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Description

The Microbiology Work Card pop-up mimics a traditional microbiology paper work card on its layout. This is the technical work area for the micro tech to enter all findings and observations through the life of an individual culture. The work card is organized by organisms that have been isolated in the order of finding. Using the work card, techs are able to get a broad overview of the culture, what media is set up, what isolates are identified and reportable, and which isolates are currently being processed for identification and susceptibilities.

Isolate-specific media descriptions and testing are located under specific isolates. The work card enables techs to work up non-reportable isolates, allowing them to complete any needed workup without including it, its tests, any susceptibilities attached to it, or its billing in the preliminary and final reports for the culture.

Orchard Enterprise Lab can integrate with automation line systems such as the Walk Away Specimen Processor (WASPLab) to receive observations and isolate tests and send preliminary or final reports. Your Orchard system can automatically update the Microbiology Work Card in tandem with WASPLab workup tasks. See WASPLab Integration with Orchard Enterprise Lab.

Access

You can navigate to this page from the Work in Progress page if your culture does have a setup date and time.

Technical Manual

Patient Information

Patient

Displays the patient's name.

Select the patient ID link to access a contextual menu of patient options.

MRN

Displays the patient's medical record number.

DOB

Displays the patient's date of birth.

Age

Displays the patient's age.

Sex

Displays the patient's sex.

Species/Breed

Displays the species and breed of the animal.

This is only available if the veterinary license is enabled.

Owners

Displays the name(s) of the owner(s) of the animal.

This is only available if the veterinary license is enabled.

Sample Information

Sample ID	Displays the sample ID. Select the sample ID link to access a contextual menu of sample tracking options.
Collection Date/Time	Displays the collection date/time.
Tube/Container Type	Displays the container type.
Diagnoses	Displays the diagnoses codes.
Sample Type	Displays the sample type.
Source Site	Displays the source site.

Testing Information

Setup Date/Time	Displays the setup date/time.
Setup By	Displays the user who initially set up or plated the culture. This is the user entered in the Setup By field on the Microbiology Media Setup pop-up.
Workflow Status	Displays the workflow status.
Report Status	Displays the report status.

Order Information

Order ID	Displays the order ID. Select the order ID link to access a contextual menu of order options.
Order Date	Displays the date the order was placed.
Ordering Provider	Displays the ordering provider.
Ordering Location	Displays the ordering location.
Results To	Displays the location where results are sent.
Encounter ID	Displays the encounter ID.
Patient Location	Displays the patient location.
Attending Provider	Displays the attending provider.
Document icon	Select this icon to add a document at the patient level, order level, or result level.
Comment bubble icon	Select this icon to open the Comments pop-up to add a comment at the order level.

Order Choice Information

This section displays information specific to the order choice.

Order choice status

Displays the order choice status.

Culture-level flag

Select this flag icon to access a contextual menu with three options:

Select the Flag Culture To Normal option to set the culture flag to normal. The flag is gray.
Select the Flag Culture To Abnormal option to set the culture flag to abnormal. The flag turns red.
Select the Flag Culture To Critical option to set the culture flag to critical. The flag turns into a red exclamation point.

If an isolate is set to an abnormal organism for the order choice in the Microbiology Culture Abnormal Organisms section of the Order Choices page, the culture flag is set to abnormal unless it was set to critical.

Order choice name

Displays the order choice name.

Department

Displays the department.

Ellipsis button

Select this button to view a contextual menu and select an option:

Review Order: Select this option to navigate to the Order Patient Samples page.
Cancel Order Choice: Select this option to navigate to the Cancel Order Choice page where you can cancel the order choice and provide a reason for the cancellation.
Samples: Select this option to navigate to the Collect Samples page.
Labels: Select this option to open the Print Labels pop-up. See the Print Labels topic.
Change Workflow Status: Select the drop-down list to change the workflow status. Select one of the following options:
- Set to Next Workflow Status
- Approved
- Bar Code Scan
- Parsed
- Received Results
- Rerun
- Rule Status

Comment bubble icon

Select this icon to open the Comments pop-up to add a comment at the order choice level.

The Comments pop-up opens with the Order Choice Comments tab selected.

The comment bubble icon is green when order-level comments exist.

Document icon

Select this icon to attach a document at the patient level, order level, or result level.

Vertical Tabs

Reports

Select this tab to expand this section.

This tab lists all reports that have been issued for the order choice.

