BloodSTAR/BloodNet User Acceptance Testing Dispenser Scenarios
This document guides you through a set of commonscenarios in BloodNet related to the implementation of BloodSTAR. Use this document to conduct structured testing, before undertaking a period of self-guided discovery.
Logging In
For the purposes of testing you will use a web address specific to our user acceptance testing environment.
- Enter the address into your browser.
You will be directed to the BloodPortal login screen.
- Enter the provided username and password and click Log In
If you are a registered user of other NBA systems do not enter your regular BloodPortal login details. You will not be able to access the UAT environment with these credentials.
You will be directed to a page where you can select your role and facility.
To support these scenarios test data has been created in the UAT system. As there may be multiple users logged into the same facility, other users may access the data before you.
Where there is not data available to undertake testing scenarios, you may refer to the Medical Officer and Nurse scenarios in order to set up authorisations for you to use in your testing.
See:
The Authorisation Menu
The new Authorisation menu in BloodNet provides additional functionality for the management of immunoglobulin dispensing.
The data used in these new functions is leveraged from BloodSTAR. This means that as information is updated in BloodSTAR, you can see this reflected in BloodNet in real-time. Likewise as product is dispensed for authorised immunoglobulin patients in BloodNet, BloodSTAR is updated to reflect this.
The Authorisation Menu includes functions that will assist dispensers to
-Check the Authorisation Status of patients
-Receive and action requests to dispense product
-Reconcile dispense events to authorised immunoglobulin patients.
The Roles of BloodSTAR and BloodNet
•BloodSTAR will be the source of truth about the authorisation status of the patient and the doses for which the patient is authorised
•A change to a patient’s authorisation can only be made through BloodSTAR, therefore it will always have the latest information
•BloodNet will integrate with BloodSTAR so that dispensers can check a patient’s authorisation
The Responsibilities of Dispensers
•Dispensers are solely responsible for ensuring that product is dispensed as authorised
•Nursing / ward staff will no longer submit orders to the Blood Service and there will be no authorisation checking undertaken before stock is issued to the lab/dispenser
•Product should only be dispensed where:
- It is for a patient with a current authorisation
- The requested product is the authorised product
- The quantity matches or is less than the authorised quantity
- The interval since the last treatment episode matches the authorised interval
Immunoglobulin Dispensing Process
Receiving a Dispense Request
BloodSTAR and BloodNet do not require that Dispense Requests are received in any particular way. It is understood that hospital processes may not be readily changed and existing processes may need to prevail.
Dispense Requests outside BloodNet
Where requests are received by a dispenser outside BloodNet, the dispenser will need to check the authorisation status of the patient, and check that the requested doses is within the authorised dose quantity and that the interval since the last dose is not shorter than the approved interval. See Check Authorisation Status and Approved Dose below.
You can make this process easier by encouraging staff requesting product outside BloodSTAR to note the authorisation number on the request. Adding the authorisation Number for the patient to a request outside the system will be a significant help to dispensers in checking authorisation.
Electronic Planning Sheets
BloodSTAR provides hospital staff a mechanism to submit electronic planning sheets which replace the paper planning sheets in use in some jurisdictions currently. The benefit of using electronic planning sheets is that when you receive a request on an electronic planning sheet you can be comfortable that the requested dose is either within the constraints of the authorisation or where it is not, a reason has been provided by the hospital staff.
The planning sheet functionality may not be appropriate in all circumstances. For example in some circumstances nursing staff may not have adequate access to computers to complete planning sheets in BloodSTAR; other facilities may have other regulatory requirements to be met by requesting products using existing processes.
With the rollout of BloodSTAR dispensers should enter into a discussion with staff from the facilities to which they dispense immunoglobulin products to agree on the most optimal process for requesting and dispensing immunoglobulin product.
Scenario: Viewing a Dispense Request on a Planning Sheet
- Select List Planning Sheets from the Authorisation Menu
A list of planning sheets that have been submitted to the dispenser is displayed. - Select the View link on the planning sheet that you wish to view.
The Planning Sheet lists a row for each of the patients for whom hospital staff have requested product.
- Click the View Request link on one of the rows.
Details of the authorised dose and the requested dose are displayed. If the user at the hospital provided any comments about the request this can be viewed here.
Once you have viewed the detail of the request, close the popup window.
Check Authorisation Status and Approved Dose
Where a dispense request has been received outside BloodNet (for example within an in-hospital system or on a paper form), the dispenser can use either Authorised Patients at this facility or Check Authorisation functions.
Authorised Patients at this Facility
The Authorised Patients List in BloodNet displays a list of all patients who are authorised to receive immunoglobulin treatment where your facility has been nominated as the dispensing facility on the Authorisation.
