Blood Transfusion with EMR

[bmarotto]

If your hospital has implemented an EMR, how are transfusions being documented? Our hospital is in the build process of Eclipsys Sunrise Acute Care. I have been involved in the Order Entry and Resulting build for Blood Bank. I am now meeting with the team about the transfusion end. Currently, our transfusion tag has a label that has all the patient and crossmatch information as well as a place for two signatures and the start/end date/time. It is peeled off and placed on a mount sheet that has a place for the vital signs. Six labels fit on each side of the mount sheet. The peel and stick is very efficient in massive transfusions. Eclipsys wants to "mimic" this electronically. I asked how the unit information would get on the flow sheet and was told "it gets typed in". I did not like that answer and nursing liked it even less. Then they thought they could use the pharmacy module to scan the unit and the patient wristband. I asked if they had 510k clearance to do that for blood administration. They do not. I told them they need anesthesia and trauma involved because whatever is decided will have a huge impact on them. Meetings will continue but I am wondering how hospitals that do not currently have a bedside transfusion module are documenting transfusions in an EMR. We are on a fast track to go live so my current suggestion is to keep the manual process and scan the mount sheets into the record. This will buy us time to look at other options.

[Eagle Eye]

I believe if they do not have 510K for transfusion module then they can not use EMR as primary documentation it can be used as backup???

I believe EPIC has same problem.

[clmergen]

We use Epic EMR. Nursing has a flow sheet for documentation of vitals. We use a " significant event" to document transfusion reactions. Signatures and start of transfusion are manually captured on the blood unit tag which is subsequently scanned into Epic. It is a very clumsy process and I am interested to see what AABB and CAP say during our upcoming inspections.

[gvanan]

Firstly I am wondering what is the issue here, from what I gather so far, it seems to be a issue of sharing transfusion records from Blood Transfusion System to the EMR system.

Curently what we are doing is that, all of the transfusion records (with PID, Visit number, and all relevant HL7 info) are broadcasted to a web services which is running as one of the EMR software task. Hence once these messages have been accepted by the EMR software, it will be added into the EMR software's medical records.

This is the way we are doing it currently.

Does solve the problem?

Regards,

G.Saravanan

The Blood Bank Guys!

http://centiumsw.com

mailto:sales@centiumsuite.com

[kate murphy]

We also use Eclipsys Sunrise. We use peel/stick unit tags, mounted on a flow sheet. At discharge, these papers are scanned and attached to the EMR at discharge.

We are not the only ones generating paper charts - other departments do as well.

Eclipsys doesn't have 510k for blood admin, and we could not figure a way to force a 2 RN check. OR and trauma is a huge issue.

There is a separate "nurse to transfuse" order, since not all blood XM'd is transfused.