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albaugh

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Everything posted by albaugh

  1. I think you should invite members of that committee to remove a bag from its cube, try to label it sufficiently (substance, lot #, expiration, etc.), attach that label in such a way that it will stay attached when the bag 'collapses' as it's emptied, hoist the bag up to the level of a cell washer without the aid of the box (especially this part), and suggest ways to keep the collapsed bag at an angle that will ensure all the contents are used. I'm willing to bet they'll come around.
  2. If you have matching turned on in the Epic BPAM module, you'll see that it does a wonderful job of ensuring the unit matches the intended recipient. Nurses have to scan the patient's hospital armband, then unit number, product code, etc. are validated against the patient. Not sure why you'd want nursing to document the Blood Bank armband number in Epic, although I do understand the difficulty in letting go of this piece of the process.
  3. Do you have a custom script in Cerner for tag printing? When we were on Cerner the script would occasionally lose the setting for lines per page, resulting in the situation you described. It wasn't a printer problem at all, in our case.
  4. WBIT is where it all starts. But there are several other steps in the process where the brakes could/should be applied, as we all know. Thanks for this great visual representation!
  5. We are on 2012, looking to start the upgrade process later this year. I have seen the new icons - I don't love them!
  6. Just curious why you're looking at changing from Cerner for Blood Bank? Is there a reason not to keep it? I ask this because we have Epic EMR and Cerner LIS (for the whole lab, not just Blood Bank). We haven't gone to Epic Beaker yet, but I imagine that will be in the cards in the future.
  7. Was so happy to see them and smash them yesterday!!
  8. Congratulations!! Enjoy your freedom and thanks for your involvement and expertise.
  9. We also use E3591 Thawed POOLED CRYOPRECIPITATE|None/XX/rt, because the corresponding frozen product is E3587 POOLED CRYOPRECIPITATE|None/XX/<=-18C
  10. What code level are you on in Cerner? We have Cerner, too, and issuing units in an emergency, even if the patient is unknown, shouldn't be that difficult. Bypassing the LIS and handwriting a bunch of tags is far more cumbersome.
  11. We have Epic on the hospital side and Cerner for the lab, including Blood Bank. I worked in Blood Bank for 20+ years in 2 different hospitals, both of which used Cerner, so I can't compare it to anything. I will say that it's a very good system - lots of functionality and checks and balances. As Terri indicated, a poorly built system makes all the difference. If it's built well, it rarely presents end users with any problems. Very customizable.
  12. Aubergine, We are a Cerner Millennium site also looking at interfacing blood product info with Epic BPAM. We've just started investigating it, so it sounds like you're further along than we are. There are a few threads about it in uCern. Also, we spoke with folks from St. Elizabeth's Healthcare in Kentucky - they are Millennium and have it up and running with Epic. You may want to contact them. Good luck!
  13. Thank you, Cliff!! We appreciate your efforts. Merry Christmas and Happy Holidays!!!
  14. Is anyone else missing the snow and smashable Christmas lights from last year as much as I am?
  15. I have worked with the Cerner Blood Bank module for many years and there is a ton of flexibility and functionality. As Byfaith noted, worksheet tabs in Result Entry are extremely useful. Since you're in the build phase, something else that might help is to be aware of the length/name of each DTA. The longer the name of the DTA, the wider the column in Result Entry, and the less you'll be able to see horizontally without scrolling. For example, with the ABORH, if you name your DTA's Anti-A, Anti-B, Anti-D, A cells, etc., it will take up a lot more real estate than naming them A, B, D, a, etc. Hope this helps!
  16. In our lab IT department, 4 of the 5 clinical analysts are former blood bankers, and 3 of those 4 worked in the blood bank at this hospital (myself included). So maybe we're at a bit of an advantage!
  17. Aha! We asked our ARC region to clarify whether they will truly be manufacturing the pre-pooled cyro using an open system. They informed us that they will now be using a closed system. Problem solved! Sometimes it's good to press an issue....:o:o
  18. Our supplier is ARC, South Carolina region. I'm checking with them now to verify that they will be using an open system manufacturing process.
