Co-Oximetry in Cath Lab

If you were keeping your AVOX, I'd say work on getting it interfaced ASAP.  Within our health system - your state citation is EXACTLY the reason I encourage others to get devices interfaced at nearly any cost.  But I would say having a secondary validation using results sheets they scan to you to be a good interim solution.  

To all,

I do not audit these results for the Cath Lab AVOX. AVOX results are within the procedural charge so consequently are not billed.  Our AVOX are not interfaced.  These results  are entered into the Horizon Cardiology system at time of performance.

I did ensure that the expected ranges were in Horizon Cardiology for all of the various heart chambers.

Deanna Bogner

Hello Everyone,

Question for you all....do any of you have a lab report for your AVOX results?

Recently POC was required to split from the main lab (CAP), obtain a separate CLIA license and be accredited by TJC.  During our initial inspection, TJC cited us for not having a lab report in EPIC Beaker for AVOX results.  I checked with the other hospitals in our system and not one has a lab report for AVOX.  Currently IT is working on extracting that report from EPIC Cupid and we are manually creating a  lab report.

Thanks!

Sherilyn,

My lab is also TJC and we do not currently enter POC Avox results into our LIS.  The nurses manually enter into MACLAB during the case with all the TJC required components- date/time of collection, MD order, ref. ranges, etc.

Were you cited specifically for not having Avox results in LIS?  Or for a problem with the way results were charted in Cupid?

Yikes, these questions and citations are kinda scaring me.  Do you guys have any particular point of care checklist items that are causing these deficiencies?  I do not currently review the AVOX results at my facility. 

The CATHLAB puts the lab results in their system called MACLAB.  I don't even know where or how to begin to look for these results.  I have QC logs (daily and monthly) that I keep track of.  I also request BIOMED clean the sensors twice a year. 

My system is set up much like Deanna's.  Are we missing something?

Kammy

Our Cath Lab enters the AVOX results in their McKesson system as well as EPIC manually.  An order for the testing was created in EPIC .  Once the order is placed "Verbal with repeat back.  Cosign required" which the providers signs off on,  the staff are allowed to enter the O2 sat results for each chamber into EPIC.  The appropriate reference range for that chamber is appended next to the results.  Charges are done through McKesson.

We have chosen not to interface the AVOX for two reasons, the first is that often times the docs disregard some of the results.  Sometimes they are doing the testing as a guide and will disregard and not chart the result.   The second reason is that the AVOX does not have a barcode scanner attached, therefore staff have to manually enter the 12 digit EPIC number.  It is very easy to be a digit off and have the result go to the wrong medical record without anyone being aware. 

Andrea Spence

Point of Care Testing Coordinator

Hartford Hospital

Hartford, CT   06102

That's how I handled the Avox when I was in Texas but Kentucky is a little different, unfortunately. We're trying to get creative so we don't stress the cath lab or ourselves!

Does anyone have the Cath Lab keep a manual log of their patients?  Our facility uses MacLab.