Select Save and Issue Microbiology Report to open the Issue Microbiology Report Pop-up.

All enterability on the work card is disabled after a final report is added to the Reports tab.

Reports will be in reverse chronological order with the most recent report always at the top.

Media

Select this tab to expand this section.

This tab lists all culture media issued for the order choice.

Select the gray arrow next to the media name to expand or collapse media information.
Select the comment bubble icon next to the media name to open the Media Notes pop-up to add a non-reportable comment.
Select the vertical ellipsis button next to the media name to open a contextual menu of options:
- Select Add Media to enable the Media to Add search-as-you-type field, select the Sub-Media checkbox, and populate the Parent Media field.
- Select Inactivate/Reactivate Media to inactivate or reactivate media. The inactivation of the media results in its removal from the Media Observations area in each isolate section of the work card.
- Select Print Media Labels to open the Print Labels pop-up to select a printer and the quantity of labels to print.
Select + Add Media to enable the Media to Add search-as-you-type field. Select media to add and select Save to add media to the list.
- You can select the Sub-Media checkbox to enable the Parent Media search-as-you-type field, where you can search for and select a parent media for the sub-media. Select in the field to see the parent media listed with their sample IDs, parent media, and assigned isolate numbers. (If the parent media was not assigned to a specific isolate, the Isolate column will display All.) Select media to add and select Save to add media to the list.
  - Select in or begin typing in the Isolates search-as-you-type field to search for and select isolates to assign to the media sub-container. If you don't designate an isolate for the media, it will show up on all the isolates. The isolate numbers you select display to the right of the search field as links; select the links to display a menu option to remove the isolate number.

Billing

Select this tab to expand this section.

This tab lists all items that will be billed for the order choice in a table, including CPT codes from the order choice itself, CPT codes from the tests on the order choice, and bill-only items that have been manually added.

Add Bill-only Item: Select this button to open the Add Bill-only Item pop-up that contains a search-as-you-type field with the available microbiology bill-only items for the testing facility that the order choice is being tested at. Select Add on the pop-up to add the bill-only items to the work card. Select Cancel to close the pop-up without making any changes to the bill-only items.

Orchard Software recommends all CPT codes for Microbiology be set up as bill-only items. Adding bill-only items to a culture is the only manner in which new CPT codes may be applied to the order, even if a CPT code is removed from the order by accident.

To add bill-only items to the work card, they must first be created on the Bill-only Items administration page. See Bill-only Items.

Billing ID: This column contains the CPT code or charge code that will be billed. Select the arrow button to display the CPT code/charge code description, who the code was added by, and when the code was added.
Order Choice/Test Name: This column displays the name of the order choice, test, or bill-only item that is related to what is being billed.
Qty: This column displays the quantity of the code to be billed. Select the x button to delete the billing item from the order choice.
Mod: This column displays the billing modifiers for the Bill-only Items and CPT Code records.

All changes made to the Billing tab will not be saved until the work card itself is saved.

This tab is only visible with the View/Edit the Microbiology Billing Tab right.

Work Card Tab

This tab displays the technical work card for the micro technician to enter findings and observations through the life of a specific culture.

It provides an easy toggle to switch between the Work Card tab and the Susceptibility Panels tab as needed.

Various input fields on the work card can take advantage of text shortcuts. In addition to the standard text shortcut functionality, this also takes into account usage restrictions.

If a text shortcut has specific user restrictions configured, it is only available if the current user is one of the users on the text shortcut.
If a text shortcut has specific role restrictions configured, it is only available if the current user has one of the roles on the text shortcut.
If a text shortcut has specific location restrictions configured, it is only available if the current signed-in location is one of the locations on the text shortcut.
If a text shortcut has specific order choice restrictions configured, it is only available if the work card displays a culture for one of the configured order choices on the text shortcut.
If a text shortcut has specific testing facility restrictions configured, it is only available if the work card displays a culture sent to one of the configured testing facilities on the text shortcut.

Text shortcuts are available for the following fields:

Text field for a culture observation
Result field for culture test that accepts a text response
Description field for a media observation on an isolate
Observation field for an isolate test that accepts a text response
Media Notes pop-up

See Text Shortcuts and Using Text Shortcuts for more information.

+ Isolate

Select this button to add an isolate section to the work card to document the finding of a unique organism growing from the culture.

Individual isolate sections are added for each organism found and will handle the identification and susceptibility testing for that specific organism.

