Expiration of preadmit specimens

[bevydawn]

Currently at the facility that I work, we use the general rule of all specimens are only good for 3 days. I would like to extend preadmit specimens to 14 days given the patient signs the statement of no transfusions, no pregnancies. My problem is with our computer system. We use Cerner Millenium and when we have tried doing this in the training environment, the only way we can get it to work is to over-ride again and again which I think could be confusing to some people. Does anyone else using Cerner have any ideas about how to make this process flow a little better?

[donellda]

Sorry, we use Sunquest/Misys and there is no problem in changing expiration dates. Have you contacted Cerner to see if there is a way to change the expiration date? I would think that most systems would have a way to do this.

[bevydawn]

Well I have discussed this at great length with our LIS specialist who does all the blood banking/computer things. She says the problem is that anything the computer recognizes as a crossmatch or screen it will give the same expiration date, that there is no way to differentiate between a preadmit and a typical inpatient type and cross. She says that even if we build a different test code for a preadmit type and screen or type and cross that the computer will automatically give it the general 3 day expiration, or if we were to extend the expiration it would extend ALL specimens expiration.

Surely there has to be a more simple way around this out there somewhere...?!?!?

[donellda]

I hope that you will be able to figure out a way. My former employer used Meditech and we could extend the date with that system. I know they are switching to Cerner so they might not be too happy about not being able to extend the expiration dates for PAT patients. Good luck!

[Mary]

We added an override reason of "specimen not expired" to use in dispense. If you do not perform the crossmatch within 3 days, the system completes it. We order a new crossmatch when this happens.

We used to use 14 days, but lowered it to 10 days, because many reagent manufacturers state that testing should be performed on specimens that are less than 10 days old.

I think you could change the number of days in Cerner Millennium in Blood Bank tools (Preference for Crossmatch release) but then these crosmatches will remain in your pending inquiry for that many days.

Cerner calls it a "NAPWAD" (Not a Problem, Working as Designed)!!

[labgirl153]

Have been following this discussion closely now on the pre-admit expirations...my facility is switching from cerner classic to mill too. Am sure this situation with the inflexibility of Cerner Mill. will not make my co-workers and supervisor happy!

Currently, with Cerner classic, we can order a test code to extend our pre-admit x-matches to 7 days, but if the patient is drawn on Tues. and gets transfused Thurs. (whereupon the xmatch should revert to 3 days exp. from Thurs.), we have no way of changing the expir. to reflect that (in cerner classic). In the system, the x-match remains at 7 days from the drawing of the specimen.

Had hoped that with Millennium, that this and other pre-admit issues would be resolved. Now I see it might not be so.

Must admit...I'm also a Mysis/Sunquest fan. And what's with Cerner and the Julian calendar?? Thought the rest of the world has been using the Gregorian calendar for the past ~500 yrs.

[connies]

I am currently using Meditech for Blood Bank. Can anyone help me with the 14 day expiration for preadmit crossmatches? Meditech doesn' t know how to accomplish that task.