14 February 2024 (Wednesday) - Getting the BTLP-TACT Wrong. Again.

Time for another BTLP-TACT exercise… It gave me two cases.
 
00403 – a fifty-eight year-old woman needing group & save for a hernia repair.
 
Her blood group was indeterminate as a positive result in the control tube invalidated the entire blood group. Apparently.
Fortunately the antibody screen was negative.
  
92445 – a seventy-six year old woman needing four units of FFP for reversal of warfarin therapy. Personally I wouldn’t have used FFP for reversal of warfarin therapy, but presumably the nice people at BTLP-TACT had already had that argument.
 
She grouped as A Rh(D) Negative with antibody panel positive in cell 3. I requested antibody panels. The IAT and enzyme panels were positive in cell 8 corresponding with anti-Kp(a)
I issued two units of A Rh(D) Negative FFP, and two units of A Rh(D) Positive FFP as there was no more A Rh(D) Negative FFP or any AB Rh(D) Negative FFB
 
I got the thumbs-down. I wasn’t supposed to issue any plasma at all. Well, I know that. But when I said “presumably the nice people at BTLP-TACT had already had that argument”, clearly they hadn’t.
 
I’m getting fed up trying to second-guess this software…

 

13 February 2024 (Tuesday) - Eighty Four Point Five Per Cent

I started this quality management course three weeks ago when I said “I’ve always considered “Quality Management” to be a load of blah-blah-blah that gets in the way of doing my job, and for years I’ve been wondering just what I’m missing. I must be missing something.
So far the course has been nothing but blah-blah-blah, and all it is doing is confirming my preconceptions.
 
I finished the course today and got eighty four point five per cent. I’ve clearly learned something during this time, but it has to be said there was a *lot* of “blah-blah-blah”. It really could have done with a whole lot less general theoretical and a whole lot more specific practical examples.
 
But eighty four point five per cent is eighty four point five per cent, isn’t it? There’s something tangible I can stick in a CPD audit should the need arise.
The course I’ve just done made it quite clear that a CPD audit of the sort I’m talking about here in no way contributes to workplace quality. And that’s why I’m still cynical.

8 February 2024 (Thursday) - MDS

The nice people at Oncology Central sent their update today. As always, much of it went over my head, but there was one rather interesting article about the diagnosis of myelodysplastic syndrome.

Back in the day MDS was something of a catch-all labelling of pre-leukaemic conditions. Things are getting a tad more specific these days


7 February 2024 (Wednesday) - Placental Growth Factor

The future? Here’s an article about a quick, accurate new blood test for pre-eclampsia which is contributing to safer pregnancies and better outcomes for tens of thousands of women and their unborn babies every year.

How long will it be before I’m performing placental growth factor assays?


6 February 2024 (Tuesday) - Fritsma Factor Newsletter


Cryoprecipitate, platelet function tests… again the Fritsma Factor newsletter comes up trumps.
You can read it by clicking here. There’s not lots, but what there is, is good.

3 February 2024 (Saturday) - More Quality Management

Having identified a problem... is it really a problem? Was there an error that came to light? Has there been a complaint? Or is there something in the workplace that could be changed easily and that would be used to tick a quality management box?
Having identified a real (as opposed to imagined or made up for a paperwork exercise) problem, is this one that can be readily rectified? And exactly how can we be sure that what changes we make actually eliminate or reduce the percieved problem?

An example was given from a well-known manucaturer of office equipment who felt they were paying far too much in transport costs when getting stuff in from their suppliers. At the end of the process they cut a list of three thousand suppliers down to three hundred; thereby eliminating the transport and administration costs of dealing with two thousand seven hundred companies. 

Suddenly quality management is all making sense.

2 February 2024 (Friday) - Haemostasis Update

The Journal of Thrombosis and Haemostasis sent its update today. Some interesting articles…

I’m always interested in haemostatic articles – when you think about it, there is such a fine line between our bodies bleeding out and clotting into one solid lump.