CPOE Order Entry with Meditech and Transfusion Criteria

[Susan Betler]

Does anyone have CPOE Order Entry with Meditech that has Transfusion Criteria "attached" to the order? I am going to ask the IT department to begin investigating this process. I would like to see a "pop-up" box occur when orders are placed with the "acceptable" criteria stated. If the physician orders products that are not within the established guidelines, they would be "required" to enter a reason to justify the order in order to proceed. Probably cannot make a hard stop.  Thanks

[BankerGirl]

Susan,

We set this up a couple of years ago.  We added several drop down boxes to our transfusion orders and made them mandatory so they have to put something there.  If they wish to transfuse outside of the accepted criteria, there is an "Other" option which mandates a free text field for them to list the justification.  Of course, they can always put in a space or some nonsense reason in there, but if they do that, then our Medical Staff Performance Improvement Committee reviews it and determines if the physician needs to further justify it.  If you would like to see our screen, I can email you a copy.

[MAGNUM]

what version of meditech are you using Bankergirl?

[rrcc1974]

I would very much like to see the screen.

[Susan Betler]

Thanks I will follow up with email!!

[BankerGirl]

I have attempted to attach a copy of our current protocol.  The physicians were confused about the actual product orders and when to order a type and screen versus a crossmatch, and they also didn't want to have to place a nursing order AND a blood bank order.  We chose to hide the blood bank orders by placing a "z" as the first character in the orderable and reflexing appropriate blood bank testing to the nursing orders.  Based on the answer to the questions, blood bank places any additional orders necessary to fulfill the request.  This may be confusing, but I will try to clarify anything if necessary.

[BankerGirl]

Well I can't seem to get the attachment to show the CPOE screens, so I will email them to Susan, and anyone else who wishes to see them.

[BankerGirl]

what version of meditech are you using Bankergirl?

We are on version 5.66 right now.

[goodchild]

Bankergirl, I'd be very curious to see how you have set up your blood bank orders reflexing off of nursing orders.  Would you be willing to share with me as well?

 

We're grappling with how we can restructure our order sets for blood products to make them easier/more streamlined but capture all the information that we need. Right now we're doing the separate order concept for BBK and NUR orders (but honestly it's even more confusing than that..) and I'm not happy with it.

[Winter]

Bankergirl, I, too, would love to see how you have set this up. We also have Meditech 5.66 and are hoping to do what you have accomplished.

[BankerGirl]

I managed to get the education handout uploaded to the library section under SOPs.  Not quite sure this is the perfect place to put it, but that's where it is.  Since we made the type and screen order the same as a RC product order due to physician request, we decided to not reflex any products since it is an all or nothing reflex situation.  Otherwise we would have to cancel the RC order on all type and screen specimens.  If anyone has any other questions, I would be happy to address those.

[blossie]

What version of meditech are you using? We have 5.66 and our IT dept is saying there is a limit to 25 characters for the indicators.

[blossie]

In addition, are you using magic or client server meditech?

[BankerGirl]

We have Client Server v. 5.66 and I believe that was the version we had when we instituted this, but it might have been 5.65.  I don't know anything about character limits, we just told IT what we wanted it to say and they figured out how to word it so it fit.