Scenario: Viewing the Authorised Patients List
- From the Authorisation Menu select List Authorised Patients.
All authorised patients where your facility is nominated as the dispenser are displayed.
- To limit the results returned, enter search criteria and click Search if you are trying to find a particular patient.
- The Authorisation number is a link that you can click to view the detail of the patient’s authorisation.
Check Authorisation
The Check Authorisation function allows you to search more broadly than your own facility for authorised patients. This functionality is intended for scenarios where a patient has presented for treatment at a hospital that is not where they would normally receive their treatment.
Scenario: Checking the Authorisation Status of Patient
* Before beginning this scenario, note some patient details from your authorised patients list to use in your search.
- From the Authorisation menu, select Check Authorisation.
- Enter either an Authorisation Number (if you know it) or patient details and the search scope (see below)
- Click Search.
Where more than one potential result is found you will be presented with a table of potential matches.
Select the match that relates to the patient that you are searching for.
If only one authorisation is found, the authorisation record is displayed.
What is Search Scope?
Due to requirements of the Australian Privacy Principles and privacy legislation in individual states and territories BloodSTAR must only display patient information to users who have a valid need to access this information. Any user searching for a patient must constrain their search to the minimum search scope to avoid returning records that are unlikely to be the patient for whom they are searching.
Select the Search Scope that is most likely to return your search. For example if you are searching for a patient who receives treatment at your logged in facility, you should select the Search Scope Patients at [Facility Name].
If you select a search scope that is broader than your role would normally be expected to have access to, you will be required to select a reason for selecting this search scope.
As you work through the system if your attempt to view a patient record for a patient that you would not normally have need to view, you will also be prompted to provide a reason.
The Authorisation Record
The authorisation record is the place in BloodNetthat displays authorisation status of a patient and details exactly what the patient is authorised for.
Patient Details
The patient details panel summarises the identifying details of the patient.
Authorisation Details
The authorisation details panel sets out for which medical condition and indication the patient is approved for immunoglobulin treatment, the dosing regimen, the authorisation end date and the Treatment arrangements (which facilities are involved in the treatment)
Treatment Plan
The TreatmentPlan sets out the planned treatment episodes as forecast by the system at the time of approval. Over the course of the authorisation the treatment plan will be updated to display the quantities of product dispensed for each treatment and planned dates will be updated in order to ensure that the approved interval between doses is maintained.
You can initiate Dispense Fates from the TreatmentPlan which will ensure that BloodSTAR is updated with the dispensing information (further details below)
Keeping Patient Information Up to Date
The BloodSTAR and BloodNet systems will always work best when data is complete and accurate. As such we encourage users to update data as they work when they notice erroneous data.
A mismatch of patient identifying data between BloodNet/BloodSTAR and a hospitals internal system may cause an additional overhead in reconciling dispensing events. To mitigate this, BloodNet provides the functionality to update patient data. This updated data will also be updated in BloodSTAR, so the next time a nurse or medical officer is accessing the patient record in BloodSTAR they will be viewing the updated data.
Scenario: Updating Patient Information
- From the Authorisation record, select Edit Patient Details.
- Update the patient details.
- Select Save.
The patient details will be updated and sent back to BloodSTAR.
You can also edit the patient’s Facility Identifiers (MRN, URN or other) if this is incorrect by clicking Edit on one of the rows of the Facility Identifiers table
Dispensing Immunoglobulin at a non-LIS Interfaced facility
In order for BloodNet and BloodSTAR to assist dispensers in determining whether a patient is due for their next dose, dispensers must record the dispense of immunoglobulin product in BloodNet.
Note: LIS interfaced facilities will leverage data from the Laboratory Information System and recording dispense fate in BloodNet is not required.
When product is dispensed in BloodNet, the record is updated in BloodSTAR with the product, quantity and date of the dispense. Dispensing is recorded using the BloodNet Fate module which has recently been enhanced to include the Dispense Fate type.
To ensure that the dispense event is attributed to the correct authorised patient and treatment episode it is important to initiate these dispense fates from one of the following immunoglobulin authorisation functions.
-Treatment Plan in the Authorisation Record
-Planning Sheet
-List of Dispense Requests
Dispensing from the Treatment Plan on the Authorisation Record
The treatment plan on the Authorisation Record lists all of the planned treatment episodes that were forecast at the time of approval. There are options on some of those treatment episodes to Dispense product or Return to Stock.
Initiating the dispense from the dispense link will ensure that this fate episode is attributed to this planned treatment episode.
Scenario: Dispensing from the Treatment Plan
- Locate an authorised patient from the Authorised Patientslist.
