Guidelines

Service Guidelines

Transfusion medical laboratory tests are available to the patient wards and clinics Hospital USM . Patients of government hospitals and clinics , hospitals and private clinics , and other health centers can use the service in advance through consultations between the relevant patient medical officer with the Medical Officer / hematologist at Hospital USM . The specimens are processed and released after test results confirmed by a hematologist , medical officer , science officer , or medical lab . Applicants are asked to fill space test ' status ' ( emergency or routine ) on MyTransfusi system / application form .

Tests Application Guidelines

Routine tests

Definition: Tests performed on the clinical condition of the patient to detect the normal or as an early screening for the next test.

Can be applied during office hours and outside office hours (oncall).

Urgent tests / STAT (Short Turn Around Time)

Definition: A test that hastened by emergency reasons only. Tests applied will be given priority in the process of analysis and production test results.

Can be applied during office hours or outside office hours (on-call).

Emergency test

Definition: A test that is performed immediately for a blood transfusion and involve certain tests only in Transfusion Medicine Unit.

Special tests

Definition: The confirmation test. Application tests have to be made by appointment or no appointment depends on the type of test requested.

Just received and analyzed during office hours, except for emergency cases.

Routine Tests Offered In Time Out of Office (Oncall)

Test GXM & GSH

Tests other than those mentioned here will only run if there are application-specific and necessary. The approval of the medical officer in charge of the call hematology needed.

List Of Tests

Tests	Routine	STAT	Special	Appointment
Group and Crossmatch (GXM)	✔	✔	✘	✘
Group, Screen and Hold (GSH)	✔	✔	✘	✘
ABO & Rhesus Group	✔	✔	✘	✘
Neonatal Study (ABO/ Rh & DAT)	✔	✔	✘	✘
Direct & Indirect Anti - Human Globulin Test	✔	✔	✘	✘
Antenatal Study (ABO /Rh)	✔	✔	✘	✘
Blood Group Phenotyping	✔	✔	✘	✘
Rhesus Genotyping	✔	✔	✘	✘
Antibody Titer	✔	✔	✘	✘
Antibody Identification	✔	✔	✘	✘
Transfusion Reaction Investigation	✔	✔	✘	✘
Human Platelet Antigen (HPA) Antibody Test	✘	✘	✔	✔
Quantitation of CD34 Positive Cells for Stem Cell Transplantation	✘	✔	✔	✔

The lab is ready to provide consultation services related to the type of test and application test according to the patient's needs . The test results are only issued to those who apply for the exam . The lab did not release the test results directly to patients . The lab is ready to receive complaints and suggestions for improvement of services through channels provided by the laboratory ( phone , the customer complaint form and a customer satisfaction survey ) .

Guidelines For Filling Up The Request Form

All request forms Transfusion Medicine Unit tests need to be completed with the following information correctly :

a ) Patient information ( name , RN , gender , age , hospital / clinic )

b ) The name of the doctor who applied .

c ) The type of specimen and test requested .

d ) The procedures that have been passed by the patient ( pre / post transfusion , prescriptions , etc. ) .

e ) Treatment is being given .

f ) A summary of the relevant patient clinical history .

g ) Date , time and date the specimen was taken .

h ) Request must be registered in the MyTransfusi ( for certain tests )

Request tests are sent to the laboratory must have received the consent of the patient . The ward / clinic is responsible for obtaining approval. It is the responsibility of the laboratory to maintain the confidentiality of test results and patient information.

List of Tests (MyTransfusi)

Specimen Preparation Guidelines & Shipping

a) Make sure identitifikasi patients identified before blood specimen taken (eg, patient name, RN, I / C, etc.). Take a specimen of a patient at a time

b) Fill the specimen up to the benchmark set in the specimen tube.

c) Label the specimen with the patient's name, RN, hospital or clinic, time, date, and type of test. Staff who collect specimens and specimen label staff that they must be the same individual at the patient's bed. Prohibited labeling two or more samples of patients at one time.

d) Take the patient's blood aseptically and use the correct specimen tube.

e) Mix blood with an anticoagulant in a tube containing an anticoagulant, to prevent blood clots (clotted).

f) The specimen should be sent immediately to the laboratory.

g) Lupus specimen material (needles, syringes, cotton, etc.) into an appropriate biohazard container yellow.

