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Hi Steve,

We upgraded to 5.5 this past January and we also testing possibility of using 
the NUR/BBK integrated Transfusion Administration Record (TAR).  Although we 
are not using barcode scanners for BMV yet, TAR can be used without barcodes.  
After setting this up and testing it, we concluded that this will someday be a 
very nice feature to use... but currently it has several problems that 
prohibited our use of TAR.  They are:

1)  Once in the NUR TAR routine, there is a "Special Instructions" button that 
provides special instructions regarding the infusion of that product... perhaps 
"Use in-line Leukocyte filter".  Although there is an asterisk on the screen to 
indicate the need to review these instructions, there was no way to be sure 
that these would not be overlooked and the patient potentially harmed.

2)  Vital Signs associated with the transfusion must be documented using a 
"Document" button in TAR.  This links those vitals with that product and shows 
these in PCI along with the product history.  However, any vitals taken before 
or after the actual start and end time of the infusion are NOT linked to the 
product.  Since our policy requires a nurse to record vitals prior to beginning 
the transfusion as well as one hour post transfusion, we need those vitals 
linked as well.  Meditech states that there is currently no way to do this!

3)  Anytime there is a suspected transfusion reaction, we have a procedure for 
nurses to follow.  A pathologist then reviews the records and determines the 
type of transfusion reaction, if any, that occurred.  He then uses a 
Transfusion Reactions routine in BBK to record the type of reaction the patient 
had to the product.  All of this is linked to the product and displays in PCI.  
HOWEVER, the TAR includes a "Reactions" button.  This button takes the user 
into BBK's Transfusion Reaction routine and would allow a nurse to enter 
transfusion reaction information that only our pathologist should be entering.  
And of course... there is no way to remove the button as this is standard 
Meditech design!  :-)

4)  The TAR provides a time that the next vital signs are due based on customer 
defined directions.  However, each "Next VS Due" is calculated based on the 
lasted documented time... not the time the infusion was started.  So if the 
user is 10 minutes late documenting the first set of vitals, EVERY subsequent 
"Next VS Due Time" will automatically be thrown off 10 minutes... but this is 
"Working As Designed" (WAD)!

There are many things about this routine that we did like.  But because of the 
critical nature of blood products transfusion, we felt that using the TAR as it 
is currently would require so many workarounds that we would be better off 
sticking to our current paper transfusion record for now!

I hope this information is helpful!

Good luck,
Kenny Whiteside


Kenny Whiteside RN, BSN
Patient Care Information Systems
Catawba Valley Medical Center
810 Fairgrove Church Road
Hickory, NC 28602
[EMAIL PROTECTED]



>>> "Johnson, Steve K." <[EMAIL PROTECTED]> 05/01/2006 4:49:27 PM >>>
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======================================

We are already live with BMV and EMAR in 5.4.  We are just beginning to
test our 5.5 update ring.  We would like to try out the 5.5 enhanced
BBK/NUR integration which supports barcode bedside patient
identification and electronic Transfusion Administration Record (TAR).
Is there anyone out there who has already been through this?  Willing to
share your experience??

 

Respectfully,

 

Steve Johnson

Clinical Systems Analyst

Island Hospital

1211 24th Street

Anacortes, WA 98221

[EMAIL PROTECTED] 

(360) 299-4254 office

(360) 630-4381 mobile

(360) 299-1369 fax

 


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