Printer Friendly

Software applications at a blood center reference lab.

Based at a community blood center, our reference laboratory is one of 47 in the United States accredited by the American Association of Blood Banks.

A processing laboratory located elsewhere in the blood center performs basic testing for the 70,000 to 80,000 donor units drawn annually. The reference laboratory usually does not become involved unless an antibody identification problem arises. Its primary function is to assist the 26 hospitals affiliated with the blood center when they have antibody identification problems or difficulties finding compatible blood for a patient.

The staff consists of three technologists, including myself. In the last year and a half, a microcomputer has made it considerably easier for us to perform our duties.

Our reference services include identification of simple, single alloantibodies; multiple alloantibodies; high-titer, low-avidity antibodies; to high- or low-incident antigens; and warm or cold autoantibodies. Once the antibodies are identified, we assist in finding donor blood of the appropriate phenotype that is suitable for transfusion.

Depending on how common or uncommon the particular antigens are, this may involve screening fresh units, turning to an inventory of several hundred frozen units, calling in donors, or contacting individuals listed "in our rare donor file. Our blood center is a member of the American Association of Blood Banks' raredonor file, so we also assist other blood centers and hospitals throughout the United States when they have a patient who is in need of blood with an unusual or rare phenotype.

As is common at blood centers that are similar in size and scope of activity, the business office was the first department to be computerized. During the last two years, the processing laboratory has made significant automation headway, with installation of Abbott's Data Management System, which is interfaced with several Abbott EIA instruments, the Abbott VP Super System, and Gamma Biological's Standardized Test System-Microtear.

To supplement the systems that were already in place in the business office and processing Laboratory, several microcomputers were purchased in recent years for other departments. We acquired our IBM-compatible Texas Instruments Business Pro microcomputer in 1986, along with a Texas Instruments Omni 800 printer.

The pfs:file software supplied by Texas Instruments enabled us to convert manual card files to computerized files. The computerized files can be accessed through one or more information fields in a matter of seconds.

For example, two cumbersome card files contained information about uncommon and rare donors whose red cells had been extensively phenotyped. One file was indexed by donors' last names, the other by blood group system: ABO, Rh, MNSs, etc. Formerly, we spent a good deal of time searching through the cards for a specific antigen type--e.g., c--, Jk(a--),S--.

These card files were merged into a single computer file, which includes fields for such donor information as name, address, and telephone number, as well as a field for each antigen tested. There are now nearly 1,000 donors in this file.

Records can be quickly accessed by donor name or antigen type. In the latter instance, all donors with the desired phenotypes are listed.

Any donor information field can serve as an index. For example, we can call out all of our black donors when we are looking for the phenotypes that are unique to them.

At Christmas time, we sent out cards to uncommon and rare donors, asking them at the same time whether or not they wanted to remain active. Sorting the printout of address labels by zip code, for Postal Service ease of handling during the holiday crush, was a simple matter on the computer.

Inventory management improved when two other manual card files were entered into the microcomputer via pfs:file. The files keep track of several hundred rare cell aliquots frozen in liquid nitrogen (used for our antibody identification workups) and several hundred frozen units are thawed and sent out, their records are updated and transferred to another microcomputer file.

Now we can respond to requests for rare or uncommon blood immediately. While the requesting party is still on the telephone, we call up the appropriate program on the microcomputer to determine whether we have frozen units available or donors who can be called in.

On weekends, or after normal working hours, the technologist who is on call carries an updated printout of the frozen inventory file. When requests come in for rare or uncommon units, they are relayed to this technologist, who scans the printout for blood of the appropriate phenotype. If such blood is available, the technologist phones the blood center and tells distribution personnel to ship the units.

In another pfs:file application, we list blood center employees, their departments, and their red and white cell phenotypes. This file is used when fresh cells of specific phenotypes are needed for controls or when we are employing such techniques as heterologous adsorption.

We recently purchased a software package for paternity calculations. It is called Paternitysoftware package for paternity calculation

Index Program and is available from its developer, Myrna I. Traver, M.D., Transfusion Service Director, University of Wisconsin Hospitals, 600 Highland Ave., Madison, Wis. 53792 for $650 (red cell and HLA systems) or $800 (red cell and HLA plus red cell enzymes and serum proteins). The program has already paid for itself at our laboratory in terms of employee hours saved.

Red and/or white cell phenotypes of the alleged father, the mother, and the child are entered, and a report is obtained in just minutes. We perform the red cell phenotypes, testing for any or all of the following antisera: A, B, A(sub.1), D, C, c, E, e, C(susp.w), K, k, M, N, S, s, Fy(susp.a), Fy(susp.b), Jk(susp.a), and Jk(susp.b). These results are analyzed in conjunction with any white cell testing that may have been performed in the blood center's human leukocyte antigen lab.

The report lists all the phenotypes along with results of the mathematical calculations performed by the software to determine the probability of paternity and the paternity index when the alleged father is not excluded. Manual calculations, which formerly were performed by two technologists to make sure results were correct, took 15 to 45 minutes per paternity trio, depending on the phenotypes involved and how experienced the technologists were.

Using the pfs:file software, we are in the process of establishing a file of all patients worked on by the reference laboratory. This will enable us to provide rapid information to our hospitals when they admit patients with previously identified antibodies.

Another file, created with dBase III software, contains information on reagents and equipment routinely used by the reference laboratory, including manufacturer or vendor names, prices, quantities, and unit sizes. We can look up price per ml on reagents, for example, and comparison-shop for the best buy.

Future projects include implementation of commercial educational software with both instructional and problem-solving segments. This would assist in training and assessing new employees, provide continuing education for technologists, and augment educational programs for medical technology students and pathology residents.

Initial loading of information into files and double-checking for accuracy requires investment of a fair amount of staff hours. This investment pays off handsomely, however, once the files are put to use and significantly less time is required to locate information. Printouts generated from the programs save additional time by eliminating the need to write or type reports and data.

As in other clinical laboratory areas, computerization of blood bank reference laboratory opens the door to significant applications that can streamline operations and enhance productivity.
COPYRIGHT 1988 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1988 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Author:Guizzo, Mary Lou
Publication:Medical Laboratory Observer
Date:Feb 1, 1988
Previous Article:The successful woman supervisor: climbing from strengths.
Next Article:What ever happened to service?

Related Articles
A microcomputer network for interlaboratory QC.
A quality system for transfusion medicine ... and beyond.
Power blackout affects blood supply.
Blood-bank systems, instruments, products, and services.
Ongoing issues portend future challenges.
Bedside barcoding for the blood bank.

Terms of use | Copyright © 2016 Farlex, Inc. | Feedback | For webmasters