[Histonet] RE: Histonet Digest, Vol 24, Issue 15 labeling issues
In response to the question regarding an acceptable range for identification errors, there can be no range. It must be 100% correct. It has always been my habit to refuse specimens that are incorrectly labeled or otherwise lacking information. In the case of biopsies or other signicant cases where we do not want to lose control of the specimen, we insist that the person who was involved in the origin of the specimen come to pathology and identify the patient or correct the error. We do not process the specimen until all problems have been rectified. after a while when the people involved get tired of your calls and their having to come to the lab, they will hopefully change their ways. We recently had an ongoing problem with the OR sending specimens down without labeling the containers. I met with the nurse manager for the OR and went over the problem with her. She was able to identify the employee who was ignoring the step of labeling the specimens. That employee was counseled and was warned that her job was at risk. It has not happened again with that employee. Drastic steps have to be taken to avoid these errors as part of meeting JCAHO standardsMichael Rice CT.HT(ASCP)-----Original Message-----From: histonet-bounces@lists.utsouthwestern.edu[mailto:histonet-bounces@lists.utsouthwestern.edu]On Behalf Ofhistonet-request@lists.utsouthwestern.eduSent: Thursday, November 10, 2005 1:04 PMTo: histonet@lists.utsouthwestern.eduSubject: Histonet Digest, Vol 24, Issue 15Send Histonet mailing list submissions to histonet@lists.utsouthwestern.eduTo subscribe or unsubscribe via the World Wide Web, visit http://lists.utsouthwestern.edu/mailman/listinfo/histonetor, via email, send a message with subject or body 'help' to histonet-request@lists.utsouthwestern.eduYou can reach the person managing the list at histonet-owner@lists.utsouthwestern.eduWhen replying, please edit your Subject line so it is more specificthan "Re: Contents of Histonet digest..."Today's Topics: 1. Re: tonsils (Rene J Buesa) 2. RE: any suggestions? (Patsy Ruegg) 3. RE: any suggestions? (Pamela Marcum) 4. Process improvement monitors (John.Sheppard@Health-Partners.org) 5. RE: tonsils (Monfils, Paul) 6. RE: (no subject) (O'Reilly, Siobhan) 7. reproducing microwave temperatures (Bernadette Weston)----------------------------------------------------------------------Message: 1Date: Thu, 10 Nov 2005 08:19:49 -0800 (PST)From: Rene J Buesa Subject: Re: [Histonet] tonsilsTo: Linda Blazek , histonet@lists.utsouthwestern.eduMessage-ID: <20051110161949.42007.qmail@web61216.mail.yahoo.com>Content-Type: text/plain; charset=iso-8859-1We used to gross them only but the PA (usually at requests from the surgeon or the medical practitioner) could ask for a microscopic evaluation sometimes as results of a request by the insurance company!. In that case we used to process them and do just H&E.Essentially you will have to ask your pathologist what to do about them.Rene J.Linda Blazek wrote:I need some information on how other facilities are handling tonsils. Are they gross only and what criteria is used to have microscopic performed on them? Thanks for any info. - LindaLinda Blazek, HT (ASCP)Department of PathologyChildren's Medical CenterDayton, Ohio 45404(937) 641-3358fax (937)641-5482blazekl@childrensdayton.org_______________________________________________Histonet mailing listHistonet@lists.utsouthwestern.eduhttp://lists.utsouthwestern.edu/mailman/listinfo/histonet --------------------------------- Yahoo! FareChase - Search multiple travel sites in one click. ------------------------------Message: 2Date: Thu, 10 Nov 2005 09:23:37 -0700From: "Patsy Ruegg" Subject: RE: [Histonet] any suggestions?To: "'Rene J Buesa'" , "'Till, Renee'" , Message-ID: <200511101623.jAAGNbxT021885@chip.viawest.net>Content-Type: text/plain; charset="us-ascii"Renee the IHC question asker. I too, like Gayle think that your questionwas appropriate for this list and I thought that you gave a lot ofinformation. In my opinion yes he should be using goat serum block to matchup with his secondary host. There may also be a too close species with hisanti-rat primary on ms tissue causing non specific binding of ms serum IgGjust because ms and rat are so closely related. Frozen sections can be veryactive with antigen since they don't go thru all the processing related toffpe tissue, so in my experience you need to carefully titer your IHCantibody reagents often diluting much more than you would for ffpe tissue.Also much of the endogenous issues, such as biotin, peroxidase and alk.phos.Are inhanced in frozens, or preserved more than in ffpe tissue. AB block,fc receptor block, serum block before the primary