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EPIC Rover and AABB


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Good morning friends!

I hope everyone is having a great week!  We are currently in the process of converting to EPIC/Soft.  Does anyone use Rover?  Does it cover the AABB standard requirement 5.14.1 which states:

3. Retesting the same sample if patient identification was verified at the time of sample

collection using an electronic identification system.

Thank you! Have a great day!

Sara 

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Yes, that is an electronic ID system. Just make sure that you write your specimen collection procedure very carefully.  The phleb should still be verbally IDing the patient and comparing that with the patient armband (full name, birthdate) and matching the Rover info with the patient armband. The procedure should also state that the label will be printed at bedside and the tube labeled at bedside. You will also need policy for what to do if the phleb is unable to scan the armband (Rover not working, emergency specimen collection and no armband present, OP collection if Rover not used for patient ID, etc.). There may be some specimens that can't be collected under the electronic ID process, which would require another process (2nd specimen collected or Blood Bank armband or ???). 

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Because there are work arounds to the Rover collection process, we still require a second sample or historical lab-reported result before RBC products can be issued (or issue Group O).  Our hospital uses the Rover but some floors are designated nurse-collect and with this comes the non-Rover process where the electronic ID verification can be circumvented (circumvention is not nursing specific by any means).

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23 hours ago, applejw said:

Because there are work arounds to the Rover collection process, we still require a second sample or historical lab-reported result before RBC products can be issued (or issue Group O).  Our hospital uses the Rover but some floors are designated nurse-collect and with this comes the non-Rover process where the electronic ID verification can be circumvented (circumvention is not nursing specific by any means).

Yes, definitely need to plan for the possibility of workarounds in your risk analysis and SOP. And its important to monitor for that to demonstrate quality improvement.

We are using a Blood Bank specific armband and require lab collection for Blood Bank specimens, with the exception of some OR collections. (OR is expected to place a BB armband or use an existing one and label with appropriate patient ID.) If we can't use electronic patient ID we require that the specimen be hand-labeled directly from the patient armband. We don't need to do this very often, but it is a part of the required competencies for phlebotomy. We collect only one specimen.

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  • 2 weeks later...

Hi Sara.  

We use Rovers, and EPIC at our facility, and I agree with all of the great responses given in this thread.  I am AABB member, SBBcm with 34 years in the business (almost all experience in  hospital Transfusion Services Trauma centers across the country).

To this day, I still feel uncomfortable with the standard mentioned above (specifically #3 Retesting the same sample...) because of the possibility of Wrong Blood In Tube (WBIT).

Positive Patient Identification (PPID) and the use of electronic hospital bracelets as risk reduction strategies are as good as the individual (s) performing the phlebotomy, as good as the individual (s) donning the correct hospital bands.

Trust is a Must.  Get to know, and audit your collectors (RNs and Phlebotomists).  Make sure they are performing EVERY step in PPID as expected.  Make sure they (especially phlebotomists) know how much you appreciate and rely on them (our frontliners) to get it right.  At the same time, DO NOT be afraid to hold them accountable, and report deliberate (at risk) behavior.  I've seen it all, and happy to say, I can rest with our current crew. 

My apologies for being so lengthy, but It's been awhile. Have a good evening.  No spellcheks please.  Cottonball.

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There is an Epic report for scan overrides.  We had to tweak it so it covered patients who were already discharged but our phlebotomy  leaders used it to increase compliance and they made great progress to the point where we dropped our separate BB banding system last year.  It does require that your organization have a strong policy for using the electronic ID and doesn't tolerate extra ID bands lying on the desk etc. Our phlebotomists are now reporting instances of ID bands being misused and one recently got a hospital award for her efforts.

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  • 2 months later...

Building Soft to join with Epic at the moment.  I have the same issues mentioned above.  The traceability work arounds are a huge issue for us.  Epic allows for "Other collector" and it will time out and autofill the collect time as the current time instead of forcing an entered result that will match the written time on the tube.  I feel comfortable with the WBIT being minimize, but since the tracking to phleb ID and correct collect time is an issue I am requiring a second tube for compliance sake.  We are dropping blood bands with the Soft go live because the security features added to BPAM are leaps beyond what we currently have.  Blood bands at current have only caused problems and patient delays,  never stopped a patient ID issue.

Edited by RRay
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