If you add an isolate for an abnormal organism to the Microbiology Work Card pop-up, the system will include the abnormal and critical flags on reports.

+ Observation

Select this button to add a culture observation to the work card.

This allows for an overall culture observation to be documented independent of any isolated organisms.

+ Test

Enter text or select in this search-as-you-type field to select a culture-level test option.

Next, select this button to add a culture-level test to the work card.

Culture-level tests are defined by clients.

+ Reopen as Addendum

Select this button to reopen the work card to add on to final results.

This button is available on the work card after a final report has been issued.

When the work card is reopened for addendum:

all previously added results remain disabled
the + Reopen as Addendum button is not visible
the + Isolate, + Observation, and + Test buttons are visible
the + Reopen as Amendment button changes to the + Switch to Amendment button

Select + Switch to Amendment to reopen the work card for amendment.

Newly added items can be edited until an addendum report is added.

For organisms that include Public Health Agency reporting, when you issue an addendum report, the system will send an update to the public health agency (if configured). See Public Health Agency.

+ Reopen as Amendment

+ Switch to Amendment

Select this button to reopen the work card to correct final results.

This button is available on the work card after a final report has been issued.

This button becomes the + Switch to Amendment button when the work card is reopened for addendum.

When the work card is reopened for amendment:

all previously added results are enabled for editing
the + Reopen as Addendum and + Reopen as Amendment buttons are not visible
the + Isolate, + Observation, and + Test buttons are visible

All items can be edited until an amendment report is added.

After you make changes to results, the results will be flagged with a blue triangle or a red triangle:

Blue triangle: A result has been modified prior to issuing a final report and saved.
Red triangle: A reportable result has been modified post issuing a final report and saved.

For organisms that include Public Health Agency reporting, when you issue an amended report, the system will send an update to the public health agency (if configured). See Public Health Agency.

Micro Clinical Information Section

This section displays all mandatory microbiology clinical information tests.

When the section contains a result and reaches a Complete Workup Status, the section automatically collapses with a brief excerpt. There is no preview of the questions or answers in the collapsed view. If all Questions have been answered according to Clinical Information setup, this section reaches a Complete Workup Status.

Isolate section

Each isolate section displays in the order it was added and cannot be rearranged.

When the section contains a result and reaches a Complete Workup Status, the section automatically collapses with a brief excerpt. It is a limited amount of the result value.

Reportable

Select this toggle button to turn it on. It will appear blue and move to the right. This indicates that this isolate section and its children will appear on the report.

If this toggle button is gray and slid to the left, this isolate section and its children will not appear on the report.

Component

Displays the component (Isolate, Culture Observation, or Culture Test sections) that have been added to the work card.

Organism name

Displays the currently selected organism name.

If no organism is selected, the current organism name does not display in the header.

The organism cannot be edited until the section is expanded.

Workup Status

Select an option from this drop-down list:

In Process: Select this option to automatically expand the isolate section.
Complete: Select this option to automatically collapse the isolate section.
Secondary Review Required: Select this option to start the secondary review process and expand the isolate section.
Not Clinically Significant: Select this option to automatically set the Reportable toggle button to off and collapse the isolate section.

This drop-down list is set to In Process when adding new isolate sections to the work card. It cannot be set to Complete until an organism is set to a genus or species and all child tests have a status of complete.

If the isolate section is set to In Process and becomes complete, the drop-down list for the isolate section is set to Complete automatically.

If the isolate section is complete, the In Process option is disabled.

If the isolate section is not complete, the Complete option is disabled.

Enabled the Complete option when the isolate organism is set to an organism class. Unlike genus and species, the Workup Status is not set to Complete automatically when a Class is selected. Users must manually set the Workup Status to Complete when the organism is set to a class.

Modified

Displays the last modified date for the section as a whole.

Modified By

Displays the ID of the person who modified the isolate.

Abnormal

Select the flag icon to mark this isolate as abnormal, normal, or critical. A menu will display with the following options:

Select the Flag To Normal option to set the flag to normal. The flag turns black.
Select the Flag To Abnormal option to set the flag to abnormal. The flag turns red.
Select the Flag To Critical option to set the flag to critical. The flag turns into a red exclamation point.

When you manually flag an isolate to a more-severe state than the culture-level flag, the system will update the culture-level flag to match the most-severe flag on an isolate.

Flagging an isolate as normal on a culture that is already abnormal or critical will not set the culture-level flag to normal.