- View the Authorisation Record by clicking on the Authorisation Number.
- Select Dispense against the next dose in the Treatment Plan
A dispense Fate screen is displayed. Details of the authorised dose are displayed on the right hand side for your reference. - Scan or enter the vials and quantities to be dispensed (following normal BloodNet processes)
Please refer to the end of this document for a list of Lot Numbers related to immunoglobulin products than can be used for this scenario. - Click Save Dispense Episode
The dispense episode is saved, BloodSTAR is updated and the View Dispense Episode screen is displayed
If you return to that patient’s authorisation record you will see that the TreatmentPlan has been updated to show that product has been dispensed for that episode.
When should I use Dispensing from the Treatment Plan?
A Dispenser would use the approach of dispensing from the Treatment Plan when they have received a request for product outside the system (Planning sheets – see below).
For example
-A patient requires their treatment.
-The nurse submits a pathology request form (outside the system) for the product.
-As the dispenser, you use either Authorised Patients List or Check Authorisation functions to find details of the authorisation. You then check that the requested dose is within the constraints of the authorisation.
-You find the next episode on the Treatment Plan and initiate a dispense fate episode from this row in the Treatment Plan.
Alternate Scenarios to Try
- Record a Dispense that is a week earlier than the planned date.
The subsequent episodes in the plan will be replanned to maintain the authorised interval for the patient.
- Record a Dispense of product that is greater than the authorised dose
The system will let you do this, however you will be prompted later to justify why the product was dispensed outside the constraints of the authorisation
- Record a Dispense of product that is less than the authorised dose.
This scenario might exist where you need to dispense the first of multiple divisions over several days. For each subsequent division you can continue to record the dispense episode against the same treatment episode on the plan. If the total amount dispensed against an episodeexceeds what was authorised you will be prompted later to justify why the product was dispensed outside the constraints of the authorisation.
Dispensing Using from a Planning Sheet
- View a Planning Sheet using the steps above.
- Select Dispense against a request that you wish to dispense.
A dispense Fate screen is displayed. Details of the authorised dose and the requested dose are displayed on the right hand side for your reference.
- Scan or enter the vials and quantities to be dispensed (following normal BloodNet processes).
- Click Save Dispense Episode
The dispense episode is saved, and BloodSTAR is updated and the View Dispense Episode screen is displayed.
If you return to that patient’s authorisation record or the planning sheet you will see that the Treatment Plan has been updated to show that product has been dispensed for the episode.
Dispensing in an emergency for a patient that is not authorised
There are very few scenarios where product should be dispensed before authorisation has been granted. Processes are in place to ensure that doctors will be able to access the authorisation request form when they need to, and the Authoriser has arrangements in place to ensure that Emergency Authorisation Requests can be assessed within 2 hours.
BloodSTAR and BloodNet integrate in real-time meaning that as soon as authorisation is granted, BloodNet will display the patient as an authorised patient.
In the extenuating circumstances where authorisation is not yet in place the dispenser can dispense Immunoglobulin using regular Fate functionality in BloodNet. As there is no authorisation in place the dispense event will be an Unmatched Dispense Event and will need to be reconciled once the authorisation has been approved. See below for details of Reconciling Unmatched Dispense Events.
Dispensing at a LIS-integrated facility
Facilities that have their Laboratory Information System integrated to BloodNet are not required to record immunoglobulin dispense fates into BloodNet. BloodNet will receive these fate episodes through the LIS Interface.
Note: Dispensing through a LIS interface does not remove the dispenser’s responsibility to check the authorised dose before dispensing. The authorised dose can be checked on the Authorisation Record accessed either through List Authorised Patients or Check Authorisation.
When a Dispense Fate is received through the LIS interface, BloodNet will attempt to match the fate to an authorisation and to one of the episodes on the Treatment Plan for that authorisation.
There will be some circumstances where the system cannot match the authorisation or treatment episode. These unmatched dispense events will need to be reconciled so that BloodSTAR and BloodNet can continue to provide accurate information the next time you need to check the authorisation status of the patient.
You can find unmatched dispense events in the Unmatched Dispense Events list accessible from the Authorisation Menu
Scenario: Reconciling Dispense Fates that could not be matched
- From the Authorisation Menu select Unmatched Dispense Fates
A list of unmatched dispense events are displayed with identifying detail as entered into the LIS
- Select Match on one of the rows that you want to match to an authorisation.
The Reconcile Dispense Fate screen is displayed.
Refine the search criteria to find the correct patient. This may mean correcting any spelling errors or if known entering an authorisation number.
Possible matched authorisations and possible treatment episodes are displayed. - Select the treatment episode to which you want to attribute this dispense event.
The system will reconcile the dispense event.