Blood Bank Wristbands with Epic

[ab9537]

We are going live with Epic/BPAM and Softbank (current system) this year. Our hospital uses blood bank wristbands and wants to continue their use, but we are having difficulty getting Epic to document the Wristband check at the bedside by the two RNs. Group O policy is not an option. Does anyone have experience with the blood bank wristband documentation in Epic/BPAM?

[Kathyang]

   We have the nurses place the wristband in BPAM. They have to put it in to start the blood. We also had to create a test in Softbank called BBID and the answer it Y. In the comment box we scan the BBID number and it goes across to Epic do that number has to match. I an attaching what the screens look like in Softbank. Wristband.docxWristband.docx

[ab9537]

Thank you so much! I think our new version can send the WB # out. Can you show me the screen in BPAM? Epic is telling us no questions can be added to BPAM! And does it match electronically or do the RNs need to certify that it matched? 

[PBM RN]

We actually have not added the field to Epic but do have it in Soft. In epic the BBID is entered in the free text field in BPAM in the blood unit verification screen. For the majority of care scenarios we have moved away form the BBID in favor of the Epic patient band. I would be interested to know where and how the BBID bands are being used in other Epic Centers?

 

[Mabel Adams]

We still use a BBID# because we have too many situations (pre-ops, outpatient transfusions) where patients aren't wearing Epic bands when their specimen is collected.  I think we still have too many work-arounds too.  We have not yet been live for a year.  We have a flowsheet row that the nurses are expected to answer "Blood Bank band # checked and matches" but they aren't perfect at documenting it. 

I would be really careful in mapping what you are checking as you create these things because comparing BB band numbers from the unit in hand with what came across from your BBIS is not useful if you don't also check the BBID# on the patient.  In fact, it could give a false sense of security.  Someone could have used the wrong specimen in BB and put that ID number into the computer so all of the checks in the computers will match between the unit and the computers but the blood did not come from that patient and he has a different number on his wrist.  Sorry if I am misunderstanding the process.

[AMcCord]

We use the FinalCheck band system and it works 'outside of' BPAM. The unit of blood is issued in a tough plastic bag w/ a ziplock top. There is a 'padlock' on the bag that prevents it from being opened (the ziplock can't be opened). The combination to the lock is 4 alpha characters on the FinalCheck armband that the patient is wearing. This is the first step in the ID process at the patient bedside. (We still use 2 person ID for transfusions.) If the lock won't open, there is a problem and the BPAM ID process doesn't proceed until Blood Bank has investigated and solved the problem. If the lock will open, then BPAM ID and the transfusion proceeds. That is how their policy for transfusion is written.  Their policy also says that the alpha code is not to be recorded anywhere in Epic or on paper towels or on the back of someone's hand. The bags are not cut open.

We do not have a problem with bags being cut open - has not happened once in the several years we've used the system - because that action is subject to serious disciplinary action because it is considered blatant disregard for patient safety. Human behavior says that cheating the system is always possible, but we've had really great cooperation from nursing staff because enough of them realize the advantage of the bands/locks for patient safety. They self-police very well. . . And our phlebs are really good confidential informants .