GFR calculations for waived i-STAT creatinine testing

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A while back I had asked for input on switching to the i-STAT for creatinine testing at an off campus clinic location due to COLA no longer being accepted by TJC.  We more than like are going to make the switch, but the most difficult challenge will be with the GFR results.  Currently we use the StatSensor creatinine meter and this gives the GFR results on the screen of the meter with the creatinine results.  I don't think that having the employees look up GFR results on a website and somehow manually documenting this is going to be an option.  With that being said, we use RALS and Meditech expanse.  Does anyone use these and have one or the other calculate the GFR when results are transmitted across?  I would love to get some input on how others have this set up.  I believe we will have to do this in Meditech, but does anyone know if RALS can calculate the results for GFR?  Thank you for any input!  You may also email me at aholland@catawbavalleymc.org if you would prefer to respond by email.

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  As I'm sure you realize, what you had with StatSensor was the best option with the immediate display.  No doubt other downstream systems can make the calculation for you provided they have access to the patient age and sex; unfortunately with any of those options, users have to wait until the result uploads and processes through the various systems.  Even when it's relatively quick, it's often not quick enough for clinical staff to be willing to wait for it so they can move the patient on.  In spite of your best efforts, staff will likely calculate it off a website anyway.  Doing that correctly is something I emphasize a lot in both initial and annual training, to ensure they are using the correct eGFR calculator.  But there's not a whole lot else you can do.
  Additionally, to enhance availability of the downstream calculation, position your iSTAT downloaders to be as conveniently located as possible so there's no excuse not to upload.  Or better yet, go wireless.

We use the i-Stat waived creatinine and Meditech.  Meditech calculates the GFR.  The whole process takes about three minutes including running the creatinine. By the time the patient is ready to move on the result is ready.  Cat Scan had to arrange the workflow to allow time for results to flow to meditech so the patient didn't have to sit and wait.  It works very well for us.   

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Ashlee Holland
almost 3 years ago
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