Has any one been successful in setting up the bed-side scanning with Meditech? We are currently in the process of setting this up but have encountered several road blocks. Right now, the verifications performed by the nurse prior to transfusion are done manually and documented on a card that becomes part of the patient's medical record. With TAR, the patient's armband would be scanned, then the unit #, product code, and source code. All other transfusion information would be documented in Meditech. I'd like to hear if anyone has encountered any problems and how they worked around them.

BloodBankTalk > United States > Transfusion Services » meditech and TAR

We too have Meditech and it looks like more trouble than it's worth. Maybe someday when I run out of work to do.....

That's what I am finding out. I am keep running into roadblocks and...Meditech just doesn't get it!

Do some use Bedside Medication Verification instead?

Our facility is up and running with eMAR. The I.T. person that brought that up is now helping me with the TARs and she says that it is much harder than eMAR. One problem is that it requires the nurse to scan 4 barcodes (patient armband, unit #, product, and source). eMAR requires them to scan the patient id and the NDC# of the drug. Everything about the drug is tied in to the NDC#. With blood products the unit# cannot be used this way because you may have more than one product with the same unit# (donor i.d.#).

That's what I am finding out. I am keep running into roadblocks and...Meditech just doesn't get it!

Try dealing with Cerner Millenium:eek: You will gain a whole new appreciation for Meditech!!!

We are going live with TAR on 8 Feb 2010. Considering the system we have now, it should be easier, more compliant, and safer.

I'll let you know how it goes next month ...

We had planned on using TARs with our Meditech system but we are waitng to update first. From what my IT has told me it is very difficult to set up but is suppose to be worth it.

We have not implemented TAR yet. I am certain we will in the future, but I am not sure how far out that is.

One question I have about it is blood volume. We have an actual volume for PLTs and Thawed Plasma, but just an average volume for RBCsn (unless we divide or split an RBC). I don't know how TAR works if nurses enter a volume that is less than the default average volume (does this mean that the computer thinks there is blood left over?) or if they attempt to enter a volume more than the default or if places using TAR just have the nurses enter the default volume for the transfusion volume (pretty much what happens now).

Any thoughts?

Linda Frederick

We are not up on eTAR yet, but the blood bank enters all transfusions right now. This also helps us with monitoring the completeness and accuracy of the transfusion record. One of our sister hospitals uses the "presumed transfused" feature. They have the system set to enter that transfusion after 24 hours. That is done in case there is a transfusion reaction that needs to be entered. Those exceptions are entered PRIOR to that 24 hour period.

Does anyone still plan on entering the transfusions, or MUST this information be entered through OE? I'm a control freak, and I'm not sure I want to relinquish control over transfusion entries. Who monitors if the transfusions are completed with eTAR?

How facilities are handling aliquot preparation with eTAR and ISBT 128. We did not purchace HEMATRAX labeling so our labels are all done by overlays. What is going to happen when you try to read that barcode at the bedside and it has a suffix on the DIN when you scan the product number?

We chose to use the "Make component" routine even for our aliquot preps. We entered in the Product Dictionary "allow aliquots?" as NO. At the Component Product field, we entered all of the possible aliquot products that could be prepared from that parent product. Because each "aliquot" has it's own product code, currently we can issue aliquots without the suffix being added to the DIN.

It is my impression that when you use eTAR, the product code is scanned, which will now be a problem with eTAR because MEDITECH will ONLY recognize the first 5 digits of the product code.

E0224V00

E0224VA0 would be seen as the SAME product code in MEDITECH.

What has anybody done about aliquots and eTAR?

Linda - not that we use (or are thinking of using TAR) I just have a comment about the volume .... we enter the actual volume of the unit when we are entering the unit into the system. Staff don't seem to think the few extra seconds it takes is a big deal.

Janet,

Do your red cells come with a volume? or do you weigh each one?

Thanks,

LF

Janet,

Do your red cells come with a volume? or do you weigh each one?

Thanks,

LF

Yes Linda, since we went to "ISBT" in Canada all our products have the volume on the label .... I just assumed all ISBT labels would?!?!?! (Now that I think about it though, it's just the barcodes that are 'universal' isn't it).

