chapter 19 differential keyboard gui - quia · differential keyboard __ gui ... the participant...

Misys Healthcare Systems Client Education

Chapter 19Differential Keyboard __ GUI

Differential Keyboard __ GUI

Proprietary/Confidential–Misys Client Education Managing Your GenLab Database19-1

Managing Your GenLab Database

Objectives The participant will be able to define a differential keyboard.

The participant will be able to result a differential using a differential keyboard.

How many Diff keyboards may I define? As many as you want or need! Diff keyboards can be customized to individual needs.

In this chapter:

Application Overview Cumulative Report Styles for Morphology Results Differential Result Entry Defining the Keyboard Multi-facility Considerations



Application The system's differential keyboard capabilities enable you to identify and define multiple keyboards that provide particular resulting functions through key assignments. Some keys are defined to enter various differential results, while others are defined to enter morphology results that also allow for comments.

Differential results are entered through the GUI differential application or the function DF using a standard terminal keyboard as a differential counter. The differentials can be counted either online or manually. You may also define and use differential keyboards for counting cells in different types of fluids.



Overview

All keyboards are user defined. If you don't like where the keys are, you can change them.

You can make either right or left handed keyboards.

You can set up Fluid keyboards.

If you go to result a differential and only the hemogram was ordered, the keyboard will ask you if you want to order one.

The keyboard displays previous hemograms and differentials.

You can reset the cell count if you don't want to count 100 cells.

There is logic to auto correct the WBC for any NRBC found.

You can add Bill-only tests (GUI application only).

Multiple counts can be performed for an accession number, then added or averaged together for the final count (GUI application only).

Non-revenue workload can be tallied when resulting (GUI application only).



Cumulative Report Styles for Morphology Results Type 1 Morphology:Each Observation is a Test Code

COMMUNITY HOSPITAL LABORATORY: DR. THOMAS MAKER, DIRECTOR 2343 NORTH SCIENCE AVENUE

PAGE: 6NAME: NOONON,KERRY AGE : 38Y SEX: F MR# : 16052 LOC: ICU ROOM: 100 ACCT: 237513 DR : SLOAN,THOMAS

****************************** DIFFERENTIAL ******************************* DATE: [-------1/16/2002-------] 1/15/2002 TIME: 1900 0700 0700 LOC: ICU ICU ER REF RNG UNITS ___________________________________________________________________________ GRAN 62 64 65 60-75 % LYMPH 22 26 19 15-35 % MONO 10 9 15 6-15 % EOS 3 1 1 0-5 % BASO 3 0-3 % NRBC 1 1 0-1 % ANISO 1+ *MACRO 2+ *TARGET 1+ *POIK 3+ 3+ *MACRO 2+ *SHISTO 2+ *TOXIC GRAN 1+ 1+ *DOHLE BODIES 1+ *PLATELET EST ADEQUATE ADEQUATE ADEQUATE *

PAGE: 6KERRY NOONON CHART COPY CUMULATIVE SUMMARY PRINT TIME: 1/17/2002 15:36



Cumulative Report Styles for Morphology Results (continued) Type 2 Morphology: Each Observation is a Result

COMMUNITY HOSPITAL LABORATORY: DR. THOMAS MAKER, DIRECTOR 2343 NORTH SCIENCE AVENUE

PAGE: 6NAME: NOONON,KERRY AGE : 38Y SEX: F MR# : 16052 LOC: ICU ROOM: 100 ACCT: 237513 DR : SLOAN,THOMAS

****************************** DIFFERENTIAL ******************************* DATE: [-------1/16/2002-------] 1/15/2002 TIME: 1900 0700 0700 LOC: ICU ICU ER REF RNG UNITS ___________________________________________________________________________ GRAN 62 64 65 60-75 % LYMPH 22 26 19 15-35 % MONO 10 9 15 6-15 % EOS 3 1 1 0-5 % BASO 3 0-3 % NRBC 1 1 0-1 % RBC MORPHOLOGY 1+ ANISO 3+ POIK 2+ SHISTO * 2+ MACRO 2+ MACRO * 1+ TARGET * *WBC MORPHOLOGY 1+ TOXIC GRAN 1+ TOXIC GRAN * 1+ DOHLE BODIES * *PLATELET EST ADEQUATE ADEQUATE ADEQUATE *

