Pitfalls of the routine of antenatal screening

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Pitfalls of the routine of antenatal screening

• Mark Williams/ Tess Hook,
• RCI Leeds

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AN screening in Leeds RCI
Taking it on and giving it away

• All screening performed in Donor Testing Lab
• RCI took on work in 2003
• LTH took AN screening in house
• Redesigned process
• Currently testing 27,000 samples p.a.
• Using 2x DiaMed Gelstations

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Communication- before

• Work with current provider
• Map process
• Establish what needs to be done to make the
  change
• Work with service users
• Roadshow
• Reciprocal visits
• What can we provide?
• What do users need?

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LTH Communication- during/ after

• Sample routing
• Agree protocol for misrouted samples
• 5 years in it still happens!
• Where was my patient tested?
• Contact numbers for previous provider
• Whos tested the most recent sample?
• Follow-up meetings

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Supply of consumables

• Sample tubes
• Compatible with collection systems
• Compatible with automation

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Supply of consumables (2)

• Request forms
• Request forms
• What to use?
• Use of tear-off reports for repeat?
• Micro request on same form?
• How many to print?
• Distribution
• Training midwives to complete

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Patient registration

• Establish required identifiers
• Patient ID
• Ethnic origin
• Gestation
• Obstetric history
• Patient data already on PAS?
• Electronic ordering?

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Requesting tests

• Group and screen
• protocols for repeat and new patients
• initially all New patients!
• Abbreviated testing of repeats cheaperquicker
• Potential for error sample sorting
• Micro screening
• protocols for checking tests ordered match tests
  requested

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Testing

• Number of sample tubes per patient
• Booking/repeat
• Sample for Group and screen
• Sample for micro
• Logistics
• Liaison with other labs
• Downloading results

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Reporting Results

• Screens neg concluded group
• Paper/ electronic only
• Report to whom
• Repeat sample requests lt28/40
• Antibody screen positive/ anomalies
• Investigate in house or NBS
• Micro screen positives
• System for reporting
• Following up repeat samples
• Liaising with Clinical Microbiologist/GUM

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Technology changes

• Grouping
• Rh D changed status
• D weak
• Establish protocol for testing/ managing
• Antibodies
• Change screening method
• May alter antibody detection profiles
• e.g. ? anti-M

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Dealing with the queries

• Telephone calls for
• Results
• Copy reports
• Advice
• Issues
• Resource, staff time training
• Recording results/advice given
• Data protection

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3 keys to success
Communication
Communication
Communication