To help clarify: The problems that we initially heard about in beginning the NUR transfusions had to do with:
1. So many problems that Meditech has indicated that several sites are not utilizing this until DTS's are developed and moved... 2.. EDM can't use this functionality... 3. The info that goes to the BBK from NUR is sparse and incomplete.... 4. Cannot see the arm band number when in the bbk process.... 5. The CDS screen has room for 8 lines, can get crowded with all the info you need to put in there.... 6. 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..... 7. 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! 8. 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)! Another site is utilizing the OE process to do this: About 3 years ago we had a PI initiative with regards to our paper BBK transfusion record. We have the NUR module, but not used by all areas, thus we needed a solution that all staff would have access to. We set up a Transfusion completion form in Order Entry. The Customer Defined screen has all of the questions that BBK needs to complete their job and it has worked very well for us. The nurse who completes the transfusion does the OE procedure. Upon filing the completed form prints in the BBK dept, and nursing just discards the bag. This is done in the ED, L&D, as well as all of our general med surg units. Compliance dramatically improved and BBK is very happy. Thanks to all those that replied...Hope everyone has a great weekend...Diane Diane Folsom, RNC Clinical Information System Specialist Sid Peterson Memorial Hospital Kerrville, TX 78028 830-258-7080
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