PAGE: 6KERRY NOONON CHART COPY CUMULATIVE SUMMARY PRINT TIME: 1/17/2002 15:36



Differential Result Entry Accessing the GUI Application

To result a differential using the GUI application: 1. Launch the Lab application using the desktop icon. 2. The login window displays. 3. Login using the correct User ID and Password. 4. Click on Differential keyboard button on the Launchpad. 5. The information dialog box displays. 6. The tech code, keyboard, and shift must be entered before an accession number can be resulted.

The Information Dialog box displays. The technologist's tech code, keyboard and shift must be entered, before an accession number can be resulted.

A keyboard must be selected since a default keyboard was not defined



Differential Result Entry (continued) Patient History The patient History tab is the first window that displays. Previous hemagram, counts and morphology results display, if defined in maintenance.

C = Current Acc.# H = Hold data F = Filed data I = Instrument data

Results followed by …, indicate a comment is associated, to view the comment, click on the Comment button.



Differential Result Entry (continued) Entering the Differential Count Differential counts can be entered using the keys on the keyboard, or by using the mouse and clicking on the appropriate keys on the screen.

The numeric keys can still be used as counting cells. On the keyboard display, the top row of numbers display the cells.

In maintenance, the hemagram battery can be defined to display in a different order



Differential Result Entry (continued) Entering the Differential Count (continued) The chart below outlines the button options available when performing the cell count.

Button Use to.. New Count clear the current count and do a new count from scratch Set Count… reset the cell count to another user defined count, if set to zero the special cell count

defaults defined in maintenance will apply, i.e., Too Low To Count Temp Save… temporarily save the current count for averaging or adding to other counts Count perform a count using the keyboard Manual enter cell counts manually into the boxes Comment… add, delete, or modify comments, English text codes or free text Morphology>> go to the Morphology tab and enter results Save save the results to the patient file Hold place the current results in Hold for future retrieval Reject reject the current accession number Close close the existing window Workload enter non-revenue workload or modify the method code Retain Morph Hold, retain the morphology results from an on-line instrument or a differential from but recount

the cells Retain Count retain the cell count results from an on-line instrument or a differential from Hold, but

enter morphology results

Using Temporary Save Results can be placed in a Temporary Save file, counted again and then a selected set of results can be chosen or the results added or averaged together. This is a save for this entry session only. Once you leave the accession number, the results will not be saved.



Differential Result Entry (continued) Workload The method associated to the battery through keyboard maintenance can be modified, or non-revenue workload can be accrued by clicking on the Workload button.

Appending Comments To append a comment to a cell, click on the cell, then select the Comments button. Once the comment is appended, an ellipsis (. . .) appears after the cell.

Terminating the Count If defined, a key is available in the Count tab to terminate the cell count, no matter how many cells have been counted.

To change the default workload, select the new method Select the workload code and the

number to accrue for extra work

Enter free text. Do not precede the comment with a semicolon.

Enter a text code, or use the Lookup button for a list of codes defined to the keyboard through the filter.



Differential Result Entry (continued) Entering Morphology Observations Morphology results are entered using the keys on the keyboard, or by using the mouse. Mandatory test results are yellow.

The chart below outlines the button options available when entering Morphology Observations.

Button Use to.. Clear All remove all Morphology Observations currently entered Remove remove individual Morphology Observations by selecting the incorrect result, then clicking

this button Edit/Comment add, delete, or modify morphology comments, English text codes or free text QA Review>> go to the QA review tab to perform the QA checks

Bill-only tests can be added to the count or morphology



Differential Result Entry (continued) QA Review The QA Review tab must be selected before you can save any results.

