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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5565_Библиотеки_им_академика_М_И_Перельмана.pdf
MANAGING A HOSPITAL TRANSFUSION SERVICE 191
B. Food and Drug Administration.
C. ICCBBA.
D. College of American Pathologists.
E. American Society of Clinical Pathology.
B. Any morbidity or mortality coinciding with the timing of a transfusion should be
investigated for any possible links to the transfusion. Any transfusion-related mortal-
ity should be reported to the FDA. Reporting to other organizations or hemovigi-
lance networks is recommended, but not required.
________________________________ ________________________________
夝
Question 2: What does MSBOS stand for?
A. Material safety blood operating system.
B. Maximum safety in blood ordering system.
C. Maximum surgical blood order schedule.
D. Minimal stipulations for blood ordering safety.
E. Morphologic standards in blood ordering safety.
C. MSBOS stands for maximum surgical blood order schedule. It represents an insti-
tution’s guidelines for ordering blood on the basis of expected blood loss in each
type of surgery. Requests for more units than indicated in the MSBOS may be a rea-
son for consultation with the blood bank.
________________________________
_____________________________
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Question 3: What is the best description of a maximum surgical blood order sched-
ule?
A. A list of the absolute maximum allowable blood usage for a procedure.
B. An ordering list for the blood bank for routine blood component purchase.
C. The dates and times surgeons are allowed to order blood components.
D. A list of the number of RBC units that the blood bank will crossmatch for a spe-
cific surgical procedure.
E. None of the above.
D. The MSBOS standardizes blood usage, eliminating the need for surgeons to make
individual requests for each case. It allows the blood bank sufficient time to meet
the surgeon’s needs, and avoids situations where the surgeon may order too much
or too little blood for a procedure.
192 PRACTICAL SELF-ASSESSMENT FOR TRANSFUSION MEDICINE PROFESSIONALS
________________________________ _______________________________
夝
Question 4: Which of the following statements is true regarding the transfusion of
Rh-positive cellular blood components to Rh-negative recipients?
A. The blood bank should inform the patient’s physician of the exposure and the
possible risk of Rh alloimmunization.
B. The blood bank is required to report the event to the FDA.
C. The blood bank should notify the patient or patient’s guardian.
D. The unit and attached tubing should be returned to the blood center where the
unit was drawn.
E. All of the above.
A. Although there is no requirement for physician notification, this is good practice.
The use of prophylactic RhIG may be indicated.
________________________________ _______________________________
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Question 5: Which of the following is NOT part of root-cause analysis?
A. Collection of data regarding the error or incident.
B. Interview of key personnel involved in the error or incident.
C. Charting causes of the error or incident.
D. Identification of root causes of the error or incident.
E. Punitive corrective measures against individuals involved in the error or incident.
E. Errors should be viewed as an opportunity to improve a system. Because most
errors are due to system failures, root-cause analysis aims to improve the system.
Instead of a punitive approach, an action plan should be instituted to reduce the risk
of the error or incident recurring.
________________________________ _______________________________
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Question 6: Within what period should transfusion-related deaths be reported to the
FDA in writing?
A. 1 day.
B. 1 week.
C. 1 month.
D. 6 months.
E. Up to 1 year.
B. Deaths should be related to the FDA as soon as possible by phone or email fol-
lowed by a written report within 7 days.
MANAGING A HOSPITAL TRANSFUSION SERVICE 193
________________________________ _____________________________
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Question 7: How often should standard operating procedures (SOPs) be reviewed?
A. Weekly.
B. Monthly.
C. Quarterly.
D. Yearly.
E. Only when revised.
D. CAP accreditation requires annual review of SOPs. The review of
each
SOP
should be documented with date and either initials or signature of the transfusion ser-
vice medical director, or his/her designee such as the transfusion service supervisor.
________________________________ _____________________________
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Question 8: Which of the following terms refers to identifying and notifying recipi-
ents of blood components collected from donors who subsequently tested positive
for transfusion-transmitted infectious diseases?
