Hey Deb,

We have been Tamtron users for approximately 4 years and have been happy
with them for the most part.  To try to answer your second question first,
I'm not exactly sure what you mean by specimen rejection?  If you mean that
your lab will not accept a specimen, i.e. an adequacy problem (specimen not
labeled).  We record those occurrences on the Req. Date tab portion of a
case in Tamtron.  Our PA built a query to track these for us.  He is very
good with computers and works closely with the Tamtron people.
On your first question, again, I'm not exactly sure what you mean.  I would
be wary of allowing nursing units to do any kind of ordering in any Anatomic
Path information system.  All specimens accessioned into this lab are done
so via a histology assistant, histologist or PA.  They then pass by a
histologist, PA or pathologist as they are grossed in.  Those are the people
I want involved in handling the tissue and having access to an information
system specifically pertaining to these tissues.  We will only accept orders
from a pathologist.  There is no need for nursing units to order anything.
If by ordering you mean accessioning cases, again, I would not want the
nursing units involved.
My views are not meant to come down on hard on nurses.  I realize that the
units order tests for microbiology etc.  That is a completely different
ballgame versus anatomic path.  I also believe that nursing units are busy
enough without this added task.  You would also need to install multiple
work stations on various floors to accommodate all possible anatomic path.
Some of those units would probably see little use, pediatric intensive care
(PICU) comes to mind.  Yet they would probably require a work station.
There is then the training issue, again a problem if the system is seldom
used yet needed.  My own experience here with surgery techs and nurses is
that many still have some problems filling out a surgical requisition form
properly.  So I don't think it would be a good idea to give them more to do
in that arena.  And as I previously stated I know they are already very
busy.
Just my thoughts as this could create some complex problems.  I am all for
change when needed and I don't know how your hospital or service run.  But I
have the feeling it would be a mistake to give this responsibility to the
nursing units.  

Thomas Jasper HT(ASCP)BAS
Anatomic Pathology Coordinator
SMDC Clinical Laboratory
Duluth, MN
tjasper@smdc.org