Order modifiers can be appended to each result

English text codes or free text can be appended to all results



Differential Result Entry (continued) Reviewing an Automated Differential or a Differential in Hold

Save the automated/hold differential's cell count or morphology

Select the Count tab to do a manual count



Differential Result Entry (continued) Reviewing an Automated Differential or a Differential in Hold (continued)

Click the New Count button to delete the automated/hold count and to perform a manual count

Select the QA Review tab to choose the automated/ hold count or manual count

Select the count desired



Defining a Differential Keyboard Before defining a differential keyboard, the following definitions first need to be made in function MA:

Definition of... Function MA, option... -------------------------------------------------------------------------------- Test/battery codes 1 Quality assurance 19 English text codes 4 Workload 20 Workstations 15 Worksheets 3 -------------------------------------------------------------------------------

To define a differential keyboard using the GUI application, click on the Maintenance button on the Launchpad, and then click on the Differential Keyboard button.

Keyboard Selection The Keyboard Selection tab is displayed below, with a chart describing the new features.

Field Description Default Keyboard If selected, the keyboard code displayed will be the default keyboard. The default

keyboard code displays in maintenance and in result entry. Select Lab Departments to be added to the Filter List

Enter the lab department code(s) of the tests, batteries and English text codes which should appear in the drop down lists when defining the keyboard. If you do not specify a department, the drop down lists will be empty.



Defining a Differential Keyboard (continued) General Definitions Use the General Definitions tab to define:

the automatic hold rule whether to delete on-line or hold data when a correction statement should be applied the display order of the hemogram tests how morphology will be resulted

Field Description Automatic Hold Options

specify under what conditions the differential should automatically be placed in the HOLD file

Delete Instrument/Hold Data

determines what happens to data in the HOLD file once it is loaded into the keyboard, applies to both automated and manual differential results

Append Correction Statements to

determines if a correction statement should be appended when filed results are modified

Keyboard Morphology Type

determines how morphology will be entered, the observation is a test (i.e., Target Cells = Test) or the observation is a result to a generic test code (i.e., RBC Morphology = TEST and Target Cells = modifier)

Hemo Test Display Order

determines how the hemogram tests will display in the count tab when resulting



Defining a Differential Keyboard (continued) Order Codes Use the Order Codes tab to define the differential order codes that can be resulted on the keyboard, associate workload methods by order code or location, and to define the workload codes for non-revenue.

Field Description Order Codes define the batteries that will be resulted from this keyboard Method Rules by Location or Method Rules

define the default workload method for differential result entry; if both defined

Other Workload Codes define non-revenue workload codes (English text codes

Enter the type W code(s) or perform a lookup



Defining a Differential Keyboard (continued) Search Codes

Use the Search Codes tab to determine which test and battery codes will display when resulting, how many will display, and how far to search back for them.

Field Description Search History Codes

define the codes to display previous results when in differential result entry, and define the codes that should be used to perform the WBC correction if nucleated red blood cells are present

Keyboard Search Code Parameters

determine the number of days to search for previous results and the number of previous accession numbers to display



Defining a Differential Keyboard (continued) Counting Definitions Use the Counting Definitions tab to define the standard cell count, the acceptable entries for other cell counts, the Count Terminate key, the code to use for total cells counted, and the way absolutes will be reported. An absolute only keyboard can be defined. The Count Terminate key and alternate cell counts do not have to be defined.

Field Description Standard Cell Count enter the most common cell count Unable to Calculate Code

if the NRBC correction or absolute count calculation cannot be calculated, they will be resulted with the code defined here, i.e., NCAL = NOT CALCULATED

Default Result if a cell is not counted and is part of the battery, enter the result for the cell, i.e., 0 or HIDE

Count Terminator Key this key terminates the count and adjusts all counts to 100% Alternate Cell Counts define the other valid cell counts that can be entered when the Set Count button is

clicked Total Count Test Code define the test code to be resulted with the total cells counted Absolute Rules select the option for handling absolute counts



Notes:



Defining a Differential Keyboard (continued) Counting Keys Definition

Breakdown chart of screen on next page.



