1. Soarian Orders Update: ► Type and Screen ► Crossmatch ► Transfusions Implementation Date: Nov 6, 2012 Oct 2012

2. New Ordering Picklist Orders for:  Type & Screen  Crossmatch  Transfusions of blood and blood products  Prepare blood product order for LAB will be found under Lab ► Blood Bank ► Transfusions

3. NEW PROCESS: Type and Screen Physician writes order for Type and Screen SA/Nurse/CPOE physician selects √Type and Screen and completes the order detail including transfusion history NOTE: The # of units field is no longer on this detail order screen

4. Type and Screen cont’d NOTE: The review of the transfusion history is still a requirement

5. Type and Screen cont’d The phlebotomist uses lattice to ID patient and draws sample For patients with central lines, the nurse draws the sample using Lattice and sends to lab** **Make sure the Nurse collect box is checked on the order detail screen to send to the nurses’ collection list on Lattice

6. Type and Screen cont’d Results will be posted to the patient record

7. NEW PROCESS: Crossmatch Physician writes order for Type and Crossmatch SA/Nurse/CPOE physician selects Crossmatch units and completes the order detail screen including transfusion history and # of units if requested NOTE: Type and Crossmatch requires a valid Type and Screen. Type and screens are valid for 3 days for inpatients

8. Type and Crossmatch cont’d The phlebotomist uses lattice to ID patient and draws sample For patients with central lines, the nurse draws the sample using Lattice and sends to lab** **Make sure the Nurse collect box is checked on the order detail screen to send to the nurses’ collection list on Lattice

9. Transfusion of packed cells cont’d Detail the order screen including # of units or ml for neonates Blood product unit requisition (slip) will print on the nursing unit. This will be placed in the front pocket of the patient’s chart Make a copy for each unit and take the req to the lab to pick up the product.

10. Transfusion of packed cells If Packed cells are to be transfused 1.Review the pt record to ensure patient has valid type and screen and crossmatch has been done 2.Verify product is allocated and available to transfuse This information can be found on the Patient results screen

11. Transfusion Process The transfusion order will: send the blood transfusion assessment to the nursing worklist NOTE: The blood transfusion record; documentation requirements and process for obtaining blood from the Lab have not changed The nurse uses the established process for administering blood products per policy.

12. Transfusion Process cont’d Orders to transfuse, once placed, will then be found under Patient Care in the current order summary screen on the Orders display on the Patient record and

13. Transfusion of Blood components If other blood component(s) are ordered, enter the applicable order for both the transfusion and ‘preparation’ order Cryo Platelets FFP

14. Reminders Review/update the patient’s transfusion history to ensure its accuracy A transfusion order requires a: ►valid type and screen ►finaled type and crossmatch ►an order to transfuse for nursing ►an order to prepare for Blood Bank for blood products other than packed cells Type and screens are valid for 3 days for inpatients Documentation requirements for transfusions remain the same Availability of the blood/blood components can be found on the Patient Results Screen