Presented by Technology Education Services and Information Design, DHTS

1. Presented by Technology Education Services and Information Design, DHTS CPOE Blood Transfusion Update (To advance each slide during this presentation, either left-click the mouse, or use the arrow keys on the keyboard.) • CPOE (Computerized Physician Order Entry) advisors have been built for blood products. Some of the traditional paper forms regarding transfusion have been eliminated. • This presentation is designed for healthcare providers to provide an outline of the new processes for setting up, ordering, and dispensing blood products in DUH Adult Inpatient and some of the Emergency Department areas. • Although HUCs have access to CPOE, they will not be these using transfusion advisors. HUCs should be familiar with these new processes in this presentation. • The Go Live Date for CPOE Blood Transfusion Advisors is April 6on DUH adult patients only.

2. Transfusion Work Processes

3. Transfusion Preparation OLD Paper Process

4. Transfusion Preparation NEW Electronic Process • Blood Product Preparation Request Advisor • Used to set up RBCs, platelets, plasma (FFP), and cryoprecipitate. • Recent lab results will display for reference. • If a current Type & Screen is not active, a warning will display. • Use the keyword “preparation” to search for this advisor in CPOE. Warning. Current Type & Screen not active

5. Transfusion Preparation NEW Electronic Process Platelets The second half of this advisor contains sections to prepare: • Platelets • Plasma (FFP) • Cryoprecipitate FFP Cryo

6. Order to Transfuse OLD Paper Process

7. Order to Transfuse New Electronic Process • Blood Product Administration Advisor (RBC part) • Used to enter an order to transfuse. • To order Platelets, FFP, & Cryo (not pictured here), use this advisor following similar steps as RBCs. • If no order exists for the crossmatch, a warning will display. • Use the keyword “administration” to search for this advisor in CPOE.

8. Order to Transfuse New Electronic Process Related orders for the transfusion can also be ordered from the Blood Product Dispense / Signout Advisor: • Medications • Order to dispense blood product • Vital signs monitoring • Post transfusion labs • Order to release blood in cooler

9. Transfusion Dispense Request OLD Paper Process

10. Transfusion Dispense Request New Process • Blood Product Dispense / Signout Advisor • Used when the nurse wants Transfusion Services to dispense the blood. • A green YES displays if an order is present or a pink NO displays if no order exists. • Use the keyword “dispense” to search for this advisor in CPOE. • The nurse would select the delivery method, check the box to dispense, enter number of units, and click the Place Orders button. Must specify delivery method

11. Release of Blood in Coolers • Red blood cells and plasma can be released in coolers. • When the MD enters the dispense order, CPOE displays as • A dispense request automatically prints in transfusion services. • RN needs to arrange pick-up only by calling messenger service. • A separate order to transfuse does still need to be entered by the MD.

12. Emergency / Conditional Blood Release Advisor • If a patient’s condition warrants, an emergency release of blood can be requested. • In addition to this advisor, the Emergency Release Form (Next slide) must also be completed on paper.

13. Emergency / Conditional Blood Release Form Still used in emergency situations • This form is still used in emergency situations. • Physicians must sign this form.

14. Transfusion Orders in eBrowser As with other orders, transfusion orders display in eBrowser. An OCR (Order Confirmation Report) will still print out after the transfusion orders are entered.

15. Transfusion Report Form • The Transfusion Report Form is dispensed with the blood product. • This form is still to be completed by nursing.

16. Transfusion in the Emergency Department • Transfusion orders will be written via CPOE for CEU and inpatients admits being held in the E.D. • E.D. nurses for these patients should review OCRs (Order Confirmation Reports) and eBrowser to see the orders.

17. CPOE Blood Transfusion Highlights • The 4 blood transfusion advisors replace the handwritten forms (except for emergency release form). • CPOE will send a pop-up reminder to providers when crossmatch has expired. • Recent lab results display in transfusion advisors. • Transfusion Services receives a printed report from CPOE after each order is entered. • The Go Live on April 6 for CPOE Blood Product Advisors is for DUH adult patients only.

18. CPOE Blood Transfusion Highlights • If you have more questions about the April 6 Go Live on the adult inpatients at DUH, you can page the CPOE team at 970-9999. • If you need additional computer training, you can contact the Technology Education & Information Design’s registrar at 668-4740. • This concludes the CPOE Blood Transfusion Update. • Click “Close and Save Progress” in the upper right hand corner to finish this course.