HA1c Results Management and Sample Handling Workflow on the Atellica Solution

Continue Continue Continue Main Scene HA1C Result Management and Sample Handling Workflow on the Atellica® Solution Day in the Life of the Lab Series Look for more content in our Day in the Life of the Lab Series. Welcome Welcome to the HA1C Result Management and Sample Handling Workflow on the Atellica® Solution. A part of our day in the life of the lab series. Blank Hi, it’s me Sandy. I am an experienced user and I have responsibility for training others in my lab on the Atellica Solution. One of the new hires recently asked me how to best manage HA1C results and the handling of the HA1C samples on the Atellica Solution. I am going to show you how I train people in my lab on the proper procedures so we can continue to process samples efficiently. I like to make sure everyone uses the same steps. Some Foundation Knowledge… There are various methodologies used to measure HbA1c levels, such as High-performance liquid chromatography or HPLC, immunoassay or enzymatic. My lab also uses the Siemens Healthineers Enzymatic Hemoglobin A1c Assay on our Atellica CH Analyzer. Blank Cheng, an assistant in another lab, recently told me about a conversation he had with Dr. Morris, about the various methodologies used to measure HA1C levels, as well as the Siemens Healthineers Atellica Enzymatic Hemoglobin A1C Assay. My lab also uses the same Siemens Healthineers assay on our Atellica CH Analyzer as part of our routine testing menu. I wanted to make sure that my new hires understand this foundational knowledge about methodologies of how this is done and the application. Then I start to discuss about the part that whole blood plays in the handling of the sample. The very first step of managing HA1C results is related to the handling of the sample and specifically whole blood. The quality of the sample you will be running is a very important part of obtaining accurate HA1C results. HA1C Testing– Did You Know? Requires a sample of well mixed whole blood - Whole blood samples settle between 10 to 15 minutes The Atellica Solution will flag a sample with whole blood timeout feature after a set period* *The whole blood timeout also applies when testing HA1C samples with Aptio. Both the Atellica Solution and Aptio communicate the time between the sample being mixed and the time it was aspirated at the CH Analyzer. Please refer to Online Help for more information about Whole Blood Samples. Blank Accurate HA1C testing requires whole blood so I emphasize that the sample needs to be fully mixed. Because of this it is good to know that our Atellica Solution has this built-in whole blood sample integrity check. It is called the whole blood timeout; it is not an error but rather a quality check that ensures that we have a homogenous whole blood sample. It really helps us in our lab to make sure the sample is correct to process. The whole blood timeout will flag a sample after a set time, which you can configure to be set between 10-15 minutes. I like that this is customizable for our lab because we can set it by one-minute intervals, and we also have the option to turn off the whole blood timeout feature, but we like to leave ours turned on. You can find what works in your lab. So that is really the first step but let me explain further with a photo. Left – whole blood sample that has been sitting for a long time Right - fully mixed whole blood sample for an accurate analysis Blank Shown on the left is a whole blood sample that had been sitting for a long time. We see that the red cells have begun to fall to the bottom. We know that the A1C resides in the red blood cells. This one would be flagged by the quality check of the whole blood timeout that I have been discussing as well as automation on our system that also does an integrity check of this when it goes from the mixer to the analyzer. While, on the right is fully mixed whole blood. The red blood cells are mixed with the plasma and will be aspirated for an accurate analysis. It is recommended to load HA1C small volume samples to a Tube Top Sample Cup and load in a STAT rack as shown here to ensure they get aspirated quickly Refer to the Managing Small Samples Workflow on the Atellica Solution and companion Job Aid on PEPconnect Blank It is recommended that we load our HA1c small volume whole blood samples in a STAT rack because they have a higher risk of settling and this ensures they get aspirated quickly. For more information on how my lab manages small samples please refer to my Day in the Life of the Lab Series video on that subject. Now let’s talk about the different types of results you get after running the test. Results Scenario One Normal Patient Results sample calculation Blank The first results scenario I would like to discuss is a normal HA1C patient result. In this case, the instrument will measure the total hemoglobin and the HA1C component. These measurements are utilized to calculate the reported HA1C result whether in percent or IFCC units. Although I would normally not have to look in here during my workflow if my results were normal, let me show for example purposes what that would look like. Blank I started at the worklist screen and used the filters to find the appropriate test. I clicked on the test to see the details and the results I am showing here. The results are broken down by the HA1C and the total hemoglobin components. Results Scenario Two Abnormal Patient Results - Hemoglobin component is too low Blank The next type of patient results you could get is an abnormal result, in which the hemoglobin component is too low. Sometimes it could also be too high but for the purpose of this recent example in my lab let us look at the low hemoglobin component and the steps we followed. Action: Remix the tube Reference the IFU Reprocess the sample Hemoglobin Component is too Low* *The system flags all values that are outside the specified measuring interval. In this example Hemoglobin is outside that interval. Blank So recently in our lab we had a situation when doing an HA1C test that the hemoglobin component was too low and not within the assay range. The first step that I suggest in my lab is remix the tube and make sure that it didn’t settle out. I always reference the IFU which states to repeat testing if one of the components is outside the assay range, and then follow the remix information and then reprocess the sample again. If you obtain the same result after remixing and reprocessing, the next option is to test the sample using another method. Results Scenario Three Test Complete- HA1c component is low Blank Our third result scenario is that the other component, which is the HA1c component is low and out of range. What are the next steps that we should take? Blank Our first step is always to review our components, and as I mentioned in this example it was determined our HA1C component is out of range because it is too low. What we do in my lab is that we first remix it and repeat it to see if we get the same result. If we do get the same results again, as a best practice, we use an alternate methodology to test the patient sample. I hope that helped to explain things further for this very important test. To Sum it Up…. We discussed how this assay is part of our routine testing menu and how we utilize it. Blank So to sum it all up we discussed how Siemens Healthineers Atellica Enzymatic Hemoglobin A1C Assay is part of the routine testing menu in my lab and how we utilize it. Are you ready for a knowledge check? Knowledge Check You have just learned about HA1C Result Management and Sample Handling Workflow on the Atellica® Solution. Select Start to test your knowledge of the presented content. Start Knowledge Check Select the best answer. Knowledge Check Whole Blood Samples settle between ____ to ____ minutes. 10 to 15 5 to 10 25 to 30 Multiple Choice Incorrect Whole Blood Samples are already settled at this point and are not useable. Incorrect Whole Blood Samples do not settle in that amount of time, but best to do a visual inspection of the sample. Correct Knowledge Check Completion Review Retry Retry Continue Continue You have just completed the Knowledge Check. Select Review to assess how your responses compare to the correct answers. Select Retry to test your knowledge again or select Continue to advance through the course. Knowledge Check Completion Refer to Online Help and PEPconnect for more information! Blank Thank you for taking the time to learn more about HA1C Result Management and Sample Handling Workflow on the Atellica Solution. For more information you can search by specific keywords on Online Help, or check out PEPconnect, where you have access to additional job aids and videos. I look forward to spending another day in the life of the lab with you very soon and sharing more information about the Atellica Solution. Disclaimer Please note that the learning material is for training purposes only. For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Please note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. © Siemens Healthcare GmbH 2023 Siemens Healthineers Headquarters\Siemens Healthcare GmbH\Henkestr. 127\ 91052 Erlangen, Germany\Telephone: +49 9131 84-0\siemens-healthineers.com Disclaimer Exit A part of the Day in the Life of the Lab Series You have completed the HA1C Result Management and Sample Handling Workflow on the Atellica® Solution Completion Question Bank 1 HOOD05162003355623 | Effective Date: 02 Jun 2023