Nova StatStrip Meter - Reject Result Option

We do use the "Reject" option with Telcor/QML.  If the Reject button is used, the result is stopped in the middleware with an "X" next to the result to show that the user rejected the result.  If the user were to do the same, but using the "Comment" button, the result is still stopped but does not show the "X" beside the result.  There is one issue with the Reject button that we have not been able to duplicate .... since the button is right under the left thumb of someone who may be right handed, we have had "accidental" rejections.  We do monitor these to see if there was a repeat sample.  If not, we contact the user to see if they needed the result.  Most of the time the response is "Yes, I didn not know that I had rejected it."

We currently use the reject option to reject any result that is questionable or they are wanting to repeat.  It is held as an exception. I also require them to add a comment, "Questionable Result". When I review the exception, if they have not added the comment, I reach out to them to see if they truly meant to reject the result. If they did not mean to reject the result, I add a note to the comment for my records saying that it was rejected in error, and then send it to the chart. If they do add the comment, I just send it to the repository. The one issue that I have run into with sending a result that was rejected in error, is that our LIS system (Meditech) will not automatically file the result due to the flag. I then have to manually enter the result where I add a comment of who originally performed the test.

Yes, we also have to manually enter the results into Cerner if "reject" key is pressed.  If they used the "Comment" button, I am not sure if the result has to be manually entered.  The one or two where that happened were actual rejects, so pushing the result across was not tried. The "Questionable Result" would be nice, but our comment says "Procedure Error".  All inclusive ... LOL

We tell operators that any questionable blood glucose result should be rechecked and they should select Reject on the lower left meter display, then repeat the test. This keeps the questionable result from crossing the interface and posting on the EPIC chart. In addition, it doesn’t send a charge for the questionable result.  And we tell them selecting Accept demonstrates the operator deems the specimen testing was valid.
Rejected results route to Result Exceptions in our middleware (Telcor/QML).  I don't have the bandwidth to double check all the rejections.  If someone accidently rejects a result, they know they'll have to reach out to the POC team in lab so we can pull the result and send to the chart.  We have our LIS/HIS (Epic Beaker) setup to ignore flags from Telcor so the results with an X flag have no problem routing to the patient's chart when we pull it and resend.

If staff reject a result, then repeat it, only the second result will post if there is <20% difference.  If >20% difference, both results are held in Telcor exceptions.  Then we ask the operator if one or both should be charted.  This is a rule in Telcor.