courses (tests) on the CAP website to assess my techs' ability to catch errors.  I made up several specimens that should be rejected, took pictures of them, and uploaded them to the website.  I was able to make up questions about them:  What is appropriate to do with this specimen? A) Accept it B)Allow the collector to fix the missing info C)Reject it... I did the same with tagged units of blood, asking if they were acceptable to issue and if not, why not.  My techs say that it is a difficult test, but I think it is a good way to illustrate how important it is to pay attention to the details.