A. Testament.
B. Retrospective review.
C. Look-forward.
D. Look-back.
E. Post-donation information.
D. Look-back investigations are conducted to identify potential exposure of a patient
to a blood component collected from a donor who may have been infected at the
time of donation. Positive postdonation test results for HIV and HCV are the most
common reasons to elicit a look-back investigation.
________________________________
_____________________________
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Question 9: How often should a blood usage committee meet?
A. Weekly.
B. Monthly.
C. Quarterly.
D. Yearly.
E. Only as needed.
C. Most facilities meet on a quarterly basis. The committee should include the blood
bank director, the blood bank supervisor, senior physicians from the clinical ser-
vices that use blood products, a nursing educator and representative, and a repre-
sentative of the quality management department.
194 PRACTICAL SELF-ASSESSMENT FOR TRANSFUSION MEDICINE PROFESSIONALS
________________________________ _______________________________
夝
Question 10: When should audits for transfusion appropriateness be conducted?
A. Concurrently.
B. Retrospectively.
C. They can be performed either concurrently or retrospectively.
D. Neither concurrently nor retrospectively.
E. As needed.
C. Audits can be performed as either concurrent or retrospective reviews. There are
benefits and risks of each. Concurrent review provides for intervention before a
potential inappropriate request. However, concurrent review may delay urgent
transfusion. Retrospective review does not delay transfusion, but may miss the
opportunity to educate the physician before an inappropriate transfusion.
________________________________ _______________________________
夝
Question 11: Which of the following statements is true about informed consent?
A. The most important aspect is proper documentation of the patient’s signature.
B.
The consent must be separate from the general consent for invasive procedures.
C. Consent is a process that includes informing the patient of the risks/benefits of,
the alternatives to, and the consequences of not having the transfusion.
D. Informed consent is generally used only with Jehovah’s Witness patients.
E. All of the above.
C. As always, informed consent requires informing every patient of the risks and
benefits of transfusion, and alternatives to the procedure. Patients should also be
given the opportunity to have their questions answered. State laws vary as to
whether consent for transfusion of blood components may be part of a general con-
sent for invasive procedures, a progress note that documents consent, or a separate
consent for blood components. The focus should not be on obtaining the patient’s
signature; rather, the key element is informing the patient.
________________________________ _______________________________
夝
Question 12: What’s the best description of a staffing plan?
A. A list of all available staff.
B. A means to optimize productivity while maintaining sufficient staff to allow for
peak demands and temporary vacancies.
C. A schedule for hiring created by the blood bank director and given to the hos-
pital administration.
MANAGING A HOSPITAL TRANSFUSION SERVICE 195
D. A diagram of the nearest exits for staff to exit the blood bank in the event of an
emergency.
E. All of the above.
B. The goal of a staffing plan is to optimize productivity while providing sufficient
coverage of the tasks and duties of the service.
________________________________ ________________________________
夝
Question 13: Which of the following is an example of an indirect cost?
A. Reagents.
B. Disposables.
C. Wages.
D. Outsourcing.
E. Utilities.
E. Indirect costs are for items that contribute to the overall operation, but not directly
on the provision of a product or service. Examples include utilities, administration,
and depreciation. Direct costs are expenses directly related to the provision of a
product or service, such as wages (in-house or contracted), reagents, and other sup-
plies.
________________________________ ________________________________
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Question 14: What is the typical interval between inspections for accreditation of
transfusion services?
A. 6 months.
B. 1 year.
C. 2 years.
D. 5 years.
E. 10 years.
C. Most organizations that perform inspections or assessments for the purpose of
accreditation function on a 2-year cycle. These organizations (including the AABB,
CAP, FDA, and the Joint Commission) all perform unannounced inspections, usually
within a specific time frame.
________________________________ ________________________________
夝
196 PRACTICAL SELF-ASSESSMENT FOR TRANSFUSION MEDICINE PROFESSIONALS
SUGGESTED READING
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McCullough J. The role of physicians in blood centers. Transfusion 2006;46:854-61.
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