Just wondering how many people repeat every critical (or alert) value they produce. I know it is been considered good lab practice in the past, but is it neccessary - how often does the repeat not match the origianl? I know there is no CAP requirement. I just wanted to see what others are doing/thinking.

Thank you -

Evan Evans MT (ascp)

Core Lab Supervisor

Memorial Hospital

Bellevilel, IL 62226

eevans@memhosp.com

Why repeat it--don't you trust your system to do the job right? Personally, unless you have good reason to disbelieve the result you are taking longer to report the most urgent test results. In answer to your question, we do not repeat unless there are reason to repeat.

Like Bill, we do not repeat the testing when we get a critical value unless there is reason to suspect there was some type of problem with the testing.

Donna

Same here. We would only repeat if a delta check or some other indicator suggested that the result may be in error (just as for any result).

Delta checks are invaluable! There are many instances in my career where a crossmatch has been requested (significant number of units) and a review of the chemistry deltas has show that it was a drip arm sample. It is also our *ONLY* way of identifying for sure that the blood bank sample has been taken from the correct patient - and I have requested repeats on crossmatch samples due to erroneous deltas, and had different blood groups on the two samples. There are chemistry parameters that do not vary much with time and are invaluable to us. There is a huge amount of literature about delta checks and the need to make use of this tool! Chemistry is where good blood bank procedures begin...

In my lab we check the chemistry deltas for all crossmatch requests - it's not a difficult or time consuming thing to do - the computer does it for us - it's up to us to make use of it...

Edit - I'm doing my November CPD talk on chemistry delta checks and their impact on blood bank. If anyone wants a copy of my notes and references email me on leanne.kaut@nhs.net.

Edited October 25, 201113 yr by Auntie-D

"It is also our *ONLY* way of identifying for sure that the blood bank sample has been taken from the correct patient"

Really? I am guessing that your hospital armbands are not always reliable or cut off or something?

If its so bad you may want to look into using your own blood bank armbands for positive ID of patients from when the T&S is drawn to when the unit is hung. I am not sure why you would want to rely on delta checks as a "sure" way to detect patient ID errors. (Maybe I am misreading what you are saying?)

"It is also our *ONLY* way of identifying for sure that the blood bank sample has been taken from the correct patient"

Really? I am guessing that your hospital armbands are not always reliable or cut off or something?

If its so bad you may want to look into using your own blood bank armbands for positive ID of patients from when the T&S is drawn to when the unit is hung. I am not sure why you would want to rely on delta checks as a "sure" way to detect patient ID errors. (Maybe I am misreading what you are saying?)

Hospital policy is to use the wristbands in the case of an unconcious patient and verbal confimation for a concious patient. A delta check would pick up a failure in procedure. And if a delta check was ignored and a patient was transfused the wrong blood the legal people would be pulling their hair out. Delta checks are our final check to verify the validity of a sample.

I've just this minute used the delta check and identified a drip arm sample on a patient with a Na of 118 - all the other results were low too compared with the previous sample. I've just validated the repeat sample and all the parameters are now normal. Reporting borderline calcium, sodium and the like could have resulted a patient being treated in an adverse manner.

I LOVE the delta check

OK, thanks Auntie. I agree with the importance of delta checks, just thought the idea of being an adequate check for BB specimen reliability seemed odd considering all of the other methods available to ensure proper patient ID and whatnot. But I think I misread your point. I guess I thought I was in the Blood Bank forum!

But I think I misread your point. I guess I thought I was in the Blood Bank forum!

Nah I'm one of those multidisciplinary freaks!

Just wondering how many people repeat every critical (or alert) value they produce. I know it is been considered good lab practice in the past, but is it neccessary - how often does the repeat not match the origianl? I know there is no CAP requirement. I just wanted to see what others are doing/thinking.

All our criticals are repeated (except our Triage troponins. They use too much sample and take 15 min, and there are repeat testings). Our chem and coag analyzers are programmed to repeat a test if it flags critical. We also repeat any pos DAT's (we view them as critical)