Blood Product Administration

The Connect Care clinical information system (CIS) uses Epic's integration engine to interface with the WellSky blood product management system. Related workflows ensure that the right information is exchanged at the right time, while addressing safety, accreditation and Canadian Blood Services requirements. Things physicians most need to understand are outlined here, with skills covered in linked tip sheets.

Important to note is that express informed consent must be documented (written, electronic or two-provider) prior to the transfusion of blood components or products. This is done with the "Consent Navigator" (accessible via the patient Storyboard), where the "procedure" is administration of a specified blood product.

Blood Product Ordering Context

Blood products are ordered using four methods:

Blood Product Orders

Searching the keyword "blood" or "transfusion" in the "Orders" or SmartSet activities will list available "Transfusion Medicine" order sets appropriate to different age groups and clinical contexts. 

Routine Blood Products

Routine blood products are when the patient requires blood but there is time to enter the orders and get type and screen resulted (if required). These are linked orders - both a Prepare order and a Transfuse order must be filled in:

Emergent Blood Products

Emergent blood products are when the patient requires blood products urgently. Un-crossmatched blood is acceptable if a type and screen has not been placed. All emergent orders require the following:

Massive Hemorrhage Protocol (MHP)

In the event of massive hemorrhage and critical blood product need, the following is required:

When the MHP event concludes, the Connect Care MHP orders should be discontinued and a phone call placed to the blood bank to inform them of no further need.

Blood Derivative Orders

Blood derivatives (plasma protein products [PPP]) are also dispensed from the blood bank. 

Inpatient context

Search “PPP” or the specific name of the derivative to see the specific order panels. Similar to routine blood product orders, orders for PPP are linked orders - both a Prepare order and a Administer order must be filled in:

Ambulatory context

Ambulatory orders for PPP are placed using the Transfusion Medicine OP (Adult or Pediatrics) Ambulatory SmartSet or Therapy Plans, and are signed and held until released for the appointment day.  There are 3 components to these ambulatory orders: