Susan Betler

Can anyone with meditech experience provide me with a rule that will have a patient sample expiration date be 3 days from sample collection at 2359 (per AABB). Meditech has only been able to assist (?) me with an expiration date/time of 3 days at 2301 since we went live in 2009. Thank you.

In your facility, who is permitted to record vitals signs during a transfusion? RN must record initial and 15 minutes (along with remaining with patients). Any vital signs recorded after those time frames my facility wants to utilize nurse's aides and nurse interns (hired for summer not completed in nursing school). Question arose in regards to recognizing adverse effects to transfusion. Thank you.

if you are using BBK Specimen Internal Inquiry,which is what we use on our pending log to see what is "coming" into the department, there are a lot of headers on the left side. Example ORD PRODS: followed by ORD TESTS: followed by COMMENTS: which can be rather large and many pages if you have test view group, etc, followed by QUERIES: MARKERS: COL BATCH: ORDER SITE: RCV SITE: PERFORM SITE: RPT AUDIT: AND THEN FINALLY HX COMMENTS are printed. I have had 2 techs think that this is new meditech and there is nothing that needs to be looked at or investigated....hmmmmmm.

Hello: We just had an upgrade (?) and discovered that the HX Comments, if they are more than 4 lines, are printing NOT in the Patient Demographic AREA but after queries and reasons, etc. Techs will have to scroll through pages to find the HC Comments. My laboratory is a generalist lab with techs floating between 3 departments. I put many "helpful" hints, etc in the patient HX Comments field. Any comments for those with version 5.67? Thanks

Since this is a "one time" per day charge, regardless of how many products the patient receives, how do they keep tract? I doubt if this would be a viable option at my facility. thanks

With ICD-10 codes coming very soon, fiscal department wants Blood Bank to figure out a way to charge a patient for CPT 36430 when they receive any number of blood products on the day of service. This code is billed on a per service basis and not on the number of units of blood products transfused per day. Has anyone encountered this request and developed a "rule" for this billing code? This rule would be used for both inpatients and outpatients. There has been no valid response from Meditech---looking for "key words"???? Thank you.

This is one thing that does work in Meditech for Blood Bank. Once patient is "mapped" to the test code for your "coombs crossmatch", any RBC order that is placed with have the "coombs crossmatch" associated with it. Meditech version 5.66

Has anyone, using the TANGO, experienced "carry-over" to another patient from strong positive antibody screen? Today, we have 2 patient samples running consecutively on the TANGO. Both samples gave similar results with the antibody screen---Screen I and II positive (3-4+), Screen III-negative. First sample tested is 92yo female who is O Negative. The second patient is 19yo pregnant female who is O Positive. The 92yo female's antibody ID panel (I-8) appears to be anti-D + anti-C. The 19 year old was just at another facility on 7/30/15 and results were O Rh Positive with a negative antibody screen using gel. We purposely run our solidscreen controls to detect carry-over and have never had false positive results with the controls? I have looked at the troubleshooting guide...... Any comments?? Thanks

By the way, the rule outs were done with indated panel cells (based on all the discussion about QC on outdated panels)!!

Today we had a patient who had an undetectable anti S (previously detected by another facility) who made an anti M. The anti M was not detectable with LISS or PEG when performing rule outs. The patient delivered on July 7 at another facility. We made the decision to screen units for transfusion for S and M. Any comments in regards to the clinical significance of the anti M?

Thanks for the insight. I was also contacted by tech support and can't wait until this lot number for the screening cells is done!

The decision was made (among others) to go with TANGO solid phase because this method had much less unexpected reactions than the ECHO. We did expect "unexpected" reactivity to occur with the solid phase method. Unfortunately, there is no resolution with these patients, so far.

Does anyone utilize flowcharts to assist with TANGO antibody issues that do not make sense and would be willing to share? My facility is fairly new with the TANGO. 3 patients recently that have had positive TANGO antibody screens (one with one cell 2+; one with 2 screening cells-2+; one with all 3 screening cells 2+). TANGO panels (panel I-8 and panel 11+) on first 2 patients were negative. TANGO panel (I-8) on the third patient reacted 2+ with 5 out of 8 cells---no specificity. Crossmatches on all patients were compatible by TANGO and manual tube using LISS. I am leaning to the fact that if manual tube testing (still the gold standard) is negative and units are compatible, the TANGO reactivity is non-specific.

Thanks I will follow up with email!!

Does anyone have CPOE Order Entry with Meditech that has Transfusion Criteria "attached" to the order? I am going to ask the IT department to begin investigating this process. I would like to see a "pop-up" box occur when orders are placed with the "acceptable" criteria stated. If the physician orders products that are not within the established guidelines, they would be "required" to enter a reason to justify the order in order to proceed. Probably cannot make a hard stop. Thanks