Quality Assurance Flashcards
What is the quality system
framework that covers all aspects of the operation
What is quality assurance
PLANNED activities that assure and assess quality of operation
-maximize outcome for patient care
-MLTs are responsible or policies and procedures for testing and results
Policy: must do reflex testing for Rhogam for Rh negative women with ectopic pregnancy or vaginal bleed
-if you forget to do this do an incident report
Procedure - Follow SOP to calculate Rhlg dose
What is quality control
operational techniques and activities
What is quality management
- organizes all the labs activities
-includes the 12 quality system essentials
-coordinated activities to direct and control and organization
What was did CBS do when an audit discovered how many RBC units were wasted due to Febrile Non-Hemolytic Transfusion Reactions
Leukocyte-depleted by filtration
What does the accreditation process monitor
examines adherence
IQMH
What is compliance
measures state of adherence to established standards
-inspections done by IQMH
What is the QA policy
- statement that describes what needs to be done and reasons
Perform KLH to assess FMH for RhIg dosage
Perform antibody exclusions on panels to determine
the antibody present before finding compatible blood
What is the QA process
steps in an activity
: If the mother is Rh negative, type the neonate; if the
neonate is Rh positive, perform FMH or KLH
What are examples of QA
Donor Questionnaire * Quality of Donation (examples: method of cleaning arm, sterile equipment, blood mixer, standard volume collected within an acceptable time frame)
- Quality of Donor testing (prevent TTD) * Quality of Processing/Storing and Shipping Products
how to ship blood components
- Special containers
- Cooler packs to maintain temp
- PLTs NO cooler packs
- Dry Ice for frozen components
- Tamper-proof seals on boxes
When receiving blood products at the hospital what is checked
Check boxes for damage or tampering (Seal should be in use)
* Store blood products in properly maintained and specified temperature-controlled equipment.
* Fridges, freezers, platelet agitators, and room temperature shelves
-enter all products into LIS
-revise the expiry dates
-autologous units placed on different shelf
-special phenoyped samples are tagged for the specific patient
Expiry dates
must be placed in order
-monthly audits are done
-oldest in the front
-if irradiated units are not used place in regular inventory
-if assigned units during surgery are not used place in regular inventory
PRBCs are stored separately AFTER confirming ABO/RH
Plasma/Cryos are stored in the freezer - organized by ABO group which
how to thaw
Use plastic bags when thawing
* Not to thaw in the same waterbath as specimens
* Use a monitored, controlled temperature device to thaw plasma.
how are platelet units stored
flat on pull-out shelves and the entire shelf unit
constantly agitates the Platelets.
stored in RT incubator
What is done in blood shortages
Maximize using Rh neg blood for Rh neg patients unless they will expire
What is the compatibility policy
If transfused/pregnant within the last 3 months, the sample is valid for 96 hours.
- Not transfused/pregnant sample is valid for
14 days. - Unknown history? * No Antibody in history or current T/S use IS XM * If an Antibody is present in history or current T/S, use the IS/IAT method with antigen -negative units.
- RA/RB is required if the sample is taken from
storage.
Issuing the blood product
hospital dictates who can pick up
no volunteers
* Date, initial, and time stamp the crossmatch label on all products
* Issue slips follow the unit, and initial vitals and checks are documented on the sheet and placed in patient charts
When is the Visual check of the donor unit done
- Before release, visual examinations are performed
- Look for contamination and hemolysis
What is always kept in case of a transfusion reaction
aliquot of the donor RBC unit
What do you need PRE transfusion
- confirmation of consent for transfusion
-bedside confirmation during issue
-2 RN sign off
What is assessed prior to transfusion
temperature, vitals, and general conditions
-at 15 mins it is done again and then again at specific intervals
What is used to infuse with PRBC, FP, and Platelets
Fractionated products
- PRBC, FP, and Platelets - proper size filter infusion sets only with saline
- Fractionated products - IV or intramuscular injection
Policies regarding the time of transfusion
has to be done in 4 hours
-dont transfuse too fast or risk TACO
-if there is a delay in starting the blood has to be returned within 60 minutes of issuing
-after 60 mins its discarded
