Immucor User Group Meeting Ft. Lauderdale, Florida May 12, Mary Sue Angiulli IRL/St. Lucie Medical Center Laboratory Supervisor

Transcription

1 Immucor User Group Meeting Ft. Lauderdale, Florida May 12, 2016 Mary Sue Angiulli IRL/St. Lucie Medical Center Laboratory Supervisor

2 Explain how an integrated hospital system utilizes automation and solid phase technology by the means of the Immucor Echo Immunohematology analyzer in their Blood Banks Discuss troubleshooting of NTD, indeterminate and? Reactions

3 Comprised of 13 Hospitals 3955 Beds Aventura Hospital & Medical Center 407 Kendall Regional Medical Center 417 JFK Medical Center 472 JFK Medical Center North Campus 245 Lawnwood Regional Medical Center 365 Mercy Hospital 488 Northwest Medical Center 223 Palms West Hospital 204 Plantation General Hospital 264 Raulerson Hospital 100 St. Lucie Medical Center 229 University Hospital and Medical Center 317 Westside Regional Hospital 224

4 13 Hospitals with More than 58,000 Transfusions Annually Aventura Hospital & Medical Center 7273 Kendall Regional Medical Center 8093 JFK Medical Center 8750 JFK Medical Center North Campus 1042 Lawnwood Regional Medical Center 6000 Mercy Hospital 6500 Northwest Medical Center 3755 Palms West Hospital 2831 Plantation General Hospital 1700 Raulerson Hospital 1550 St. Lucie Medical Center 2978 University Hospital and Medical Center 3500 Westside Regional Hospital 4646

5 With greater volumes to manage with fewer specialized Blood Bank technologists, we were looking to improve workflow efficiency Implemented to bring automation to our Blood Banks Automated solid phase methodology offers quality test results in a timely fashion Broad menu STAT priority capability Small footprint for space restrictions

6 ABO/Rh Antibody Screen Antibody Identification Crossmatch on specimens with positive antibody screen

7 Some sites utilize Ready ID Extend I and II in addition to the Ready ID Some sites utilize Panocell 20 liquid panel in addition to the Ready ID panel Some sites using Echo for Cord Blood workups, including DAT, unit retypes, dependent on workflow and staffing

8 Echo ABO/Rh, Antibody Screen Negative Antibody Screen Tube Immediate Spin Crossmatch Positive Antibody Screen Echo Ready ID Panel Tube Select Cells from Panocell 20 to Rule Out Tube Antigen Type Units and Patient Echo Crossmatch NTD/Indeterminate Tube Antibody Screen, Panocell 20 with PeG and/or LISS

9 Capture ID Backup tube medium AHG crossmatch Any other special methods Echo Positive Ab Screen Run Capture Ready ID Additional Cells required? No Yes Report Ab ID, Ag type Patient, Ag type Units, Full XM on Echo Run additional cells in PeG Tube Antibody ID d

10 ABO/Rh Check reagents appearance, stir ball, bubbles, RT Check specimen centrifuged appropriately, RT Review reaction image Depending on analyzer access, the? can be changed if it appears that an artifact or minute cellular aggregate is interfering Repeat using hemagglutination tube method Recollect specimen Refer to reference laboratory

11 Antibody Screen Check reagents appearance, stir ball, bubbles, RT Check specimen centrifuged appropriately, RT Review reaction image, compare image to the assay cut-off table, access permitting - modify reaction if indicated Repeat on Echo Repeat using hemagglutination tube method Perform antibody ID on Echo using Ready ID panel

12 Antibody Identification Check reagents appearance, stir ball, bubbles Check specimen centrifuged appropriately Review reaction image, compare image to the assay cut-off table, access permitting - modify reaction if indicated Perform Ready ID Extend I and II Repeat using hemagglutination tube method with PeG Repeat using hemagglutination tube method with LISS Refer to reference laboratory

13 Troubleshooting the Solid Phase Dependent (SPD) Antibody Echo Positive Ab Screen Run Capture Ready ID and any required additional cells Specific Antibody? Yes No Neg PeG Screen Pos Report Ab ID, Ag type Patient, Ag type Units, Full XM on Echo SPD Neg Screen with PeG Full XM PeG Panel No Specific Antibody? Yes Further Investigation

14 Workflow more efficient Reactions standardized, not subjective as they are using tube method Interfacing reactions reduced opportunity for clerical errors Automated procedure reduces risks of inadvertently not performing procedure appropriately Bench technologists have more time to devote to other tasks

15 Method to electronically document QC review in the Echo DAT that includes Complement Additional FDA approved Antigen Typing Remote viewing across markets/sites Ability to perform one antibody screen without wasting the remainder of the Capture R Ready Screen 3 strip wells

16 Two vampires walked into a bar and called for the bartender. "I'll have a glass of blood," said one. "I'll have a glass of plasma," said the other. "Okay," replied the bartender, "That'll be one blood and one blood light.