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Expiring Specimens Report - Meditech 5.65

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Our Ortho unit has been running into problems with specimen expirations. We use the pre-admission testing deal like a lot of people where the patient comes in early, signs the preadmission transfusion history form and we extend their specimen. We use an algorithm where the shortest date is selected for T&S expiration when the patient acknowledges no pregnancy, transfusion, etc., on their form:

 

7 days from date of collection OR
3 days from date of surgery

 

where date of surgery/collection is considered day 0.

 

Seems simple enough, right? The tech who receives in the specimen extends the specimen expiration in Meditech and leaves a nice little comment in the specimen that's viewable in the EMR for the PAs/whoever.

 

Problem is the Ortho team says they don't have time to check things like that. Sometimes a patient's type and screen will have expired and on that day they will want blood. The Ortho people are upset that they have to draw Type and Screens in the middle of the day (every patient has labs drawn every morning ~0500) and delay the transfusion for the wait in collection, testing, etc. A bright idea was thought up, have the night shift guy run a report from the LIS that tells them who expired at midnight and will need a new specimen and shoot it up to the charge nurse!!!!

 

But then defeat once more. We use Meditech 5.65. There is a report under Management Reports: BBK Expiring Specimens Report. Stupidly enough this report does not compile specimens that are at Complete (COMP) status. What can we do to get this report to pull Complete status Type and Screens? There's an option to select "BSS (Bloodbank Specimen Status) - COMP - Include" but it still doesn't include them. Is there something in the dictionary you have to use? Is there any other alternative? I've looked through all of the other reports and nothing pops up with the Expiration date and I don't want our night shift techs to have to data mine to send a courtsey report.

 

Thank you to anyone who read my wall of text.

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Do you receive the form?  Does it have expected date of surgery?  Can you look through those forms on a nightly basis to see what samples are ready to expire?     

Edited by R1R2

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I found an electronic solution through Meditech's basic management reports that I've been using in the meantime until I can figure out an easier way.

 

Management Reports --> Specimen Log

 

Date Index: Collection

From Date: T-8

Thru Date: T

From Test: TYSC

To Test: TYSC

Show Results: N

Integrated: N

Patient, Donor, Unit Specs: P

Selection Critera:

BPX - BBK Prefix - BB - Include

PS - Patient Status - Adm In - Include

PS - Patient Status - Adm Ino - Include

LO - Location - 3South - Include

 

Obviously some information is unique to our facility. This generates a report that takes 3-4 minutes of review and the MR# of patients who have currently expired or soon to expire T&Ss can be forwarded to the PAs.

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We have a test code added to our crossmatch called "Avail until" which we result with T+3 when we set up a crossmatch on a "regular patient". We set our specimen outdate for all samples to 96 hours (would be 72hrs in the US). We use pre-op samples up to 30 days if patient was not pregnant or transfused within the last 3 months. When doing the crossmatch on these pre-op samples the day before surgery, we again result the "Avail until" as "T+3" so that they will be taken out of crossmatch 2 days after surgery. We had a custom report made that prints automatically just after midnight listing all the crossmatches that outdated at midnight. This report pulls the "Avail until" test result out of our crossmatch test. The night tech then takes the units that are listed on the report out of crossmatch. In EMR, floors can view the "Avail until" result listed in the BB tests. It works pretty well.

Edited by marvy1

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Aren't Ortho folks fun? Seems like nothing is their problem except the actual surgical procedure itself. We also see most of our Ortho patient's transfused just after the T&S specimen outdates, but the docs/PAs here don't seem to be too worried about whether or not we have to redraw/redo - it's our problem. Funny creatures, aren't they?

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We get around this with all of our patients, preop or not, who, due to their history, can be extended past the 3 days after day of phlebotomy, by simply ordering the crossmatches and red cells on a new specimen number. We enter the date drawn as T, T-1 etc. to get the new crossmatches to expire on the day we desire, and add a nonreportable test "SPEC USED" to record the original specimen # really used.

 

In the BBK custom parameters we have crossmatch autorelease hours set at 72 and time as 2359 which autoreleases them at a minute before midnight on that 3rd day. We print up the old crossmatch report to see which units we can pull off at midnight.

 

If someone is past the magic hour, we just tell them the patient needs to be redrawn. I guess they don't care too much at our place, either ("it's not my arm.......")

 

I'd love to know what your mechanism is "to extend the specimen expiration" by the way.

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I'd love to know what your mechanism is "to extend the specimen expiration" by the way.

(This is my first try with the "My Media" function on bloodbanktalk) The image is a screenshot from Meditech of a menu of options we have available in the blood bank specimen desktop. I'm not a Meditech guru, so I'm not sure how to turn something like that on if it's not on for you.

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