EPIC Blood Administration Updates/Optimization May 2013 Duly and Howell, 2013

Objectives: Verbalize the need now to scan three barcodes. Describe the proper order of scanning. Discuss the importance of charting from the EPIC MAR. Explain the importance of completing “30-minute” Transfusion Reaction assessments from the EPIC Worklist screen. Identify Discharge Education Requirement

You must scan them in the correct order as shown. Scanning Changes Need to Scan Three Barcodes: First is the Unit Number Second is the Registration Number 3. Third is the Product Number You must scan them in the correct order as shown.

Unit Number First Scan the Unit Number After the first scan you will see the prompt below to scan the next barcode Pop-up indicates your next step. Do not click on cancel, just scan the next barcode.

Registration Number Second Scan the Registration Number After the second scan you will see the prompt below to scan the next barcode

Linking Blood to Line When the Select a Line appears during the scanning process. Select a line in which the blood will be ran and click on “Link”

Verify the all numbers are noted in unit number box on the EPIC MAR Product Number Third Scan the Product Number Verify the all numbers are noted in unit number box on the EPIC MAR

Troubleshooting-Scanning Issue??? Do not delay care because you cannot scan, use the manual process! If your barcodes do not scan correctly please manually enter the numbers from the Unit number and Product number. You must enter the numbers in this displayed format with only using the Unit and Product numbers but not the Registration Number. Do Not Delay Care! Unit number Product number

Documentation Items on MAR Screen Documentation of all required items except Transfusion Reaction can be done from MAR Screen. So at the start of administration, after first 15 minutes, and at the stop of infusion, you need to access the MAR Screen and document.

Accessing MAR Screen To access the MAR Screen, choose the desired unit of blood if multiple units are running concurrently. This will help keep information concerning each unit such as Start, Issue, Complete “date and times” items separate and easily accessible. Double-click on the medication syringe and the Administration Warning will appear.

Administration Warning-What to Do?? Select the MAR action as appropriate for the clinical situation: Rate/Dose Change Rate/Dose Verify Stopped

Worklist Document-Single Unit When you select “Yes” on the “Start Assessment Checks” item from the EPIC MAR screen the Transfusion assessments flows to Worklist documentation with appropriate documentation times.

Worklist Document-Multiple Units

Discharge Education Requirement Discharge Navigator and Patient Instruction Use the Smart Text Box During patient discharge documentation, the nurse will need to search under Discharge-Patient Instructions then type in the Smart Text Box “PH OP TRANSFUSION DISCHARGE INSTRUCTIONS” and then choose “Accept” so this information will be added patient’s discharge instructions.

Conclusion