Blood Administration / Electronic Scanning & Charting

[njinformaticsrn]

Does anyone work in a facility that uses an electronic scanning / electronic administration system for transfusing blood or blood products? I'm looking for info on something like an electronic MAR, but one specifically used for transfusing blood, where the unit(s) and a patient wristband are scanned, dual RN verification is done electronically, VS entered electronically, etc. Any feedback is welcome!

[Dixielee, BSN, RN]

We use First Net/Cerner, scan all our meds and blood into the system. We still use 2 nurses as well. We can have vitals electronically if we have them on the monitor and admitted to the system, but we don't always do that.

[Reno1978, BSN, RN]

We use EPIC and all of this is done electronically.

[vanburbian]

EPIC here as well, scanning can be a real PIA though.

[Creamsoda, ASN, RN]

Epic here too. Blood admin and blood ordering has the be the most PITA thing about EPIC, but otherwise I don't mind the system

[turnforthenurse, MSN, NP]

We use Cerner (ER uses First Net). Blood is the only thing that we do not scan. We have a blood administration form that we still use and still have 2 RN's check blood at the bedside and document everything on that form. After blood is done, a copy goes into the chart and the other copy gets sent down to the lab. Lab generates that electronically for us and gets copied into the patient's EMR, but again, no actual scanning by the nurses is done.

[Reno1978, BSN, RN]

We just went to EPIC Nov 1, and maybe it's the build you use or something, but I don't find it bad at all. You tell it what you have, scan the unit, enter vitals, have someone else verify it with their login, and you're done.

[lucky_shamrock]

We just switched over to Paragon. Blood is a PITA (among many other things).

There is a tab on the daily assessment page for blood. The first nurse goes in, checks off all the little boxes (consent, VS, etc) then virtually "signs" her name and logs off. The second nurse logs on, pulls up another daily assessment, checks the boxes and "signs" her name. When we first switched over to this system, it was taking so long that apparently some people we having to return the blood to the labs. Its a bit better now, but still takes a good 15-20min for what should be a 5min task.

[vanburbian]

For whatever reason, with EPIC, the scanners have a hard time reading the blood product labels, and because there are so many labels, it was initially unclear which ones needed to be scanned and in what order.

We finally made a cardboard template and labeled them 1-2-3, so it's slightly easier now, but since it's not something we do on a daily basis in ER, it can be time consuming.

[linnaete, ASN, BSN, MSN]

Cerner. We are able to scan bloodband and blood bag unit into the system. Everything else entered into the computer. We also still fill out paper sheet attached to the unit of blood & place into paper medical record. 2 nurse verification.

[UMNbloodbank]

Dear Reno1978, Could you tell me more about how this works? What LIS do you have? What scanning system etc? Our hospital uses Misys and Epic and we've been told repeatedly that we cannot scan our blood administration information into Epic. Thanks, UMNbloodbank

[zmansc, ASN, RN]

We use something called 'TAR' on meditech. Other than the fact that it is so confusing that most times lab/blood bank calls our director and complains that the RN didn't document it correctly it works as good as anything I've seen in meditech, which isn't saying much! lol

It requires a co-signer for the identification of the proper product to the proper patient, all by scanner, and then one nurse can do the administration and vitals entry. It doesn't record, or have you enter anything about the rate of administration. Of course all bets are off in a rapid infusion trauma situation....

I think the confusion comes from the fact that in the screens on this thing there are so many steps you have to take, and they must be taken in the correct order or the documentation doesn't show up correctly at the blood bank and they think the blood hasn't been properly administrated. I haven't had a problem with it fortunately, but that's probably because of my IT background. I still write a nurses note with all the info anyways in case the blood bank/IT/Meditech/TAR thing blows up, then at least the patients medical record is complete.