Frequently Asked Questions

ED BPAM FAQ

• What actions am I supposed to se for my Transfusion? What do they mean

  When you document your transfusion in the Blood administration flowsheet you have the choice of the following actions:

  Action	Meaning
  Component Verification	The blood product has been verified by 2 RNs.
  Blood Initiated	The blood product transfusion was started.
  Blood Infusing	The blood product transfusion is ongoing.
  Blood Completed	The blood product transfusion is done.
  Blood Stopped	The blood product transfusion has been interrupted for some reason and will be re-started.
  Blood Other (Comment)	Just in case.
  Blood Restart	The previously stopped transfusion has been started again.
  Blood Rate Change	The transfusion has been slowed down or sped up from the previous rate.
  Blood Documentation Error (Comment)	To document that an error has occurred.
  Transferred to EMS with Blood Infusing	To document that the patient has transferred outside of a UTMB facility.

   

• In ASAP how do I document starting, stopping, and completing a transfusion?

  To start a transfusion: After releasing your PRBC unit you will go to the Blood Products toolbox (the right column in the narrator), select the blue “transfuse Packed RBC” link (or whichever blood product you are transfusing) you will then scan the patient and blood and complete your documentation.
  To stop a transfusion: From the Blood Products toolbox, you will click the “Infusion stop icon” (small IV bag with an X next to it) you will make any time changes needed, document a volume, and click accept.
  To complete the transfusion: In the Blood Products toolbox, you click the “Complete Unit” link- this updates the event log showing the order was completed.

• During downtime what documentation do I complete for a transfusion?

  When using the downtime transfusion documentation:

  1. Document vitals (pre-transfusion, 15-minute, and post-transfusion) start and stop times, the volume of transfusion, and suspected transfusion reaction (if applicable).

  2. Scan copy of completed Transfusion tag to: BLDBANK@utmb.edu

  3. Place original in patient's chart.

  

IP BPAM Frequently Asked Questions

• How do I get my dispensing request?

  To obtain and print your blood dispense report out of Epic You will go to the BPAM flowsheet. On the left side you will see a box with a Transfusion Report button. Click it and select the blue “0 of 1 released” (0 of 1 released, 0 of 2 released, etc.) hyperlink under the Transfuse Packed RBC. When you hit this release link your dispensing report will print and your released counter will change (1 of 1 released, etc.). Make sure you complete the pre-transfusion documentation before releasing it.

  

• What are my statuses and where can I see them?

  To review a blood order status you will go to chart review and are viewable in the Order Review tab

  STATUS	DEFINITION
  Canceled	Order/part of the order has been canceled (by either the blood bank or someone in Epic
  Issued	The product has been issued
  Ready	The product is ready in the Blood Bank and waiting to be picked up
  Released	The product was assigned to the patient but was released/unassigned from the patient (Ex: T&S expired)
  Returned	The product was returned to the Blood Bank
  WorkinProg	The product may or may not be ready for issue. A call to the Blood Bank will be necessary to clarify on a case-to-case basis.

  A column that you can add to patient lists will also indicate that blood is ready to pick up. Search for “blood ready” within the properties of your patient list.

  
  
• During downtime what documentation do I complete for a transfusion?

  When using the downtime transfusion documentation:

  1. Document vitals (pre-transfusion, 15-minute, and post-transfusion) start and stop times, the volume of transfusion, and suspected transfusion reaction (if applicable).

  2. Place original in patient's chart.

  

• Why are there orders in Units and mLs?

  Blood ordered in Units is for adult patients and order placed in mLs is for pediatric patients. If you have any issues documenting, make sure your prepare order and transfuse order are using the same volume type. "This unit is not valid for this patient and transfusion" Example- Transfuse and Prepare orders do not match (order set not used). (Ex. Transfuse order in units & prepare order in mLs)

• How do I document blood when the MTP is activated?

  Documenting blood after activating the Massive Transfusion Protocol (MTP) is done in the BPAM flowsheet.

  1. Select the flowsheet row in Epic for the product you are giving that has “Scan in Comments” in the name.

  2. Select the “1” in the row details box to document that you are giving one unit.

  3. Place the cursor in the “Comment (F6)” box.

  4. Scan the component barcode on the product to be transfused (Usually starts with "W").

  5. Verify that the information in the comment field matches the numbers above the barcode.

   

  Click here for an image of the correct barcode

• The blood bank has sent a verification tag with my blood? I have verified my blood in Epic, do I also complete the verification tag?

  Just because the blood bank sends the transfusion tag does not mean you have to sign it. If you completed the verification in Epic, the paper does not need to be signed. The verification tag will still be utilized during blood bank or Epic downtime and during MTP.

• How can I view my patients’ previous transfusion documentation?

  To view previous Blood transfusion documentation you go to Chart Review and the Blood tab

  

• How am I able to hide my transfusion groups?

  To complete/hide your transfusion group you will right-click in the header of the “Transfuse Packed RBC” and select “Complete transfuse Packed RBC (in units)” This will grey out the group and you will no longer be able to document in the group. If you do not complete the group, this could cause issues when transfusing additional units.

  

• How can I view or edit transfusion documentation that has already been completed?

  To view completed transfusion documentation in the flowsheet by “Unchecking” the Hide Comp’d box above your flowsheet. To edit that documentation, you will right-click in the “transfuse Packed RBC” Header for the unit you would like to edit, then click reactivate Transfuse Packed RBC, you can then edit as needed.

  

• What do I do when my blood will not scan?

  A: If a blood barcode will not scan you are still able to manually enter the blood unit information in your Blood Administration MAR form. If an error is received after entering manually, contact blood blank to resolve before moving forward with the transfusion process.

  B: Check your blood to see if it has an unverified sticker. On occasion, the blood bank will release blood as unverified when they see there is an urgent need. In this situation, you will follow the unverified blood workflow. No scanning is necessary.

  Reminder** if the patient’s armband will not scan replace the armband before proceeding.

• What do I do when my blood is canceled?

  If the provider cancels the blood while it is transfusing it is advised to complete documentation on the downtime form.