Clinica Chimica Acta 493 (2019) S673–S710 Contents lists available at SciVerse ScienceDirect Clinica Chimica Acta journal homepage: www.elsevier.com/locate/clinchim Total testing process, including standardisation, preanaltical process M372 clinician for the laboratory services and ultimately increase labora- tory test utilization. Successful development of real-time display of the ongoing phases of laboratory tests and expert comments by laboratory doi:10.1016/j.cca.2019.03.1493 physician on the computerized order communication system S. Kimb, T.H. Umb, C.R. Chob, D.W. Shina M373 aEmergency Medicine, Ilsan Paik Hospital, Inje University, Goyang, Republic of Korea Evaluation of BD Vacutainer® urinalysis tubes for serous fluids bLaboratory Medicine, Ilsan Paik Hospital, Inje University, Goyang, cell counts Republic of Korea a a a a b Background-aim R. Ramos , N. Del Amo , I. PeÑa , M.J. Ruiz , M.F. Calafell , M.B. Alvareza, F. Cavaa, R. Guillena aHospital Infanta Sofía-Brsalud, Spain Turnaround time (TAT) is a retrospective quality indicator for bHospital Tajo-Brsalud, Spain laboratory tests. The real-time display of the ongoing phases of laboratory tests would be helpful for clinicians to estimate the Background-aim duration required to obtain result reports. Additionally, the expert comments by laboratory physicians about the test results through In inflammatory and infectious diseases, the cellular components the Order Communication System (OCS) would contribute to the in serous fluids are increased rendering essential diagnostic infor- increase in laboratory test utilization. mation. Sample testing should occur within one-hour post collection to avoid cellular deterioration or lysis. The aim of this study was to Methods evaluate the usefulness of BD Vacutainer® Urianalysis tube (BDUt) for serous fluids cell counts. We upgraded our OCS program to enable the real-time display of the ongoing phases of laboratory tests process, which are categorized Methods as follows: 1) test request, 2) label printing, 3) sampling, 4) receipt by laboratory, 5) test carry out (manual or automated), 6) result White blood cells (WBC) and Red blood cells (RBC) counts from 9 verification, 7) interpretation by laboratory physician and 8) result fluid samples were processed and aliquoted into BDUt for further final report. Additionally, the feature enabling the easy adding and analysis at 4 and 8 hours after the initial analysis. Neubauer and browsing of expert comments with regard to test results in OCS was Fuchs-Rosenthal were used as a counting chamber. BDU contains installed. ethyl paraben, sodium propionate and chlorhexidine preservative. Results Results This upgraded OCS system has enabled clinicians to know what Although t-test showed a nonsignificant reduction of WBC and phases the requested laboratory tests are in at present in real-time. RBC neither in the first 4 hours nor 8 hours the decreased of Additionally, this system has allowed laboratory physicians to put concentration in both groups were up to 80% in some cases. interpretative expert comments about test results, even for not specialized routine tests (e.g., HbA1c, CBC) that does not normally Conclusions add interpretive comments. Conclusions Despite of several papers have published that BDUt maintains the sample integrity for urine cells, our results does not recommend use for serous fluid. We have successfully developed the OCS function for the real- time display of test phases and expert comments by laboratory doi:10.1016/j.cca.2019.03.1494 physicians. This function would contribute to the satisfaction of the 0009-8981/$ – see front matter Abstracts / Clinica Chimica Acta 493 (2019) S673–S710 M374 parameter. 22 parameters were verified: IgG, IgM, IgA, Albumin in serum and CSF and Transferrin, Haptoglobin, soluble Transferrin Should we use a tube sorting device or not? Receptor, Ceruloplasmin, IgE, C3, C4, Alpha-1-antitrypsin, IgG subclasses, Haptoglobin, CRP and Beta-2-microglobulin. Verification E. Calci, Z. Kangal, S.E. Yilmaz results were exported from laboratory information system to Usak Public Health Laboratory, Turkey modified and verified Excel templates which were downloaded from The Association for Clinical Biochemistry and Laboratory Medicine’s Background-aim website. Verification analysis for each analyte was performed for 5 days with 5 replicates per day for two different concentration levels. Laboratory processes are defined in 3 stages. (pre-analytic, Accuracy and precision of repeatability, intermediate precision and analytic, post-analytic). The most common error rate of these reproducibility were calculated. processes is seen in the pre-analytic stage. In our study, we aimed to evaluate the tube sorting device which we used in the pre- Results analytical process. All verified parameters corresponded acceptance criteria from the Methods manufacturer. The samples sent to the Uşak Public Health Laboratory from Conclusions different centers on the same day were included in the study. Acceptance and separation of the samples were done by using The protocol used