and before the secondaryare all things I consider with frozen IHC, or I try to avoid the biotinissue altogether by using a non biotin labeled polymer detection. Maybethis person is inexperienced but we all started somewhere, so probably withjust a little help we can make a big difference for this person, that iswhat we are here for, right?Patsy Patsy Ruegg, HT(ASCP)QIHCIHCtech, LLCFitzsimmons BioScience Park12635 Montview Blvd. Suite 216Aurora, CO 80010P-720-859-4060F-720-859-4110wk email pruegg@ihctech.netweb site www.ihctech.net This email is confidential and intended solely for the use of the Person(s)('the intended recipient') to whom it was addressed. Any views or opinionspresented are solely those of the author. It may contain information that isprivileged & confidential within the meaning of applicable law. Accordinglyany dissemination, distribution, copying, or other use of this message, orany of its contents, by any person other than the intended recipient mayconstitute a breach of civil or criminal law and is strictly prohibited. Ifyou are NOT the intended recipient please contact the sender and dispose ofthis e-mail as soon as possible.-----Original Message-----From: histonet-bounces@lists.utsouthwestern.edu[mailto:histonet-bounces@lists.utsouthwestern.edu] On Behalf Of Rene J BuesaSent: Wednesday, November 09, 2005 2:28 PMTo: Till, Renee; histonet@lists.utsouthwestern.eduSubject: Re: [Histonet] any suggestions?With all due respect I think that your colleague's procedure is a royalmess.On the other hand it seems that he is not very willing to change his ways,so the only thing I have to tell you (for him) is: good luck! He should bethe one doing the asking, and not you!Rene J."Till, Renee" wrote:Another tech who does not have much experience with histology came to mewith questions about his immunos. They are doing IHC with various cd markerson frozen sections of mouse aorta. He has encountered particularly strongbackground(or so he's been told, he thinks it is actual staining) with oneof the antibodies that was made in rat. He is using a goat anti-rat F(ab')2from Jackson as the secondary. It is not absorbed against mouse. I haveasked all about his dilutions and incubations times, but he doesn't seem tothink that is the problem. I gave him an avidin/biotin block to try and seeif that helps. Any other ideas? I am not familiar with cd markers myself.The only problem I could find just in talking to him was that he wasblocking with rabbit serum? I told him you normally match your block withthe host of the secondary, but would that make that big a difference as faras background is concerned? Would the fact he is using frozen sections haveanything to do with it? Or could it just be the stain? I know they are doingcd54, but I'm not sure if this is the one he is having a problem with. I know this is not much informations, but I would still appreciate any inputThanks,Renee'================================================================================================Confidentiality Notice: This e-mail message, including any attachments, isfor the sole use of the intended recipient(s) and may contain confidentialand privileged information. Any unauthorized review, use, disclosure ordistribution is prohibited. If you are not the intended recipient, pleasecontact the sender by reply e-mail and destroy all copies of the originalmessage.================================================================================================_______________________________________________Histonet mailing listHistonet@lists.utsouthwestern.eduhttp://lists.utsouthwestern.edu/mailman/listinfo/histonet --------------------------------- Yahoo! FareChase - Search multiple travel sites in one click. _______________________________________________Histonet mailing listHistonet@lists.utsouthwestern.eduhttp://lists.utsouthwestern.edu/mailman/listinfo/histonet------------------------------Message: 3Date: Thu, 10 Nov 2005 11:23:46 -0500From: Pamela Marcum Subject: RE: [Histonet] any suggestions?To: "Hofecker, Jennifer L" , "histonet" Message-ID: <6.1.1.1.2.20051110112330.019a6c60@mail.vet.upenn.edu>Content-Type: text/plain; charset="us-ascii"; format=flowedThanks, Jennifer. PamAt 11:03 AM 11/10/2005, Hofecker, Jennifer L wrote:>Well said Pam and Gayle!>I know that every time I have a problem, my first thought is "ask >histonet" not because I am lazy or because I can't look it up. I think >first of histonet because of the diversity of our listmembers and their >experience. Just because a publication lists the steps of a protocol, >doesn't mean it will work. I would rather get my info from the ones who >make these protocols work.