Rejection of Specimens and Test Guidelines

a. Clotted except serum samples

b. Application twice

c. Extent of insufficient sample

d. Extent of excess sample

e. lyse sample

f. There are no appointments for tests that require an appointment

g. Along with sample applications not MyTransfusi

h. One tube / sample container

i. Tubes / containers not labeled with complete

j. Name and RN is not the same as the sample and application

k. Incomplete applications where the identity of the application must be at least 2 identities patient information (name, RN)

l. Carbon copy is not equipped for applications is via an application form

m. Tube / sample container leaky

n. one application

o. Applications made in MyTransfusi, but no samples were sent to labs

p. Information sample application form or label can not be read aloud

q. Tube / container has expired

For Transfusion Medicine Unit

a. No numbers MMC / MMC and the doctor's signature on the application form to the Blood Transfusion

b. For patients who need blood transfusions emergency or critical, although the appli must be processed under conditions occur:

1. Carbon copy is incomplete

2. Extent of the sample is less than it should

3. Information patient (patient history, blood group) is not written in the application form

4. Applications not accompanied by slippage blood when blood is drawn however, have at least 2 identities patient information (name, RN)

5. Not registered MyTransfusi

6. Use Plain or sample tubes Clotted

Note: Specimen rejected will not be returned, and the name of the nurse who notified will be recorded on the application form that the test was rejected. Wards / clinics should send specimens and specimen application form or to replace the rejected application form.

Guidelines for Taking Blood Components

Components	Whole Blood/ PackedCells	Platelet Concentrate	Cryo/FFP
Pickup	Thermal insulation container with ice	Thermal insulation container without ice	Thermal insulation container with ice
Storage	Blood transfusion MUST start in 30 minutes and not more than 4 hours	Transfuse IMMEDIATELY within 15-30 minutes
After Use	Return the empty blood bags and blood bags card
Return (Not Use)	Thermal insulation container with ice	Thermal insulation container without ice	Thermal insulation container with ice
Notes	Return immediately if not used with ‘Borang Pemulangan Darah Yang Tidak Diguna’ with a blood bag card. Not allowed to store in the ward.

Therapeutic Apheresis Guidelines

Platelet apheresis is obtained when the blood is processed and isolated using apheresis machine . Platelets donated by a donor using an apheresis machine is equivalent to 6-10 bags of platelets are produced in the usual way ( random donation ). The use of platelet apheresis platelet production can reduce the risk of exposure of patients antibodies against the donor can be reduced. Among the indications for apheresis platelet transfusion is : Patients who have antibodies against platelet Patients undergoing chemotherapy treatment for leukemia

a . Patients with antibodies against platelets

b . Patients undergoing chemotherapy treatment for leukemia

c . Patients undergoing bone marrow or organ transplants

d . Patients undergoing coronary artery surgery

e . Patients who require a transfusion of platelets continuously such as aplastic anemia patients

Blood Irradiation Guidelines

Source: 2010 Blackwell Publishing Ltd, British Journal of Haematology, 152, 35–51

Stem Cells Guidelines

Autologous Haematopoietic Stem Cell Transplantation ( AHSCT )

Stem cell laboratory in the services provide stem cells. Autologous stem cell transplant introduced since 2008 involving cooperation ward 3S / 1TD / Daycare which is a medical procedure used to treat and cure patients with abnormal blood . To ward dealing with stem cell laboratory , a number of procedures to be followed and adhered to in respect of the application testing process and results of tests run smoothly and systematically .

Laboratory stem cells provides a flowchart to facilitate the admission ward involving CD34 test sample to sample storage until harvest . In summary, the daycare ward will call the laboratory to the patient appointment process . Among the criteria for appointment is the name of the patient , RN , diagnosis , date mobilize , day 10 and the expected date of harvest .Normally, this appointment is a month earlier than the date of harvest patients .

After the approval of the ward, the lab will issue a schedule of rotation duty roster for laboratory staff to facilitate the wards mainly weekends. On day 10 and up, Ward 3S / ITD / Daycare will make an appointment to send samples for testing CD34 EDTA. Samples will continue to be sent until it reaches the level of the patient undergoing the process of harvest. This process also requires the appointment of the ward 3S / 1TD. Harvest samples will be sent to a lab to be processed and stored.

Below are listed the requirements to be complied with by the ward:

a) The application form must dipunch CD34 delivery time

b) Appointments may be laboratory stem cells is according to priority.

- In office hours: call ext. 3343 or follow HP staff Laboratory Stem Cells

- Outside office hours: HP staff Laboratory Stem Cells

Note: HP Stem Cells Laboratory staff has been communicated to Ms. Hasiah, Daycare

Changes in the ward related to stem cell laboratory, must be notified immediately to the staff such as the abolition of the exam stem cells or change the date.

Application Flow Chart Testing And Stem Cells Laboratory Sample Submission

a. Receive notifications for PBSC schedule a month before the procedure

b. Ward 3S / 1TD / Daycare should inform the laboratory before sending samples to CD34 count ( preharvest )

c. Receive EDTA samples ( preharvest ) at least before 10.00 am

d. Inform the CD34 count ( preharvest ) to ward 3S / 1TD within 4 hours

e. Ward 3S / 1TD should inform the laboratory about PBSC harvest schedule

f. Receive PBSC harvest in the laboratory at least before 4.00 pm

g. Inform ward 3S / 1TD respect Dosage Initial results CD34

Note:

Any changes that are not in accordance with the flow chart above shall be notified immediately to the staff of the laboratory stem cells