  19. Beating hearts, at that!! Very nice, Cliff. Thank you!
  20. My supplier plans to use ”E3588 POOLED CRYOPRECIPITATE|None/XX/<=-18C|Open” for frozen pre-pooled cryoprecipitate. This leads me to think I should use "E3592 Thawed POOLED CRYOPRECIPITATE|None/XX/rt|Open” for the thawed version. This leaves me wondering what code to use for pooled cryo that we pool ourselves (from individual units) after thawing? E3592 does seem appropriate, but I can’t use the same E code for 2 different products. Is "E5284 Thawed POOLED CRYOPRECIPITATE|NS/XX/rt|Open” acceptable (NS anticoagulant vs. None)??
  21. I've only ever used Cerner, so I can't comment on whether it's better or worse than SoftBank. I will say that all of the problems noted by GilTphoto are avoidable. 1. You can create test bundles - called care sets - to make ordering easier. 2. Antibody screens can be built with 2, 3 or 4 cells (or however many you want!) with whatever phases you need. We have several different antibody screens with different parameters: 2 and 4 cells with AHG phase for the Galileo, 3 cells with AHG phase for gel, 3 cells with IS, 37, AHG phase for tube testing, etc. 3. The Interp Tool lets you say what patterns are valid for positive and negative interps, as well as ABORH and crossmatches. 'Pattern match not found' simply means that the pattern is not defined in the tool. It should be used as a way to catch omissions or what the computer thinks is an error - for example, a negative reaction at AHG without an entry for check cells in a tube antibody screen, or the forward and reverse ABO types don't match. Forcing techs to override every positive is dangerous and leads to ‘alarm fatigue’, where eventually you stop reading the alerts and override when you shouldn’t. 4. Yes, crossmatches stay on the pending for 3 days because they are not completed until the specimen is expired. This might require a change in your process. 5. If you maximize your screen view, you should be able to see the whole ABORH, depending on how many DTAs (result fields) you have built into it and how they are named (affects column width). GilTphoto, I really hate that the powers that be are forcing you to use the system in this way. It could be SOOO much better if they would build it the way it should be built. The build and validation is a lot of work, but it's ultimately safer for the techs to have a system that is easier for them to use. And that translates into safer test results and blood products for the patient. Maybe if you approach it from a patient safety standpoint, you could get them to fix some of these easily fixable issues. The tools are all there - they just have to be used. Jack J, I've used Cerner for many years, and it's got a lot of capability. It's not perfect, but no software is. And, change is always hard - even upgrading from Cerner Classic to Cerner Millennium was a huge hurdle for the techs. In time, though, things settle down and people learn how to make the system do what they want. Please don't base your decision on the experiences of a new user who is forced to use a poorly built system.
  22. David, I think the 'hypothetical' part that ackkap was referring to was the potential need for transfusion, not the entire case. Seems that ackkap and the baby had good luck on their side! Malcolm, very interesting case - and I certainly did not think that would be the answer. Thanks for sharing. It's cases like these that keep us on our toes and make our field so interesting!
  23. It’s never easy to move from one system to another, but they all have strengths and weaknesses. For the scrolling issue, I recommend maximizing your window in Result Entry. You should be able to see everything, depending on how many DTA’s you have in your ABORH. Whoever told you that you have to have 3 cells with 3 phases in your antibody screen is either mistaken or lazy. You build them any way you want. We have 4 different antibody screen orderables - 2 cells with one phase, 3 cells with one phase, 4 cells with one phase, and 3 cells with a choice of phases (for tube testing - IS, 37, AHG, 4 degrees and prewarm). There should be the same number of keystrokes for positive and negative results, unless you’re adding a result comment to the positives. If you or your IT staff haven’t already, please join the Cerner online community ‘uCern’ - there’s a ton of information from users and Cerner staff that should help. You’ll see how many different ways there are to do things in Millennium. And don’t despair; once you get through the initial growing pains, it will get better. Good luck!
  24. Just last week, we had 2 requests for this test. Makes me think there was a journal article published recently! We send ours to Blood Center of Wisconsin, ph. (800)245-3117 ext. 6250. On their website, www.bcw.edu, is a short paper describing the test (no SOP, unfortunately) with references.
  25. We've been live with the Galileo for almost 3 years and have seen several instances of antibodies that are excluded homozygously in solid phase but clearly demonstrating in gel, mostly with Anti-K, Anti-Fya and Anti-Jka. We've had to become accustomed to going to gel when the solid phase panel doesn't make sense. The 'extended panels' aren't any better, just different donors (D-positive and D-negative panels). They suffer the same issues.
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