>On the other hand, every time I am about to post a query, I have to read >it 6 times to make sure there isn't anything in the post that I will be >chastised for. While I agree that we should not "post with reckless >abandon", I do not think we should be terrified of backlash for asking how >to do something we've never done before, especially if it affects patient >care, whether directly or indirectly.>>Well, I am going to put on my bullet proof vest!>Thanks for listening,>Jennifer>>>>Jennifer Hofecker, HT (ASCP)>Vanderbilt University Medical Center>Division of Neuropathology>(615) 343-0083>(615) 343-7089 fax>>Thank You Gayle!! It is sometimes easy to forget not everyone has access>to the Internet or a way to even place a message on HistoNet. We are>attempting to assist people who are learning and while some may seem to be>using HistoNet as way to avoid looking anything up the majority are asking>questions that are not readily accessible or in an area like murine animal>models that is more difficult. I have no problem with this and will answer>most questions off line if it is a more esoteric question. I am surprised>that the person with the issue about Rene's assistance for her friend is>also the same Rene who has been asking all of us to contribute to Tricks of>the Trade.>>Pamela A Marcum>Special Procedures Manager>Bone Histology>UPENN Vet School>>>At 05:33 PM 11/9/2005, Gayle Callis wrote:> >Rene,> >> >Sorry to disagree, and I certainly did not understand what YOU meant by> >"changing his ways"? I couldn't see many changes here, other than some> >refinement of his IHC method. Many people working with murine CD marker> >IHC often need a little help with murine animal model IHC. Since our> >lab works with murine CD marker IHC approx. 95% of the time, on frozen> >sections etc per the inquiry, we are happy to sleuth problems. The> >questions were valid ones for learning/refining of his techniques and> >being a mousie person, I didn't have a problem with the inquiry.> >> >Some people (including a lot of experts in our field) do NOT want to be on> >Histonet and second hand messaging certainly doesn't bother me as long as> >more details are provided. I frequently ask questions on Histonet to> >access information for others in my department - that's part of my job.> >Your colleague is welcome to email privately if you or they wish.> >> >Gayle Callis> >Research Histopathology Supervisor> >Veterinary Molecular Biology> >Montana State University - Bozeman> >PO Box 173610> >Bozeman MT 59717-3610> >406 994-6367> >406 994-4303 (FAX)> >> >> >> >> >> >> >- At 02:28 PM 11/9/2005, you wrote:> >>With all due respect I think that your colleague's procedure is a royal > mess.> >>On the other hand it seems that he is not very willing to change his> >>ways, so the only thing I have to tell you (for him) is: good luck! He> >>should be the one doing the asking, and not you!> >>Rene J.> >> >Gayle Callis> >Research Histopathology Supervisor> >Veterinary Molecular Biology> >Montana State University - Bozeman> >PO Box 173610> >Bozeman MT 59717-3610> >406 994-6367> >406 994-4303 (FAX)> >> >> >> >_______________________________________________> >Histonet mailing list> >Histonet@lists.utsouthwestern.edu> >http://lists.utsouthwestern.edu/mailman/listinfo/histonet>>>>_______________________________________________>Histonet mailing list>Histonet@lists.utsouthwestern.edu>http://lists.utsouthwestern.edu/mailman/listinfo/histonet>>>_______________________________________________>Histonet mailing list>Histonet@lists.utsouthwestern.edu>http://lists.utsouthwestern.edu/mailman/listinfo/histonetBest Regards,Pamela A MarcumManager, Histology Special ProceduresUniversity of PennsylvaniaSchool of Veterinary MedicineR.S. Reynolds Jr. CORLNew Bolton Center382 West Street RoadKennett Square, PA 19348Phone - 610-925-6278Fax - 610-925-8120E-mail - pmarcum@vet.upenn.edu ------------------------------Message: 4Date: Thu, 10 Nov 2005 11:56:13 -0500From: John.Sheppard@Health-Partners.orgSubject: [Histonet] Process improvement monitorsTo: histonet@lists.utsouthwestern.eduMessage-ID: Content-Type: text/plain; charset=US-ASCIIHello "Histonetters", Once again I am on a "mission" for my medical director. I am hopingto find out if anyone out there has been looking at quality management /process improvement areas in histology / pathology labs in their communityhospitals. We are currently reworking our P.I. program, and we are looking atsome of the most obvious errors we find. It seems to us that many mistakescome to our lab from doctors offices, the O.R. and our birthing center.These errors come in the form of incomplete or no requisition,discrepancies between specimen labels and requisitions, and no orincomplete label on specimens. These are the issues that are of particularinterest to my director. We