emergency dispense in Cerner Millenium

[monroe]

we recently switched from Sunquest to Cerner Millenium. We were actually added "on" to a system that had been designed for use by our sister hospital. we are two very different facilities in our patient mix and in our processes. They chose not to use Emergency Dispense app and continue with a paper trail. We were use to Emergency Issue in Sunquest which generated forms and associated patient with unit. We are now requesting this "build" but a concern is raised by the other facility that if the system recognizes "uncrossmatched" as a valid state for a red cell unit, an "uncrossmatched' unit could accidentally be issued as crossmatched without the system generating any warnings to the user. Does anyone use Cerner Millenium Emergency Dispense? And if so, is my scenario possible?

[C Lumbert]

We initially used the Cerner Emergency Dispense, but devised a simpler means to deal with uncrossmatched dispense. We created a patient named "Emergency, Uncrossmatched" and "assigned" two O Neg units to it.

When the call and order comes for uncrossmatched RBCs, we document the dispense time and units dispensed on paper. After ABO specific units are ready to dispense, we back date/time the dispense of uncrossmtched units and dispense them to the patient who is now identified. This provides receipt of uncrossmatched blood in in the requesting service in seven or less minutes and all the information we need to back date the dispense is available in blood bank.

Chuck Lumbert

Lumbertc@trinity-health.org

we recently switched from Sunquest to Cerner Millenium. We were actually added "on" to a system that had been designed for use by our sister hospital. we are two very different facilities in our patient mix and in our processes. They chose not to use Emergency Dispense app and continue with a paper trail. We were use to Emergency Issue in Sunquest which generated forms and associated patient with unit. We are now requesting this "build" but a concern is raised by the other facility that if the system recognizes "uncrossmatched" as a valid state for a red cell unit, an "uncrossmatched' unit could accidentally be issued as crossmatched without the system generating any warnings to the user. Does anyone use Cerner Millenium Emergency Dispense? And if so, is my scenario possible?

[Ghell]

Hi! My hospital uses Cerner Millenium also. Its fairly impossible to dispense an emergency release as crossmatched as it doesn't even offer that option. Once you open up Pathnet, go into "Dispense and Assign Products" as you normally would. Once in, select "Task" from the tool bar and one of the options should be "Emergency dispense". Select it. Once you are in Emergency dispense, the computer is going to ask for the "Emergency patient". You can enter anything here, from a record number, hospital number, name to just "John Doe". After that, you will be prompted to scan in your unit number. Once that is done, a prepopulated box will come up asking the physician, cooler, etc and then you can dispense. At no point is there even a way to select crossmatch. I hope this helps.

Lauren

[monroe]

thanks for the info! is a blood bank unit tag generated in Emergency Dispense?

[Ghell]

thanks for the info! is a blood bank unit tag generated in Emergency Dispense?

Yes it does!

[Mary**]

:bow:There is another (easier, I think) way to do emergency dispense in Cerner. Using the dispense function, type in the patient's medical record number and enter the unit(s) numbers. You will get a message that a crossmatch is required. Override it with a reason and accept. We designed an Emergency Tag to print out of this function.

[vrduke]

I have just recently built and tested Cerner Millenium in our Blood Bank although we have not go live yet. In all my testing the Cerner System did not allow uncrossmatched blood to be dispensed without going through an emergency override flag. Valid Application States for your system can be modified if necessary but in all my testing the computer required all units to be crossmatched first or you will get the override message. Sounds like something is not set correctly and your Cerner Analyst should be able to resolve this easily.

[lateonenite]

Sorry, I haven't been checking the forums often enough.

The only thing I'd bring up with anyone using emergency dispense, is once you assign the units to a patient (correct inventory, etc.), the time and date of dispense is set to when the emergency dispense happened, not when the units were actually given to the patient.

Did you find this?

[GilTphoto]

I'm also in the testing phase with Cerner Millenium Pathetic Net. Changing from Sunquest. We are due to 'Go Live' on Oct 4th.

I absolutely hate this program!

What's with all the left and right scrolling? I can't even see the entire ABO & Rh on the screen without scrolling.

Everything is about 4-5 times more keystrokes than Sunquest.

We use a 2 cell screen at 2 phases (37,IAT), but was told I have to deal with a 3 cell screen at 3 phases (IS, 37, IAT) and can just report NT (not tested) for what we don't use. To report the Antibody Screen: Sunquest=7 keystrokes, Pathetic Net=28 keystrokes for Negative, about 40 for Positives!

I need triple the staff to handle the workload with this program!

[lateonenite]

That doesn't sound right. I've moved to a different health service using a different build - you should be able to have whatever you want. Then again, we only screen in one phase; if we use another phase (depending on the patient's requirements), we don't put that in Cerner. Maybe that's the difference.

I'm not following why you have a different number of keystrokes for positive or negative. Can you tell me what the DTA's are? (You might be guessing I've worked on an implementation - you'd be right. I don't like it or hate it, but then I came from an old, old, OLD computer system prior. Most of the work was on the bench. That's right, gasp, immediate spin crossmatching. In 2009. )

Edited July 12, 2011 by lateonenite
Forgot the date

[monroe]

i feel your pain or rather I felt your pain when we went live. your sentiments were exactly ours down to the keystroke comparison! i would like to say it gets better but i can't. Cerner is just not a blood bank friendly system. We still hate it after a year. but if you have questions on how something works, i will be more than happy to let you know how we handled it. by the way, i had to add an extra person to my staff since Cerner came on the scene. My lab director felt so sorry for us, administration added another FTE to our staff.

[albaugh]

It’s never easy to move from one system to another, but they all have strengths and weaknesses. For the scrolling issue, I recommend maximizing your window in Result Entry. You should be able to see everything, depending on how many DTA’s you have in your ABORH. Whoever told you that you have to have 3 cells with 3 phases in your antibody screen is either mistaken or lazy. You build them any way you want. We have 4 different antibody screen orderables - 2 cells with one phase, 3 cells with one phase, 4 cells with one phase, and 3 cells with a choice of phases (for tube testing - IS, 37, AHG, 4 degrees and prewarm). There should be the same number of keystrokes for positive and negative results, unless you’re adding a result comment to the positives. If you or your IT staff haven’t already, please join the Cerner online community ‘uCern’ - there’s a ton of information from users and Cerner staff that should help. You’ll see how many different ways there are to do things in Millennium. And don’t despair; once you get through the initial growing pains, it will get better. Good luck!

[SRTECH]

You can adjust the column size; then you can see everything on your screen.

[Barb Thompson]

Gil,

Tell them to build you a 2 cell screen. They can do it. They can hide anything you don't use. As for the scrolling, set up your worksheets just for ABO/Rh or just for the screen, or just for the XMs...that way, you don't have all the DTAs on one worksheet where you will then have to scroll and columns hide behind others, etc. Believe me, my techs hate to scroll and want to see it all on the page. (I have not used Sunquest, so I can't compare the 2, but Cerner is much better than our previous paper system.)

[LCoronado]

We use Cerner Millennium Pathnet Blood Bank Transfusion. We were all on paper (double gasp) prior to 2010. Computerization has been a Godsend after dealing with decades of clerical errors, etc. I've never used Sunquest so cannot compare, but we are not unhappy though of course the learning curve was huge. As for your 2 cell screen, there should be no reason why you cannot build your screen as you wish. You can also build different types of antibody screens for different scenarios, depending upon your policies. But, if you keep the DTA's you are not using routinely, the "NT" can be defaulted in so the techs don't have to think about it.

Edited July 14, 2011 by LCoronado