X

Select this button to delete newly added isolate sections.

Saved isolate sections cannot be deleted, even when all child tests are empty.

Prefix

Select an option from this drop-down list: empty or >.

This option is only visible if you have organism quantification set on AdminCenter > Order Choice Setup > Order Choices > add or edit an order choice > select Microbiology from the Module drop-down list > Microbiology Setup button > Microbiology Culture Organism Estimation section.

Organism Quantification

Enter a number in this field or select >100,000 to automatically set this field to 100000.

This option is only visible if you have organism quantification set on AdminCenter > Order Choice Setup > Order Choices > add or edit an order choice > select Microbiology from the Module drop-down list > Microbiology Setup button > Microbiology Culture Organism Estimation section.

>100,000

Select this button to set the prefix to > and to set the numeric value to 100000.

This option is only visible if you have organism quantification set on AdminCenter > Order Choice Setup > Order Choices > add or edit an order choice > select Microbiology from the Module drop-down list > Microbiology Setup button > Microbiology Culture Organism Estimation section.

Organism Semi-Quantification

Select an option from this drop-down list.

This option is only visible if you have organism semi-quantification set on AdminCenter > Order Choice Setup > Order Choices > add or edit an order choice > select Microbiology from the Module drop-down list > Microbiology Setup button > Microbiology Culture Organism Estimation section.

Organism

Enter text or select in this search-as-you-type field to select from a list that displays organisms, including the class, genus, and species.

The currently selected organism displays in the header (along with any abnormal or critical flags) as soon as a selection is made. This selection also appears in the Organism History field.

Changing a previously saved organism from one parent class to another parent class is considered a major change that opens the Organism Update Reason pop-up. The pop-up prompts you to “Enter the reason for changing the class from <Organism Class> to <Organism Class>." Select Cancel to revert to the initially selected organism.

If the selected organism is flagged to report to public health agencies (AdminCenter > Order Choice Setup > Public Health Agency > Organisms tab), a red cross-hairs icon displays in the isolate section header. This applies when the public health agency record includes the selected organism, and the other public health agency factors, such as facility, department, order choice, and sample type, apply. If the organism’s parent genus or class is selected on the public health agency record, public health reporting still applies to the organism.

Any public health agency record that applies to the current organism applies public health reporting. This means a public health agency record matching on testing facility, department, order choice, and sample type, but not the current organism, does not apply the public health reporting. However, a public health agency record set to all testing facilities, departments, order choices, and sample types could still apply public health reporting if it includes the current organism or its parents.

Organism History

Displays a list of all past organism abbreviations and the current organism abbreviation.

Hover over the abbreviation link to display date/time, user ID, testing instrument, updated to, and major change comments.

The first organism abbreviation displayed is the initial organism.

The last organism abbreviation displayed is the current organism. The current organism does not display updated to or major change comments.

Adding Isolates

Add an isolate to the work card to document the finding of a unique organism growing from the culture. Individual isolate sections are added for each organism found and are used to add the needed components for any identification and susceptibility testing for that specific organism.

Each isolate section displays in the order it was added. Each section can be expanded and collapsed to aid the tech in documenting their findings. Isolates requiring additional workup will be expanded by default, and once completed the isolates will be collapsed automatically. Isolates requiring additional workup are expanded by default, and once completed, the isolates automatically collapse.

The isolate section is divided into four areas:

