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Alesia

Scanning Emergency released blood into EPIC

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Hello BB community,

We are trying to figure out how to scan emergency released units into EPIC.  Does anyone have any experience with that?

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In order for scan in emergency release blood products at our location they have to place an order. After the order is placed we can issue the units in our seperate blood bank LIS system. After the units are released in the blood bank LIS and the transfuse order is released in EPIC they can scan in the units. The process is the same for the RN as scanning in regular units.

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The way Epic is set up here, if the patient is discharged without an order being placed for the blood, we have no way to scan the unit into Epic after discharge. We place an order on the lab side, result the crossmatch and release the unit as transfused. It's in the patient record on our side that way. We then scan downtime paperwork for the unit into the lab results tab of the patient EMR. I don't know how they deal with transfusion documentation on the nursing side in a case like that - I do know that they have a downtime paper flowsheet that could be used and scanned into the EMR. That's probably what should happen.  If the patient is not discharged, nursing does have a way to put the unit and transfusion information into the Epic flowsheet after the fact. It is done by nursing IT staff.

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We implemented the Epic Blood Product Administration Module over a year ago, and it seems to be working well for routine, non emergency transfusions (using the handheld Rover/iphone device).  Massive transfusion scenarios with uncrossmatched blood in the ER and OR are another story.  Our blood bank emergency issues uncrossmatched blood via a paper system (they feel it's the fastest way rather than using the BBIS), and we are getting significant feedback from the ER and OR that scanning blood is just not working for them in massive situations (no Rovers, scanning with handheld wired barcode gun).  They don't want to scan all 4 barcodes on the blood products, and things are moving so fast that the barcodes are getting smeared with blood and possibly preventing scanning.  We suspect we have other issues preventing clean, quick scanning but have not narrowed down root cause yet.  The ER prefers to have a scribe manually documenting unit number, etc.  It seems the OR is trying to scan, but if not successful it leads to manual documentation.

Any additional feedback on this would be appreciated.  We'd love to improve this workflow for our Providers and are meeting regularly to facilitate this.

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Our trauma coordinator has started experimenting with a module in Epic that is specifically for Mass Transfusion/Emergency Release. It is basically sort of blank with boxes suggesting what should/could be entered. She has successfully scanned in donors and added quick notes to document the transfusion process. She is going to continue working with this as it looks promising and seems quick and easy to use (relatively speaking).

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Alesia,

We are an Epic/SoftBank facility and we went live 2 years ago. After repeated attempts, we do not scan MTP blood into Epic. There are too many products moving too fast for the nurses to keep up documentation. Softbank has a downtime form that prints after the order is placed and we send that forms out with every unit to allow the nurses to check the blood and document the verification, stop and start time and VS. If the patient is monitored VS can be imported into Epic from our SpaceLab monitors. We built an MTP I&O field into the MTP order that populates instead of a nursing documentation row. From there the total volume of each product type can be entered. Those paper records go into the patient's "thin chart".  After a few hours SoftBank will have connected with Epic and the Transfusion Report wills how what was ordered and released during the MTP. The paper records also get scanned into 'Media' tab in Epic after the patient discharge.

What is your LIS? Please let me know if I can help further.

 

A

 

Edited by amburkey

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