Transfusion Record

[tbostock]

1 hour ago, goodchild said:

Have any of you gone away from paper transfusion tags attached to the blood products and instead using label/sticker technology and the transfusion record is either completed electronically or as a distinct nursing/blood bank form?

This is the road that I want to go down but I'm wondering if there are any others out there I could learn from.

Yes a few months ago.  No more transfusion tag; we now have a label that goes out with patient name, MR#, DOB, "crossmatch compatible", unit #, patient's blood type, unit's blood type.  We have SoftBank and it prints when we crossmatch the unit.  We send the unit upstairs and they scan everything into Epic BPAM and document everything there.  We review documentation compliance daily.

[goodchild]

In a downtime (or locations without Epic BPAM) do you revert to attaching paper tags?

[AMcCord]

3 hours ago, goodchild said:

Have any of you gone away from paper transfusion tags attached to the blood products and instead using label/sticker technology and the transfusion record is either completed electronically or as a distinct nursing/blood bank form?

This is the road that I want to go down but I'm wondering if there are any others out there I could learn from.

I still have the hang tag because I don't have a blood bank information system BUT almost all of our transfusions are documented electronically as part of the nursing care and evaluation documentation area of our HIS. I did have input on the format to ensure that they have spots to document the information that I want/need to see. I wanted them to have mandatory fields, but they refused...thus we have some incomplete entries. On the plus side, the indications for possible reactions appear as a list with boxes to check. Check YES, there are signs or symptoms of a reaction, then check a box or boxes for which signs/symptoms were noted and a reaction workup is ordered automatically and the order appears in the hand held devices for the phlebs. That works great!

During downtime, in the ER and OR, paper transfusion flow sheets are used.

 

Edited March 1, 2016 by AMcCord

[Auntie-D]

On 2/20/2016 at 5:03 PM, drwajiha said:

 

dear David

i want to know how do you ensure the identity of staff identifying the patient and staff extracting the sample from the patient.

also what about the authorized person to order the blood products.

how do you manage these things electronically

 

regards, 

drwajiha

I can't speak for David but the way we do it is on completion of training and proof of competency the person is given a PIN. This is required to be used - we input this on our system and it notifies us if the person is compliant for that particular task, be that sample collection, blood collection or blood administration. 

[tbostock]

On ‎3‎/‎1‎/‎2016 at 9:36 AM, goodchild said:

In a downtime (or locations without Epic BPAM) do you revert to attaching paper tags?

All locations here use BPAM, but yes, we use the old forms for downtime.  We have also had to print one in a pinch when BPAM does not work so the patient can get their blood (usually if they don't transfer the patient in Epic from ICU to OR for example...if they don't move them to the new location, the person at the new location can't access BPAM for that patient.  VERY frustrating.)

[BankerGirl]

We use stickers  for our assignment/crossmatch info and total Electronic documentaiton with the exception of Surgery, Trauma, MTP and Code Blue transfusions.  OR has a different format of electronic documentation where vitals are still only on the anesthesia record.  When I started monitoring transfusions, our compliance with vitals was <50% but now it averages >95% but it took several years and relentless incident reports to get there so keep trying.  The computer makes it easier for the nurses to document but they can still circumvent the process.  I do not do much real time monitoring because that would be way too much time out of each day.

[Teristella]

We are trying to get away from tags too, but we have issues with compliance entering vitals etc. that we are trying to work through first.

I made tags for downtime in Excel that allows techs to scan the product's barcodes to enter data; hopefully it will cut down on a lot of errors. There are two tags on half a page, one for us to keep and one for nursing to keep, and all the information is mirrored from one half to the other so it doesn't have to be typed twice. Our most recent downtime was almost 40 hours and keeping track of everything was a significant issue. Haven't had occasion to use the new tags yet, we'll see how they work.

[goodchild]

We finally implemented label technology for crossmatch/assignment tags.

Datamax O'Neil E4205A Mark III printers with FDA approved labels manufactured by Zebra. We're on Meditech 5.67 C/S. Nurses and techs love it. Amazing improvement to the workflow (we're transitioning away from a track fed dot matrix printer). We're lucky that 90% of transfusion documentation is electronic (TAR).

[mollyredone]

5 hours ago, goodchild said:

Datamax O'Neil E4205A Mark III printers with FDA approved labels manufactured by Zebra. We're on Meditech 5.67 C/S. Nurses and techs love it. Amazing improvement to the workflow (we're transitioning away from a track fed dot matrix printer). We're lucky that 90% of transfusion documentation is electronic (TAR).

Do these labels go on the back of the unit?  We still have dot matrix unit labels and "unit ready" slips.  We send the unit ready slip when the unit is crossmatched and the nurses tube it back when they are ready for the unit to be sent by tube.  Everyone but ER and OR use TAR.  ER and OR are still paper holdouts!

[goodchild]

1 hour ago, mollyredone said:

Do these labels go on the back of the unit?  We still have dot matrix unit labels and "unit ready" slips.  We send the unit ready slip when the unit is crossmatched and the nurses tube it back when they are ready for the unit to be sent by tube.  Everyone but ER and OR use TAR.  ER and OR are still paper holdouts!

We want them on the front, unless it's not possible. On the back it would be a challenge to do the product label to assignment label comparison. We designed the label to be pretty narrow. 3.5"x1".