SIGNIFICANT ANTIBODIES FOR ELECTRONIC XM

[jayinsat 137]

We just went live 3 weeks ago in 5.67.  We chose to keep all significant except Cold-Auto, passive C,D,E's and Warm-Auto's with no underlying significant ab's.  As has been said, the current antibody screen must be negative in all cases.  We love it btw.

[tbostock 1,061]

For the weak antibodies with no apparent specificity, we have determined that to be clinically significant in our LIS to ensure that the techs do the AHG crossmatch on these...just in case.

[mollyredone 318]

Terri,

That's what I decided as well, since it will save a lot of money and time to just do the AHG XM instead of sending it to the reference lab for a couple of days.

[Malcolm Needs ★ 4,456]

On 27/11/2016 at 3:02 PM, tbostock said:

For the weak antibodies with no apparent specificity, we have determined that to be clinically significant in our LIS to ensure that the techs do the AHG crossmatch on these...just in case.

 

50 minutes ago, mollyredone said:

Terri,

That's what I decided as well, since it will save a lot of money and time to just do the AHG XM instead of sending it to the reference lab for a couple of days.

Believe me when I say, if the reactions are that weak, the vast majority of Reference workers would rather you did a serological XM, rather than send it to a Reference Laboratory.  We can't perform miracles for one thing, and the antibodies causing these reactions are almost always clinically insignificant (and so a waste of time to identify).

[Darren 15]

On 11/22/2016 at 4:50 PM, Dansket said:

We don't have a "mechanical barrier system or digital bedside patient identification system".

For patients without a historical ABO on file, we test the uncentrifuged blood sample with Anti-A,B antiserum.  That test result is entered and filed in Meditech.  If the anti-A,B test is agglutinated, then Meditech reflexes the test CONFIRM which is ordered on a new specimen number that requires a second venipuncture.

Our BBK specimen collection labels are configured to view historical ABO on file and antibody identification on file without login and search in Meditech.

I'm curious what keyword you're using on your label for the antibodies to appear. The way I'm doing it is to set a marker called AbHx on anyone with an antibody just to let staff know they have to look a little deeper. The keyword I use is to make the marker appear on the label.

[Darren 15]

On 11/22/2016 at 4:50 PM, Dansket said:

We don't have a "mechanical barrier system or digital bedside patient identification system".

For patients without a historical ABO on file, we test the uncentrifuged blood sample with Anti-A,B antiserum.  That test result is entered and filed in Meditech.  If the anti-A,B test is agglutinated, then Meditech reflexes the test CONFIRM which is ordered on a new specimen number that requires a second venipuncture.

Our BBK specimen collection labels are configured to view historical ABO on file and antibody identification on file without login and search in Meditech.

I'm curious what keyword you're using on your label for the antibodies to appear. The way I'm doing it is to set a marker called AbHx on anyone with an antibody just to let staff know they have to look a little deeper. The keyword I use is to make the marker appear on the label.

[Darren 15]

On 11/22/2016 at 4:50 PM, Dansket said:

We don't have a "mechanical barrier system or digital bedside patient identification system".

For patients without a historical ABO on file, we test the uncentrifuged blood sample with Anti-A,B antiserum.  That test result is entered and filed in Meditech.  If the anti-A,B test is agglutinated, then Meditech reflexes the test CONFIRM which is ordered on a new specimen number that requires a second venipuncture.

Our BBK specimen collection labels are configured to view historical ABO on file and antibody identification on file without login and search in Meditech.

I'm curious what keyword you're using on your label for the antibodies to appear. The way I'm doing it is to set a marker called AbHx on anyone with an antibody just to let staff know they have to look a little deeper. The keyword I use is to make the marker appear on the label.

[Dansket 426]

You're almost there.  My "ABID" = your "AbHx".  I created markers for each antibody specificity, using the same keyword "bsp mri mark". 

[Darren 15]

I wandered that. Do you use a calculation to add markers to the patient once they're identified? That's something that I'm finally sitting down to do in TEST today before leaving.

Do you have the markers save on the MRI history?

[goodchild 528]

I am very interested in how you handle this setup in Meditech.

[Dansket 426]

7 hours ago, Darren said:

I wandered that. Do you use a calculation to add markers to the patient once they're identified? That's something that I'm finally sitting down to do in TEST today before leaving.

Do you have the markers save on the MRI history?

The markers are configured as MRI History markers.  See attached file

The ABID marker is added automatically whenever an antibody screen is resulted as positive.  The antibody marker is also added by a calculation, but it was written by a third party "http://new.iatric.com/" (it has to be triggered by a test that is always resulted, but can't be done by directly by resulting your ABID test).

markerdict.docx

Edited December 1, 2016 by Dansket
updated information

[mollyredone 318]

We have Meditech Magic 5.67 and if there is anything unusual in the patient history, a box pops up whenever you bring up a specimen on that patient in blood bank.  So any antibodies, antigen typing, special requests-IRR, CMV, or comments put in history will show up there.  We don't have anything that is printed on our specimen labels.