We get volumes on our apheresis PLTs and Frozen Plasmas, but not on our RBCs. The RBCs just say "from 500ml CPD whole blood" (or other appropriate anticoagulant message). I see the volume thing as a potential (but not insurmountable) problem.

I also have concerns about the 'non-traditional areas' (Surgery, ER, Endo). Surgery does excellent documentation as a part of the anesthesia record. I am just not sure how it is all tied together.

I think they can put in a volume but I am with christineh, we are waiting to implement but have been told by meditech that it isn't going to be ready until June. We are going live with CS 6.0 in July so I am waiting until at least September to get back on the electronic TAR band wagon!

Hi Everyone,

I'm resurrecting this oldie.  We've just gone live with TAR and I have questions about the volume for our LRBCs also.  We have it default to 250 for our products that are "from 450 ml whole blood--E0401) and I'm hearing that some of our units are more and the extra volume has to be documented into the "other" field on the nursing input and output section.  What do you guys do?  If I default it greater than 250, I'm afraid that if the unit is less, it won't look like the entire unit was transfused.  Thoughts?

Becky

:rolleyes:To: whbb From: rkriozere@digi-trax.com  If you wish to explore ISBT128 a bit more with HemaTrax from Digi-Trax for your Meditech system we would be happy to provide any assistance you might require.  You may email me or call our offices at 800-356-6126.  We are also anxious to learn more about TAR from Meditech for transfusion verification. Our Dir. of marketing is looking into this and her name is Michelle Jorgensen (mjorgensen@digi-trax.com).  If anyone else is interestedin commenting or responding to Michelle please feel free to contact her.

rcollins,  If you chose to have every ISBT128 product defined like I did, then for those products from apheresis, I left the volume undefined and when the unit is put into inventory, The Tech has to enter the volume on the bag.  For those products with an undefined volume, we took the average weight of about 30 units and default that volume in. We use 350ml.   We tell the RNs that they are to use the volume that appears on the I/T card as the volume of the product.

We use the TAR and set up the dictionaries as WHBB did.  If there is no volume, the default is 350.  If the actual volume is less than that, then the nurses enter the actual volume (however they determine that).  The entire unit is transfused in BBK without any leftover volumes.  Even if they enter a volume of 0 (why they do that I don't know) it transfuses the entire volume in BBK.

Yes Linda, since we went to "ISBT" in Canada all our products have the volume on the label .... I just assumed all ISBT labels would?!?!?! (Now that I think about it though, it's just the barcodes that are 'universal' isn't it).

 

We are a Canadian site and find Meditech TAR does not have the ability to scan our blood product unit#, I am assuming we are using ISBT and Meditech may not accomodate that code. We can scan patient identification, blood type, and expiration date of the product. I'm interested in hearing from other sites, and especially Canadian ones who are using scanning with their eTAR Module.

How do you  define the EMR ID for an irradiated product? Can you define an irradiated RBC as a Red blood Cell in EMR to match the order product RBC?

We are a Canadian site and find Meditech TAR does not have the ability to scan our blood product unit#, I am assuming we are using ISBT and Meditech may not accomodate that code. We can scan patient identification, blood type, and expiration date of the product. I'm interested in hearing from other sites, and especially Canadian ones who are using scanning with their eTAR Module.

 

We use TAR with ISBT. I'm not sure if there's a setting that needs to be tweaked somewhere regarding ISBT format. Our lab uses C/S 5.66.

Edited January 20, 201510 yr by goodchild

We run Meditech 5.6.6 and use both eMAR and BCTA (Barcode Transfusion Administration).  Implementing it was bumpy, mainly because nurses, (and people in general) don't like change.  Almost a year into it now, and it is the best thing that has happened as far as documentation and Unit traceablility.  There are some important steps that must be followed: Units must be scanned into inventory and not manually typed in.  Unit barcode labels must be legible and accurate (ie: if you thaw a component, the new ISBT label must be affixed).  There are a few other things, but it is wonderful!

We are using barcode scanning using TAR.  The roadblock we hit is that the new ISBT label for thawed components must be used.  Haven't tried it with aliqouts yet but am hopeful that it will work. 

Edited January 20, 201510 yr by snydercl