Reduction Plan of â€˜Undeterminableâ€™ in the Unexpected Antibody Screening by the Microcolumn Agglutination Automated Instrument

Lee, Dae Dong; Kim, Dae Seong; Kim, Dong Wook; Lee, Myung Hwan; Kim, On Jeong; Kim, Hee Dong; Huh, Kwang; Lee, Mi Kyung

Abstract

BACKGROUND
Among the results of an unexpected antibody screening test using IH-1000, "˜undeterminable' results can be obtained. Repeated tests not only use reagents and consumables but also cause a turnaround time delay. Therefore, it is important to reduce the "˜undeterminable' results and to determine the effects.
METHODS
From January to early June, 2016, 2,872 cases/259,455 tests (1.11%) of "˜undeterminable' were detected in the screening test. The factors considered to affect the "˜undeterminable' were classified into four categories: â‘ reagent, â‘¡ consumables, â‘¢ inspection environment & specimen, and â‘£ enhancing the equipment management. For data comparison, a chi-square test was conducted (95% confidence interval, 0.05 significant level).
RESULTS
The incidence of "˜undeterminable' cases decreased from 1.11% before management to 0.66% (P < 0.001) after Pool Cells management. The consumption of "˜LISS/Coombs Card' decreased from 1.07% before management to 0.51% (P < 0.001) after management. By maintaining a clean inspection environment and strengthening sample management, the rate decreased from 1.11% before management to 0.66% (P < 0.001) after management. On the other hand, there was no difference in the incidence of "˜undeterminable' between before and after IH-1000 management reinforcement.
CONCLUSION
Among the factors predicted to affect the decrease in the incidence of "˜undeterminable', the management of Pool Cells and keeping the inspection environment clean as well as improving sample management contributed the most to the reduced "˜undeterminable'. Improvements in the management of consumables, and removing dust from the inside of the equipment, had a positive impact. A continuous quality improvement theme has been adopted and it is helpful for managing and improving the predicted factors.