Organism Quantification/Semi-Quantification	This field is used to quantify growth per isolate with an exact number or from a choice list. Examples would include Colony Count or Growth. The enterability option is be determined during the test configuration. You may also configure multiple tests at once.
Testing Instrument	This drop-down list displays all instruments linked to the test with a matching department. The testing instrument must be set in order to specify which enterability to use on the Isolate Components list. Changing the testing instrument may change the enterability. If only one instrument populates the Testing Instrument drop-down list, it is selected automatically and the enterability is displayed. Once the testing instrument is saved, it cannot be changed. Select the vertical ... button to toggle whether auto-approval for an instrument is enabled or disabled. The option appears in the format Enable <testing instrument> Auto-approval or Disable <testing instrument> Auto-approval. Select the button to enable/disable the instrument.
Organism	This search-as-you-type field allows you to select a class, genus, or species from the organism index to note the current identification of the isolate. As you type in this field, the system will display organism class hierarchies in each row of the search results. Select the hierarchy arrow or use the left and right arrows on the keyboard to expand and collapse organisms in the hierarchy. Use the up and down arrows on the keyboard to highlight the next element in the hierarchy. Use the shift plus up and down arrows on the keyboard to move to the next and previous row in the search results, which is also the next and previous class. In the search results, the organism link displays the organism's display name followed by its abbreviation in parentheses. Select the organism's link or press enter on the keyboard to select the organism and close the search results. As you type in this field to search, the system will search through the organism's abbreviations and display names for the typed text. If the typed text matches the organism abbreviation exactly, that organism will be highlighted automatically. This allows you to type the organism and quickly select it. Each class in the organism hierarchy displays a maximum of five child genera at a time. Each genus displays a maximum of five species. If there are more than five genera or species, select the ... (ellipsis) to display the next or previous five items. You can use the up and down arrows or the mouse scroll wheel to move through the hierarchy. Organism History: The organism history for the isolate is displayed to the right of the field and displays a list of all past organism abbreviations and the current organism abbreviations. Hovering over the links displays more information related to the organism history.
Media Observations	This section lists all the media and sub-media for the specific culture. Enter any media-specific observations for any media that the specific isolate is growing on. Adding an observation automatically associates the isolate with that media.
Isolate Components	This section lists isolate tests, isolate observations, automatic IDs, and susceptibility panels. Enter any results associated with the appropriate isolate component or add additional components.

Media Observations

This list displays all media and sub-media added to the order choice that qualify for media observations.

Media displayed in the list have the Microbiology Media Container setting selected and the Does not qualify for media observations setting cleared (AdminCenter > Order Choice Setup > Tube/Container Types).

All qualifying media display on all isolate sections on the work card, and isolates update their list of media observations to include new media added to the work card.

When the section contains a result and reaches a Complete Workup Status, the section automatically collapses with a brief excerpt.

Sample ID	Displays the sample ID.
Media	Displays the media abbreviation.
Description	Enter a description for the media observation. All descriptions in the Media Observations list will be different between each isolate section.
Notes	Select the comment bubble icon to open the Media Notes pop-up to add a comment or read an existing comment. The comment bubble is empty when the media has no comments, and it is filled with color when the media has comments.

Isolate Components

This list displays isolate tests, observations, auto IDs, and susceptibility panels.

The isolate observation test is a system-level test that appears in the AdminCenter > Order Choice Setup > Tests list automatically. If a test’s instrument, including isolate observation, has at least one matching testing facility and department, that test can be added to the Isolate Components list.
Isolate auto IDs and susceptibility panels include additional filter functionality, such as organisms, sample types, and order choices.
- If the test setup for these include sample types, they can only be added to the Isolate Components list when the order choice has a matching sample type.
- If the test setup for these include order choices, they can only be added to the Isolate Components list when the order choices match.
- If the test setup for these include organisms, they can only be added to the Isolate Components list when the current organism or its parent genus or parent class match.

When the section contains a result and reaches a Complete Workup Status, the section automatically collapses with a brief excerpt. It is a limited amount of the result value.

Isolate Components

Enter text or select in this search-as-you-type field to select isolate components to add to the table.

X

Select this button to delete isolate components.

Reportable

Select this toggle button to turn it on. It will appear blue and move to the right. This indicates that this isolate observation will appear on the report.

If this toggle button is gray and slid to the left, this isolate observation will not appear on the report.

Component

Displays the isolate component name.

Observation

If this field is blank, enter test results in the text box or choose a result from the choice list.

Susceptibility panels display a test name link. Select the link to access the Susceptibility Panel(s) tab. Susceptibility panels are not set to "Complete" until all child antibiotics are complete. Antibiotics can be completed on the Susceptibility Panel(s) tab.

Colored triangles in the top-right corner of this field denote changes:

Blue triangle: Results were edited.
Red triangle: Results were reported on a final report and then edited.

Select the + Reopen as Amendment button to correct final results. This button is available on the work card after a final report has been issued.

Media

Select or begin typing in the search-as-you-type field to search for and select a media to specify which plate the organism came from that you ran the test on.

Testing Instrument

This drop-down list displays all instruments linked to the test with a matching department.

The testing instrument must be set in order to specify which enterability to use on the Isolate Components list. Changing the testing instrument may change the enterability.

If only one instrument populates the Testing Instrument drop-down list, it is selected automatically and the enterability is displayed.

Once the testing instrument is saved, it cannot be changed.