Defining a Differential Keyboard (continued) Counting Keys Definition (continued)

Field Description Key select the key on the keyboard for the cell Percent Test define the test code for the percent cell being defined Absolute Test define the test code for the absolute cell being defined

if you are not using absolutes, leave this field blank if the absolutes are to be appended to the percent code, then enter the percent code in this column

Display Order the relationship of the tests to one another when displayed in differential result entry; only affects those tests added to the battery

Filing Order order in which the results are displayed on interim reports and inquiry; only affects those tests added to the battery

Bill Only check the box if this is a Bill-only test previously defined in MA,1 NRBC or Megakaryocyte check the box if this is a nucleated RBC or a megakaryocyte, adjustments to the WBC will be

made when these are counted Used in Counting determine the type of key being defined:

Y = to be included in the total # of cells counted, SEG N = not to be included in the total # of cells counted, but will be included when cells are adjusted to 100%, i.e., NRBC I = to be used to identify input counts to a recipient, i.e. reactive lymphs X = not to be included in the total # of cells counted and will not be adjusted to 100%, i.e., smudge cells

Special Defaults used to answer a test with an English text code if you cannot perform a differential and the count is set to 0, i.e., WLT = WHITE COUNT TOO LOW TO PERFORM DIFFERENTIAL



Defining a Differential Keyboard (continued) Morphology Keys Definition When defining Morphology Keys, the first step is to define the tests to the keyboard. These may be general tests (RCOM, WCOM, etc.), or individual observations (ANIS, POIK, etc.), depending on how you are reporting Morphology Observations.

See detailed information on the next page.

Enter the test ode and elated nformation

Enter the key

Bill-only tests are defined to the keyboard as tests, marked in the Bill Only check box



Defining a Differential Keyboard (continued)

Field Description Test code used to store the morphology result Bill Only determine if this test code is a Bill-only test previously defined in MA,1 New Line indicate if the vertical bar delimiter should be placed at the end of the entry Result only if ordered determine if the test must be part of the original battery to enter results Allow Comments allows entry of free text or English text codes for this test Display Order the relationship of the tests to one another when displayed in differential result entry;

only affects those tests added to the battery Filing Order order in which the results are displayed on interim reports and inquiry; only affects

those tests added to the battery Mandatory/Defaults for Test

determine if the test must have a result before releasing it to the patient file or define a code which will be the result if nothing is entered

Allowable Test Qualifier Codes

limits the number of modifiers which can be entered, only applicable when observations are a test code

Key Parameters define the key for this test, if defining a modifier to a generic test code, enter a key qualifier code and a test code determines if the entry should be terminated after the key is hit and if a vertical bar should follow the entry



Defining a Differential Keyboard (continued) Once the tests have been defined the results can be associated to the test.

Multi-facility Considerations Differential Keyboards are not multi-facility enabled.

Unique keyboards per facility may be necessary if: facilities use different reporting schemes. facilities report different cells. facilities handle nucleated red blood cell corrections differently. facilities handle the reporting of cells not counted differently. facilities handle the reporting of morphology differently.

If one keyboard is used for multiple facilities, workload must be defined by location.

Enter the test code associated to the result

Enter the key and the result code Modifiers (1+, 2+ ) will not have a test code associated




Figure 11.1




General Definitions for Keyboard DFG

Automatic Hold Options No results are automatically placed in Hold ____ WBC not ordered or not resulted ____ NRBCs observed, WBC not ordered or resulted _X_ NRBCs observed, WBC ordered but not resulted ____ No WBC adjustment ____ Append Correction Statements to Cell count results _X_ Morphology results _X_ WBC adjustments for NRBCs _X_ Delete Instrument/Hold Data Delete Data from the hold file ____ Keyboard Morphology Type Obs = tests (ANISO is a test code) ____ Obs = results (ANISO is an English text code) _X_ Hemo Test Display Order Test Order HGB _10_ HCT _20_ WBC _30_ RBC _40_