are trying to establish a reasonable range tostrive for. Ideally we would like to have all specimens labelled correctlywith the correct reqistion and full clinical history / diagnosis coming into our lab, but realistically we are not sure if that is possible. If anyone has reviewed these monitors and does not mind sharing theirinformation, we would greatly appreciate using it for comparitive datapurposes. We have been monitoring this for a couple of years and we do nothave a sky high rate, but it is higher than we believe it should be.Thanks againJohn Sheppard HT(ASCP) P.S. If anyone has ideas on how to improve this performance, shortof firing nuses everytime they mess up please let me know ? (this is ajoke)CONFIDENTIALITY NOTICE: This message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.------------------------------Message: 5Date: Thu, 10 Nov 2005 12:18:36 -0500From: "Monfils, Paul" Subject: RE: [Histonet] tonsilsTo: "'histonet@lists.utsouthwestern.edu'" Message-ID: <09C945920A6B654199F7A58A1D7D1FDE01717610@lsexch.lsmaster.lifespan.org> Content-Type: text/plain; charset="iso-8859-1"Years ago, when I worked in a clinical histology lab (I am now in research),we processed and sectioned all tonsils. Since no serious pathology had everbeen discovered in any of the thousands of subadult tonsils we hadprocessed, the department was considering a "gross only" policy for tonsilsfrom patients under 16 years of age. Don't you know, that very month theyfound an undiagnosed lymphoma in the tonsils of a 12 year old girl. Wecontinued processing all tonsils. As I said, that was quite a few yearsago, and they may have changed the policy since then.> ----------> From: histonet-bounces@lists.utsouthwestern.edu on behalf of Linda> Blazek> Sent: Thursday, November 10, 2005 7:54 AM> To: histonet@lists.utsouthwestern.edu> Subject: [Histonet] tonsils> > I need some information on how other facilities are handling tonsils. Are> they gross only and what criteria is used to have microscopic performed on> them? Thanks for any info. - Linda> > > Linda Blazek, HT (ASCP)> Department of Pathology> Children's Medical Center> Dayton, Ohio 45404> (937) 641-3358> fax (937)641-5482> blazekl@childrensdayton.org> > > _______________________________________________> Histonet mailing list> Histonet@lists.utsouthwestern.edu> http://lists.utsouthwestern.edu/mailman/listinfo/histonet> > ------------------------------Message: 6Date: Thu, 10 Nov 2005 12:20:00 -0500From: "O'Reilly, Siobhan" Subject: RE: [Histonet] (no subject)To: Histonet@lists.utsouthwestern.eduMessage-ID: <4BCB18390D553D41A3FFEB77D5A3BA97012DB631@excnyuebw2k63.nyumc.org>Content-Type: text/plain; charset=iso-8859-1Please remove mine as well. -----Original Message-----From: histonet-bounces@lists.utsouthwestern.edu[mailto:histonet-bounces@lists.utsouthwestern.edu]On Behalf Ofdrosini@comcast.netSent: Thursday, November 10, 2005 6:54 AMTo: Histonet@lists.utsouthwestern.eduSubject: [Histonet] (no subject)please take my name off the histonet list_______________________________________________Histonet mailing listHistonet@lists.utsouthwestern.eduhttp://lists.utsouthwestern.edu/mailman/listinfo/histonet-------------------------------------------------------------------------------This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain information that is proprietary, confidential, and exempt from disclosure under applicable law. Any unauthorized review, use, disclosure, or distribution is prohibited. If you have received this email in error please notify the sender by return email and delete the original message. Please note, the recipient should check this email and any attachments for the presence of viruses. The organization accepts no liability for any damage caused by any virus transmitted by this email.==============================================================================------------------------------Message: 7Date: Thu, 10 Nov 2005 12:48:12 -0500From: "Bernadette Weston" Subject: [Histonet] reproducing microwave temperaturesTo: histonet@lists.utsouthwestern.eduMessage-ID: Content-Type: text/plain; format=flowedA few years back I attended a convention taht did a workshop on how to check your microwave for reproducible tempertures. I remember having a worksheet for that seminar, does anyone have a method they like to share for this monitoring?Bernadette Weston HTBarberton Citizens Hospital------------------------------_______________________________________________Histonet mailing listHistonet@lists.utsouthwestern.eduhttp://lists.utsouthwestern.edu/mailman/listinfo/histonetEnd of Histonet Digest, Vol 24, Issue 15****************************************----------------------
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