NANCY F

Is there anyone out there using Meditech, that would be willing to share their procedure?

I work at the other hospital in Joplin, MO; I really don't know how one prepares for a diaster like our town went through. We have a diaster plan, and even had a diaster drill the previous week, but you don't plan for things like , no phones, no power, no computers, the other hospital in town being hit, it was a weekend, and staffing was minimal.<BR>It was very difficult for staff trying to get in to help, to get through because of roads being closed or impassible; I know several employees who literally walked that last 2-3 miles(and this was not safe, power lines and debris were down everywhere) --no way even to know which roads to attempt, because the city of Jopin was basically shut down--ie no phone/TV/radio stations to give information.<BR>Patient ID was difficult, many patients had no identification with them, and were unable to communicate. We do have a system, but were not prepared for hundreds of unknown patients.<BR>Our pathologist ended up going and picking up the entire blood supply form our neighboring hospital, which was hit in the tornado, and Thank God someone kept track of all inventory received from where (remember it was all manual, because we had no computer) and it's temperature upon arrival, because we did receive a visit from FDA wanting to see our paperwork, and verify the temperature upon receipt.<BR>In order to order blood products from our supplier, the same pathologist got in his car, and drove until he could get a signal on his cell phone. (Not sure how he figured out which direction to try to drive)<BR>Another thing to consider, is how long will workload be increased, we are now into August, and our workload is still significantly increased.<BR>Ok, I am done venting, and most of this probably won't help anyone with a diaster plan,

I would like to know how other meditech 6.0 users are "transfusing" units in Meditech 6.0. Currently we are using meditech 5.64, and we have a routine in which we change all issued units for the previous 24 hrs, at one time, to a transfused status. Meditech is telling us that in 6.0 we will have to either "Auto Transfuse", and the units will go to a "Presumed Transfused" status, or we will have to transfuse each patient/unit on an individual basis. -- I would appreciate any help, as we transfuse several products daily, and this could really slow us down. Furthermore, Meditech even has a built in a warning about autotransfusing; Something to the effect of "Meditech does not recommend Autotransfusing do to Federal Regulations"--what regulations, and if it is a problem, why does meditech even have the function?-- Also, we are not currently using TAR, but may in the future, how will TAR effect how units are Transfused in meditech Thanks for any help

Yes it is for CVOR only, currently they do testing on an ISTAT --we call it a Stat 9--like an ABG with Hct and Lytes, and ACT's --I know it' a coag thing, but that's about all I know about ACT's. We have staffing for days and evenings, and have a call schedule for night shift. When the cases are finished, the tech comes back to the lab and helps out as needed. Typically most cases are finished by early evening--but one never knows for sure. Hope this helps

Our hospital does keep a refrigerator in the CVOR area. However, we have a small stat lab, manned by laboratory personel located between 2 surgery suites. The refrigerator is in the stat lab. If CVOR needs blood they go to the stat lab which is only a few steps. The laboratory tech issues the units to the CVOR staff, much the same as we issue units to the floor. When the case is over, and the tech leaves, the tech returns unused products to the blood bank. This tech also does some point-of-care testing for the CVOR patients.

Anyone out there with meditech computer systems, how are you doing the recheck?

We do not have a provue; but we are using ortho gel. This is what ortho told us to do for qc. --for IgG card; use IgG coated check cells for positive control and a screening cell for negative control --for IgG/C3d card: use IgG coated check cells for pos IgG control, use C3d coated ceck cells for positive C3d, and use a screening cell for negative control. All cells should be diluted to 0.8%.

We have recently added the queary, " Date of last rhogam?" to ordering fields in our computer system. The queary is attached to the fetal cell screen order. This does not cover everyone who might have received rhogam, but it does get the rH neg mom's who are here to deliver. --The amount of phone calls regarding when rhogam was given has drastically decreased.

What should we do regarding billing for HLA plt pheresis, when it was ordered in for a patient who did not end up using it? I have sometimes given these pheresis to patients who do not need HLA match or irrad, so that the product is not wasted. However, so far we've just ended up eating the charges on the HLA match and irradiation fees. Thanks for any suggestions Nancy F