Bar Code Expansion Project Class 110 VeHU 2007

1. Bar Code Expansion ProjectClass 110VeHU 2007 Jan Zeller, Education Project Manager, VALU - NT&EO Ruth Petrich, RN-MSN – North Texas Health Care System

2. HOUSE KEEPING This is a 90 minute class Restrooms are located… Cell Phones Please turn off or change to vibrate If you must answer a call, please leave the room.

3. Class Objectives • 1.  Provide an overview of the Bar Code Expansion project. • 2.  Review the available and future applications. • 3.  Identify a proposed implementation timeline. • 4.  Recognize the pre-implementation facility requirements. • 5.  Identify potential users of the applications.

4. Session Overview • What is BCE-Project Overview • Why BCE • Where is BCE Today • When is BCE arriving –Timeline • Who will be affected – BCE Users • Applications Overview • Summary • Q & A

5. Project Overview • National Center for Patient Safety Initiative • Provide centralized approach to clinical barcode applications in VHA

6. Why BCE? • Patient misidentification • Vulnerability in labeling • Case in point • Patient Safety Manager (PSM) reporting

7. Where is BCE Today • Further application development necessary • Acquire project staff • Implementation of wMA, wCareAssist and wCareView • Wireless infrastructure issues

8. When is BCE Coming to You • FY 07 • FY 08 • FY 09 • FY 10

9. Who will be Using BCE • VA Medical Facilities • Clinical Staff • Inpatient/Outpatient • Laboratory • Operating Room (OR)

10. Applications Overview • Lab/Specimen Collection – wCareCollect • Blood Administration – wBloodCare • Medication Administration – wMA • Vitals and Inputs/Outputs (I&O) – wCareAssist • CPRS view only – wCareView • Code Blue

11. Applications Icons • WCareCollect • W Blood Care • WMA • WCareAssist • WCareView • Calculator

12. Overview of the PDA • Red power button • Yellow scan buttons on each side • Integrated scanner beams from the top • Has a tethered stylus • 4 function buttons that are assigned to different applications • Home button that allows the user to navigate from application to application

13. wCareCollect (Lab Specimen Collection) • The printer attaches to the PDA for point of use printing

14. wCareCollect (Lab Specimen Collection) • Log in using your VISTA/CPRS Access Code

15. wCareCollect (Lab Specimen Collection) • Scan the patient • Wristband • Confirm patient • Allergy Alert

16. wCareCollect (Lab Specimen Collection) • It will bring up all ordered tests • You can view collection details by tapping on the item • Staff can view different collection types such as • Active • Lab • Unit • All

17. wCareCollect (Lab Specimen Collection) • After obtaining the specimen and placing the labels on the tube, staff will scan the barcode to put an electronic date/time stamp and staff identification on that specimen

18. wBloodCare (Wireless Blood Administration) The Process • Scan patient and blood unit • Record Vital Signs, presence of informed consent, documentation of reaction • Coordinated with the VBECS package • Will replace paper SF 518

19. wBloodCare (Wireless Blood Administration) • After logging in and scanning the patient barcode, you will see a listing of all available cross-matched units

20. wBloodCare (Wireless Blood Administration) • Application allows user to enter vital signs per facility policy. • These vitals are interfaced back to CPRS

21. wBloodCare (Wireless Blood Administration) • Second verifier enters their access/verify code

22. wBloodCare (Wireless Blood Administration) • Recording the start of the unit of blood

23. wBloodCare (Wireless Blood Administration) • Continuing the transfusion

24. wBloodCare (Wireless Blood Administration) • Further actions that can be taken: Enter additional vitals Complete the transfusion Stop the Transfusion

25. wBloodCare (Wireless Blood Administration) • Record total amount of blood product infused

26. WMA (Wireless Medication Administration) • Takes BCMA software and reconfigured it to display on a PDA • Is used currently at 18 VA’s • Can be used as an adjunct to med carts with laptops or as the only device for medication passes

27. WMA (Wireless Medication Administration) • Similar functionality as BCMA • Start/Stop time change • UD, IVP/IVPB, IV tabs • Rearrange Fields • Medication, Admin • Perform PRN effectiveness

28. WMA (Wireless Medication Administration) • Instead of menu bars at the top of the screen there is and “Action” menu at the bottom left

29. wCareAssist (Wireless Vitals/Inputs & Outputs) The Process • This functionality will allow staff to either Enter vital signs manually or beam them over via an infrared beam • The vitals recorded in the PDA will be stored into the appropriate VISTA file and be accessible in Vitals Lite and CPRS

30. wCareAssist (Wireless Vitals/Inputs & Outputs) Retrieving Patient Records • Scan the patient wristband • Acknowledge patient demographics • Tap on “OK” to proceed

31. WCareAssist (Vital signs and Intake and Output) Vital Sign Entry Screen -Enter Vitals -Vitals Mark Errors -View Vitals -Dinamap -View Allergies

32. WCareAssist (Vital signs and Intake and Output) • Selection of Vitals

33. WCareAssist (Vital signs and Intake and Output) • From the vitals entry screen, tap on the vital sign you want to record • It will bring up this type of screen • Enter the patient’s vitals • You can record “qualifying information” in the drop down fields • Tap on the Next or Prev. buttons, to repeat the steps for the remainder of vital signs • You may also select “Unavailable” or “Refused” • Tap on Summary and select “Save” to record vital signs in CPRS

34. wCareAssist (Wireless Vitals/Inputs & Outputs) • Vital Sign entry via beaming over the vital sign from the automated blood pressure machine

35. wCareAssist (Wireless Vitals/Inputs & Outputs) • Beam over vital sign option

36. wCareAssist (Wireless Vitals/Inputs & Outputs) • Alignment of the infrared beam with the receiving port on the PDA

37. WCareView (Read only CPRS) • The tabs at the top are the same as the tabs at the bottom of CPRS • Vital Sign and Lab trending ability is available • This is a Read only version and data cannot be entered, modified or deleted

38. wCodeBlue Under Development

39. BCE Implementation Activities Key Activities: • Forming local implementation team and plan • Selecting initial clinical areas for implementation • Hardware shipping, receiving and set-up • Software loading and testing • Information Resources Management (IRM) training (on-site) • Super user training (on-site) • End user training (by local super users) • Support

40. Food for Thought • Vendor super-user training and IRM training • BCE Coordinator pre-implementation involvement • Laboratory/Blood Bank involvement • How much testing is really needed • Need for cohesive team • Need for effective communication • Who should be part of local team and decision making processes • Where should BCE be implemented/tested • When should BCE be implemented at your facility • Who should be your super-users • How will you train your end-users • How will you receive support

41. Summary • BCE focused on Patient Safety • Need for further development • Appropriate wireless infrastructure • BCMA-C involvement not appointment • Facility workflow/process assessment • BCE NT&EO Website http://vaww.vistau.med.va.gov/vistau/bce/

42. Questions?