Keyboard Selection Definitions for Keyboard DFG

Select or Create a Keyboard Name

Keyboard DFG

Default Keyboard Yes _X__ No ___

Select Lab Departments to be added to the Filter List

Department _H___ ____ ____ ____ ____




Order Codes for Keyboard _DFG_

Order Code Entry Order Code _DIFF ____ ____ ____ Result Type: Cell Counts _X___ ____ ____ ____ Result Type: Morphology _X___ ____ ____ ____

Method Rules by Location Location ____ ____ ____ ____ Method ____ ____ ____ ____

Method Rules Order Code DIFF ____ ____ ____ Priority unspec ____ ____ ____ Method MANO ____ ____ ____

Other Workload Codes Code REPS ____ ____ ____




Search Codes for Keyboard _DFG_

Search Code Entry Search Codes _CBC _WBC DIFF RETIC

Order Code Type CBC Order Code _X__ ____ ____ ____ WBC Test Code ____ _X__ ____ ____ Differential Order Code ____ ____ _X__ ____ Other Test Code ____ ____ ____ _X__

Display in History Okay to display in history _X__ _X__ _X__ ____

Keyboard Search Code Parameters Maximum number of days to search for previous results to display (0 - 30) _30

Maximum number of accession numbers to display (0 - 3) _3




Counting Definitions for Keyboard DFG

Standard cell count _100_

Unable to Calculate Code _NCAL_

Default Result _0__

Total Count Test Code TCNT

Display Order _20_

Filing Order _20_

Absolute Rules Option Percent only keyboard ____

Two separate test codes _X__

Append to % result ____

Precede % result ____

Absolute only keyboard ____

Count Terminator Key _T__

Alternate Cell Counts _25_ _50_ _200_




Counting Keys Definitions for Keyboard DFG

Define Recipient Tests and Recipient Input Cells on this Page

Recipient Only _X__ ____ ____

Recipient LYMP ____ ____

Absolute Test ____ ____ ____

Display Order _15_ ____ ____

Filing Order _15_ ____ ____

Include in Total _Y__ ____ ____

Key _R__ ____ ____

Percent Test ATLY ____ ____

Absolute Test ____ ____ ____

Display Order _20_ ____ ____

Filing Order _20_ ____ ____

Used in Counting Recipient Input _Y__ ____ ____

Recipient Test LYMP ____ ____




Counting Keys Definitions (continued) for Keyboard DFG

Key _N__ _S__ _M__ Percent Test POLY SCAN MONO Absolute Test APOL _____ AMON Display Order _10_ _90__ _30_ Filing Order _10_ _90__ _30_ Bill Only _N_ _Y__ _N__ NRBCs or Megakaryocytes _N_ _N__ _N__

Used in Counting Included in total _X__ _____ _X___ Not included in total ____ _X__ ______ Not adjusted and ____ _____ ______ not included Recipient input ____ _____ ______ Recipient test ____ _____ ______

Special Defaults Order Code DIFF _____ _____ Test Code POLY _____ _____ Special Default WBCL _____ _____




Morphology Keys Definitions for Individual Tests for Keyboard DFG

Test RCOM PLTE PSCAN Key _R__ _P__ _N___ Bill Only _N__ _N__ _Y___ New Line _N__ _Y__ _Y___ Result only if ordered _ N__ _N__ _N___ Allow Comments _Y__ _Y__ _Y___ Display Order _110_ _130_ _160__ Filing Order _110_ _130__ _160_ No Mandatory Order Codes _____ __X__ _X___ Mandatory with no default text _____ _____ _____ Order Codes DIFF DIFF _____ Mandatory with default text _X___ _____ _____ Default text NORM _____ _____ Order Codes _____ _____ _____ Default text _____ _____ _____ Qualifier Codes _____ INCR _____ _____ DECR _____ _____ ADEQ _____




Morphology Keys Definition for Keyboard DFG

Test PLTE RCOM RCOM

Key _0__ __T__ __M__

Key Qualifier Code ADEQ TARG MACR

Terminate entry _Y___ _Y___ __Y__

New Line __Y__ _Y___ __Y__

chapter 19 differential keyboard gui - quia · differential keyboard __ gui ... the participant...

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