1. Neonate Handling in SoftBank
Presented by:
Tracy Dorgan BSMT(ASCP)
LIS Trainer

2. Session Objectives
Identify how to set up the system for neonates including the hosparams involved.
Identify how a patient will qualify to be considered a neonate.
Identify how to divide a red cell and charge the patient.
Identify how to perform a WB exchange transfusion in SoftBank.

3. Overview Based on the setting(s) of setup/parameters the system can:
Recognize a patient as a neonate
Prevent unnecessary antibody screen warnings/exceptions at unit selection and issue
Prevent unnecessary crossmatch warnings at emergency issue
Take both the neonate and mother’s blood type into consideration when selecting units

4. Neonate Hosparams

5. Default setting: 0 (not set)
hos_Neo_Age
Determines the age, in days, after which a patient will no longer be considered a neonate.
Example: 120
Default setting: 0 (not set)

6. hos_NeoMOrdSearch
Determines how the system will look for the mother’s specimen.
C – current specimen (default)
D - Looks back the number of days
(defined in a coordinating parameter)
Determines how the system will look for the mother’s specimen.
C - Looks for mother's blood bank order that is in date at the time of the baby’s product order (default). D - Looks back the number of days (defined in a coordinating parameter) from the baby’s DOB for mother's blood bank order.

7. Note: Only used with D setting in hos_NeoMOrdSearch
hos_Neo_MOS_DOBDays
Number of days the system looks back (from the baby's DOB) for a mother's order/specimen. Default: 3 Days
Note: Only used with D setting in hos_NeoMOrdSearch

8. Set Up

9. Neonatal ABO/Rh Table
ABO/Rh table specific for patients that are less than or equal to the age specified in hos_Neo_Age
Setup/Blood/Blood Product
Select B-Neonat.abo rh
Main Products only
Define exactly what they can receive
Site-specific or client level
An ABO/Rh table specific for patients that are less than or equal to the age specified in hos_Neo_Age has been added to Setup/Blood/Blood Product.
This table can be accessed in Setup/Blood/Blood Product by selecting ‘B-Neonat.abo rh’ on the navigation bar or by pressing the “B” key.

10. Neonate Table Example Patient = Baby Mother’s ABO – Linked Mom
Table for each baby type
Empty no type
Mother’s ABO – Linked Mom

11. Neonatal ABO/Rh Table (ABO example)
The system allows for 5 ABO columns

12. Neonatal ABO/Rh Table (Rh example)
There are two Rh columns for each females and males.

13. Neonatal ABO/Rh Table The system will use the product specific table:
Compare the unit’s ABO/Rh to both the baby’s and the mother’s ABO/Rh
Select, Issue, and Emergency Issue
Determine if the unit is acceptable
*Note: This table will be used for all patients that meet the age criteria set for hos_Neo_Age

14. Neonate Qualification

15. When
The system determines if a patient qualifies for neonatal compatibility checking at the order level.

16. Two Situations
There are two different sets of criteria utilized when determining if a patient is recognized as a “neonate”.
Baby and mother (linked)
Baby only (mother not known)

17. Baby and Mother Patient less than age specified in hos_Neo_Age AND
Mother is linked and does not have any clinically significant antibodies
Mother has a negative antibody screen on a specimen (depends on hosparam setting)

18. Searching for Mother’s Specimen
New parameters
hos_NeoMOrdSearch
C – current specimen
D – number of days
hos_Neo_MOS_DOBSearch
Number of days to look back

19. Baby Only (mother not known)
Patient less than age specified in hos_Neo_Age
AND
Negative Antibody screen on current order
(Expirable Specimen Type)

20. Warnings
If the patient meets the neonatal criteria, the system will NOT:
Warn/generate an exception about an incomplete antibody screen at unit selection, issue, or emergency issue.
Warn/generate about an outdated specimen at unit selection, issue, or emergency issue.
Warn/generate an exception about the unit being uncrossmatched at issue and emergency issue.
Finish the order until the patient is older than the age in “hos_Neo_Age”.

21. DAT Handling

22. Neonatal DAT Handling Warn/generate an exception
Unit Selection and/or Issue
If DAT has not been performed for that patient
(stay specific)
DAT test must be assigned to the category of “D” in Setup>Tests>Group
*Note: There is no DAT completed checking done in Emergency Issue.

23. hos_POS_DATCmpl_S Format: “Y/N/S,<exception code>
Patient less than age specified in hos_Neo_Age
Controls the incomplete DAT warning at unit Selection
Format: “Y/N/S,<exception code>
Default is empty

24. hos_POS_DATCmpl_I Format: “Y/N/S,<exception code>
Patient less than age specified in hos_Neo_Age
Controls the incomplete DAT warning at unit Issue
Format: “Y/N/S,<exception code>
Default is empty

25. Mother/Baby Linking

26. How? Mother’s Medical Record Number
Patient > Edit > Demographics
Prompted when resulting
via test category
Linked to CABO and CRh

27. Patient>Edit>Demographics
Add Mother’s MRN to Baby’s demographics

28. Resulting – Test Category
SETUP>Tests>Group

29. Resulting - Prompt
Prompted for Mother’s MRN

30. Verify Mother

31. Dividing Unit and Charging

32. Dividing a Unit Method A – Modify then select
3-INVENTORY>Edit>Cr_Product>Divide
Method B – Select then Modify
3-INVENTORY>POS>Create_prod>Divide
(POS = Product Orders Service)

33. Divide Unit (A)
Select unit
Select number of products

34. Divide Unit (A) cont. Enter divide time (creation date/time)
Enter unit volumes
Change Expiration date/time, if needed

35. Adding Supplies Select appropriate unit Select Ctrl+R Supply
Select Lot number and amount
Add comment, if needed

36. Perform Label Verification
Apply new label to units
Scan labels on units to verify label

37. Instruction for Unit Outdate/Billing
Add to Patient Order
Instruction will be automatically added for each selected unit
Confirm Instruction

38. Neonatal Syringe Instruction Example
Completion Flag = 1, Y, A

39. Confirm Instruction for New Outdate
3-INVENTORY>Edit>Instr
Completion Flag 1, Y, A only
Allows you to change outdate to 4 hours automatically
Allows you to bill patient if ordered on Patient
Capture point must be met

40. Confirm Instruction 3-INVENTORY>Edit>Instr Select Unit
Confirm Instruction – Date/Time

41. Select to Patient
Scan unit and product code
No warnings

42. Issue to Patient
No warnings
Crossmatch not required

43. Instruction for Billing Only
Add to Patient Order
Confirm Instruction
At Selection, Issue, or after Issue
Completion Flag P only
No unit outdate changes
Instruction will be automatically added for each selected unit

44. Instruction for Billing Example

45. Action Add to Patient Order Confirm Action Billing only Added during
unit division

46. Blood Product Set Up New Divide Field
Create Divided Red Cell for Billing only

47. WB Exchange

48. Prepare and Pool Products
Select Red Cell and Thaw plasma
Pool Red Cell and Plasma
3-INVENTORY>Edit>Cr_Product>Pool

49. Add Supplies
Select Ctrl+R Supply

50. Label Verification
Place label on unit
Scan label for verification

51. Select and Issue
Select and Issue the unit to the patient

52. Questions?

53. Contact Info
Name: Tracy Dorgan
Work: ext. 4230

54. Please remember to fill out your evaluation online
Session Evaluation
Please remember to fill out your evaluation online