[Dansket 426]

36 minutes ago, mollyredone said:

We have Meditech Magic 5.67 and if there is anything unusual in the patient history, a box pops up whenever you bring up a specimen on that patient in blood bank.  So any antibodies, antigen typing, special requests-IRR, CMV, or comments put in history will show up there.  We don't have anything that is printed on our specimen labels.

So does Meditech C/S 5.67.  For security purposes, our IT department has configured all terminals to automatically log out after 5 minutes of inactivity.  For our purposes, it is extremely efficient to be able to visually access that information from the specimen container label as opposed to the many computer steps required to access the information from the Meditech; login to terminal, launch Meditech, login to Meditech, navigate menu system to Enter/Edit results, scan in specimen number, click on tab to view history, select history option and finally view antibody, etc.

[mollyredone 318]

Our labels are configured completely differently and are only 1-1/2 inch long, so there wouldn't be room for all that info. In Magic, when you scan the patient's barcode in result entry, the box pops up immediately so you don't have to click anywhere else.  The pertinent lab values (hgb, hct, plt count/pt, inr) also pop up if products are ordered.  I also have those lab values pop up when products are issued, so you can see if it's an appropriate transfusion or not.

 

 AB pop up.pdf   

[Darren 15]

On 11/30/2016 at 9:33 PM, Dansket said:

The markers are configured as MRI History markers.  See attached file

The ABID marker is added automatically whenever an antibody screen is resulted as positive.  The antibody marker is also added by a calculation, but it was written by a third party "http://new.iatric.com/" (it has to be triggered by a test that is always resulted, but can't be done by directly by resulting your ABID test).

markerdict.docx

You don't have your antibody markers set to store in the BBK History?

I can see how to write a calculation that would add a marker from a positive screen cells, but how does that work in an antibody panel? I'm assuming you have your ABID test built into your panel, maybe you don't. Or maybe you don't even enter your panels. I remember in magic there was a way to put panels and lots into meditech and it would calculate possible antibodies based on your results. That could probably be handy for markers and calculations and is the only way I can think of adding antibody specific markers at the moment. Meditech did away with that feature for some reason in 6.0. Which is a shame when you have an analyzer that's interfacing the panel.

[Dansket 426]

Correct, the antibody markers are stored in MRI History.  There are many other markers in BBK History and I only wanted antibody markers to print on the Meditech specimen collection labels because of limited space on the label.

We are using Meditech C/S 5.67. We don't enter antibody identification panel results into Meditech.

Per Iatric, there is no way to cause antibody markers to be added when the test ABID is resulted using the BBK Antibody dictionary. 

[Darren 15]

On 12/6/2016 at 9:49 AM, Dansket said:

Correct, the antibody markers are stored in MRI History.  There are many other markers in BBK History and I only wanted antibody markers to print on the Meditech specimen collection labels because of limited space on the label.

We are using Meditech C/S 5.67. We don't enter antibody identification panel results into Meditech.

Per Iatric, there is no way to cause antibody markers to be added when the test ABID is resulted using the BBK Antibody dictionary. 

It's frustrating what meditech has forgotten to include in calculations and interfaces and rules. With the right keywords available it would be highly customizable and much simpler to get the system to do what you want. In the case of the way your labels printing with antibodies it would be simpler if there were a keyword in the label format dictionary that would display all antibodies. I guess that's what happens when programmers have no experience working in a lab with their system.

Do you find that you get false markers applied to patients? As in someone typos a positive ab screen, the marker attaches, then they correct it and the marker is still attached?

[Dansket 426]

40 minutes ago, Darren said:

It's frustrating what meditech has forgotten to include in calculations and interfaces and rules. With the right keywords available it would be highly customizable and much simpler to get the system to do what you want. In the case of the way your labels printing with antibodies it would be simpler if there were a keyword in the label format dictionary that would display all antibodies. I guess that's what happens when programmers have no experience working in a lab with their system.

Do you find that you get false markers applied to patients? As in someone typos a positive ab screen, the marker attaches, then they correct it and the marker is still attached?

Darren,

Put it a service request for custom keyword.  I have had some success with this approach in the past.

I have intentionally not trained staff to add or remove markers. 

If a positive antibody screen entry is saved and verified, a whole lot of tests are automatically reflexed. So it is much more than just correcting a marker.  I review all antibody identification workups for appropriate computer entry.  It hasn't been an issue ....Yet.