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Dansket

Eliminate potential for ABO/Rh resulting error in Meditech

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Currently we are updating from Meditech C/S 5.64 to Meditech C/S 5.66.  During a validation scenario, I discovered that it is possible for a user to enter and file serological test results that do not match the calculated blood type!  I reported this to Meditech and they offered this solution (overnight Saturday-Sunday :) ).

 

Background

Whenever a Blood Type calculation is created in the BBK Calculation Dictionary, Meditech inserts generic code below into the Calculation Formula field:

 

Existing code

[bbk truth table]^X,

IF{'X [bbk err msg]("Invalid blood type calculation.")},

X;

 

Enhanced code

[bbk truth table]^X,

IF{'X [bbk err msg]("Invalid blood type calculation.")},

IF{'X [f bres delete]^X},

X;

 

The introduction of the line IF{'X [f bres delete]^X},  tells the system when the answer is not equal to the calculation for X then delete the calculated result for the target test, BT.

 

As a result, whenever an “Invalid blood type calculation” warning is displayed, system also erases the currently displayed blood type calculation, preventing a user from filing serological test results that do not match the calculated blood type.

 

I strongly encourage Meditech users to take advantage of this enhanced code to prevent the potential for ABO incompatible blood transfusion.

 

 

Edited by Dansket

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We are in the middle of doing the same upgrade. What was the exact scenario that you were able to enter the wrong blood type?

Thanks

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Gerald,

 

1. Enter results for anti-A, anti-B, anti-D, Rh control, A1cells and Bcells for Group O Rh positive.

2. Observe the calculated ABO/Rh in the blood type field.

3.  Move the cursor back up the screen to the line for anti-A

4.  Change the anti-A result from 0 to 4+

5.  System should display warning "Invalid blood type calculation"

6.  Click on "OK"

7.  Press F12 to Save

8. Press spacebar

9. Press F12 to file

10.  Re-enter specimen number

11.  Observe that OPOS is displayed at the top of the screen, yet anti-A was resulted as 4+

Edited by Dansket

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We are in the middle of doing the same upgrade. What was the exact scenario that you were able to enter the wrong blood type?

Thanks

 Are you planning to implement the electronic crossmatch?

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Also check the Access dictionary for Override Blood Type Calc Mismatch? setting.

 

David,

 

Whether it is set to Y or N, it has no effect on this issue.

 

Dan

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Dansket,

Yes, we are planning on implementing electronic crossmatching. I'm about halfway through the validation process. Thank you for describing the scenario that produced the typing problem. I'll run through it and see if it is behaving the same at our site..

Thanks

Gerald

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Dansket,

Yes, we are planning on implementing electronic crossmatching. I'm about halfway through the validation process. Thank you for describing the scenario that produced the typing problem. I'll run through it and see if it is behaving the same at our site..

Thanks

Gerald

 

   Be aware that after rbc's are issued uncrossmatched, Meditech does not allow computer crossmatch of those unit(s) regardless of a negative antibody screen, no history of clinically significant antibody and two blood types done.

Edited by Dansket

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 "Be aware that after rbc's are issued uncrossmatched, Meditech does not allow computer crossmatch of those unit(s) regardless of a negative antibody screen, no history of clinically significant antibody and two blood types done."     Quote
 

 

I'm not sure I understand this last statement.  Our Meditech system (not set for electronic crossmatch) will allow us to input crossmatch results on units that were released under Emergency Issue Units.  The units will be on the correct Type and Crossmatch specimen if you are careful while releasing (and the specimen does already exist) or you can move the Type and Cross to the specimen the units were relesed under.  Again, this can be one specimen if you take the time to override NEW and find your specimen.  After that, the units, which are already in "Issued" status, can be opened on the Result Entry Screen with a <shift> <right arrow> and the results entered so you an complete the crossmatch results.  Your Meditech system doesn't work that way?  Because of the electronic crossmatch setup?  Just curious.

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 "Be aware that after rbc's are issued uncrossmatched, Meditech does not allow computer crossmatch of those unit(s) regardless of a negative antibody screen, no history of clinically significant antibody and two blood types done."     Quote

 

 

I'm not sure I understand this last statement.  Our Meditech system (not set for electronic crossmatch) will allow us to input crossmatch results on units that were released under Emergency Issue Units.  The units will be on the correct Type and Crossmatch specimen if you are careful while releasing (and the specimen does already exist) or you can move the Type and Cross to the specimen the units were relesed under.  Again, this can be one specimen if you take the time to override NEW and find your specimen.  After that, the units, which are already in "Issued" status, can be opened on the Result Entry Screen with a <shift> <right arrow> and the results entered so you an complete the crossmatch results.  Your Meditech system doesn't work that way?  Because of the electronic crossmatch setup?  Just curious.

 

Our Meditech system is set up for electronic (computer crossmatch).  Due to an oversight in Meditech's electronic crossmatch coding, it is not implemented for rbc units that have been issued using the Emergency Issue units routine.  So, even though a patient meets all requirements for electronic crossmatch, the system does not recognize rbc units that were issued uncrossmatched as qualifiying for a computer crossmatch.  We are forced to perform and enter serological crossmatch results.

 

It is a computer flaw that I reported to Meditech!  Some day they will correct it.

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