proved to be a fast and reliable tool for carrying personnel and tube sorting device. The elapsed time was recorded. out the verification of a number of parameters. Verification provides The difference between recorded times was evaluated. a deeper insight into the quality of the material used in the medical laboratory, thereby increasing confidence in analytical results. In our Results case, all the verified parameters were consistent with the manufac- turer’s data, so we could introduce the BN II analyzer within a short When different numbers of blood samples were examined at period of time into a clinical practice. different times during the day, it has been observed that the tube sorting device achieved the blood seperation and acceptance doi:10.1016/j.cca.2019.03.1496 procedure nearly half time shorter when compared to personnel. Conclusions M376 The study showed that the blood acceptance and separation Turnaround time in emergencies process in the pre-analytical stage can be done with the tube sorting device with less error, less labor force and shorter time and we can A. Vílchez Rodríguez, S. Esteve Poblador, C. Valldecabres Ortiz, J. fi evaluate the personnel more ef ciently in different departments. González Cantó, M. Ortuño Alonso Hospital Universitario La Ribera, Alzira, Spain doi:10.1016/j.cca.2019.03.1495 Background-aim M375 Turnaround time (RT) is the interval between the arrival time of a sample to the laboratory and the time of clinical validation of results. Verification of BN II analyzer according to ISO 15189 It is an indicator of laboratory quality, which has an impact on diagnosis and treatment. M. Krsnik, M. More, U. Čegovnik Primožič Our goal was to evaluate RT of samples received from the fl University Medical Centre Ljubljana, Institute of Clinical Chemistry and Emergency Department, in a 5 days period and study the work ow Biochemistry, Ljubljana, Slovenia in preanalytical, analytical, postanalytical and total phases. Background-aim Methods Each examination procedure must be verified in order to Data of 385 stat requests were evaluate in an ADVIA 1800 guarantee that performance characteristics comply to the intended Chemistry System® (Siemens Healthineers). We calculated RT for scope of the test. There are limited guidelines available on how to each phase and for each of the four time periods studied: 1 (8-11h), perform analytical part of verification for ISO 15189 at the moment. 2 (11-15h), 3 (15-20h), and 4 (20-8h). RT was measured in minutes. Upon the start of the verification process, one is confronted with Data were processed with Excel 2013. many undefined steps, not mentioned in ISO 15189 or any other standard. That is why we prepared our own verification protocol Results which will be explained below. Analyser BN II was verified by our protocol. 49, 80, 125 and 131 samples were analyzed for periods 1, 2, 3 and 4 respectively. Average number of determinations for sample were Methods six, with the most frequent determinations being glucose, creatinine, urea, sodium, potassium and chloride in serum samples. Each step of verification must be planned in detail, well RT average was 24, 12, 12 and 48 minutes, for preanalytical, documented, reviewed and written in the verification plan for each analytical, postanalytical and total phases, respectively. For periods 1, Abstracts / Clinica Chimica Acta 493 (2019) S673–S710 2, 3 and 4, RT average total was 50, 48, 50 and 40 minutes, − Androstenedione: Y=0.34X + 1.14 respectively. Constant “a” differed from 0, we can state that both methods Conclusions present constant differences. The plot slope did not contain the value 1, there are proportional differences. The mean difference leads to a During periods when our emergency samples were mixed with negative bias. The functional sensitivity concluded that the method inpatients and Primary Health samples (8-20h), RT was higher, was sensitive up to concentrations of 0.197 ng/mL mostly because of time used in preanalytical phase. During period of − 17-OHP: Y=0.49X + 1.02 20-8h, in which only stat samples were analyzed and there was less work load, RT decrease. It is necessary to analyze which factors fall “ ” on preanalytical phase and prioritize stat samples to adapt to The constant a differed from 0, we can state that both methods healthcare needs, although RT for stat samples are always less than present constant differences. There are proportional differences 60 minutes. between both methods. The mean difference leads to a positive bias. Value 0.158 ng/mL is proposed for functional sensitivity. doi:10.1016/j.cca.2019.03.1497 The MAGLUMI1000® method showed good repeatability and reproducibility. Conclusions M377 The results obtained with both methods are not interchangeable, Measurement of free testosterone, androstenedione, and 17- the reference values cannot be adopted. In addition, proportional and hydroxyprogesterone: Comparison of current laboratory methods constant differences were observed. Therefore, new population reference values should be set using MAGLUMI1000®. J. Gorrín Ramos, N. López Lazareno, C.