Select the vertical ... button to toggle whether auto-approval for an instrument is enabled or disabled. The option appears in the format Enable XXX Auto-approval or Disable XXX Auto-approval. Select the button to enable/disable the instrument.

Rerun

Select to send another HL7 message for the selected test to be reran.

If an Auto ID has been rerun, its previous organism appears with a gray background indicating it has been rerun.

Status

Displays the status.

Saving tests with results sets this column to Complete. Once set to Complete, the test can no longer be set back to In Process, even if the results are cleared.

Modified

Displays the date/time the component was last modified.

Modified By

Displays the user's CLIA ID.

Culture Observation Section

Each culture observation section displays in the order it was added and cannot be rearranged.

When the section contains a result and reaches a Complete Workup Status, the section automatically collapses with a brief excerpt. It is a limited amount of the result value.

Reportable

Select this toggle button to turn it on. It will appear blue and move to the right. This indicates that this culture observation section will appear on the report.

If this toggle button is gray and slid to the left, this culture observation section will not appear on the report.

Culture test name

Displays the culture test name.

The culture observation test must be associated with the work card’s testing facility and department in order to be available on the work card. If none of the culture observation test’s instruments have a matching testing facility and department, the test cannot be added to the work card.

Preview text

Displays a preview of the current result that populates the Text field. The result cannot be edited until the section is expanded.

This is only visible when the culture observation section is collapsed. When you expand the section, this preview disappears and you can see all results in the Text field.

Workup Status

Displays the workup status: In Process, Complete, Secondary Review Required, Not Clinically Significant.

When a culture observation test is answered on the work card, its workup status will be marked as Complete.

Clearing test results does not revert the culture observation back to In Process.

Modified

Displays the modified date.

Modified By

Displays the CLIA ID of the person who modified the culture observation.

Abnormal

Select the flag icon to mark this culture observation as abnormal, normal, or critical. A menu will display with the following options:

Select the Flag To Normal option to set the flag to normal. The flag turns black.
Select the Flag To Abnormal option to set the flag to abnormal. The flag turns red.
Select the Flag To Critical option to set the flag to critical. The flag turns into a red exclamation point.

X

Select this button to delete newly added sections.

Previously saved sections cannot be removed unless results are empty.

Results fields

Enter your results in the available field(s). Your available fields depend on your enterability settings.

If a culture observation test’s instrument has a matching testing facility and department, that test’s instrument’s enterability is used on the work card.

The enterability for the culture observation is limited to Enterable as text/choice list only; however, this does allow for choice list options.

Select the bottom-right corner of the Text field to expand or collapse your text box to your desired size.

Test Section

Each testing section displays in the order it was added and cannot be rearranged.

Reportable

Select this toggle button to turn it on. It will appear blue and move to the right. This indicates that this test section will appear on the report.

If this toggle button is gray and slid to the left, this test section will not appear on the report.

Culture test name

Displays the culture test name.

Preview text

Displays a preview of the current result that populates the Text field. The result cannot be edited until the section is expanded.

This is only visible when the test section is collapsed. When you expand the section, this preview disappears and you can see all results in the Text field.

Workup Status

Displays the workup status: In Process, Complete, Secondary Review Required, Not Clinically Significant.

When a culture observation test is answered on the work card, its workup status will be marked as Complete.

Clearing test results does not revert the culture observation back to In Process.

Modified

Displays the modified date.

Modified By

Displays the CLIA ID of the person who modified the test.

Abnormal

Select the flag icon to mark this test as abnormal, normal, or critical. A menu will display with the following options:

Select the Flag To Normal option to set the flag to normal. The flag turns black.
Select the Flag To Abnormal option to set the flag to abnormal. The flag turns red.
Select the Flag To Critical option to set the flag to critical. The flag turns into a red exclamation point.

X

Select this button to delete newly added sections.

Previously saved sections cannot be removed.

Results fields

Enter your results in the available field(s). Your available fields depend on your enterability settings.

If a test’s instrument has a matching testing facility, that test’s instrument’s enterability is used on the work card.

Susceptibility Panels Tab

This tab provides the micro technician with an easy way to switch between the Work Card tab, containing the isolate workup information, and the susceptibility panels ordered on the isolates documented on the work card. The Susceptibilities tab allows the tech to compare antibiotic MIC results and interpretations isolate-to-isolate. Advanced cross-isolate filtering highlights those antibiotics that have been tested against multiple isolates and which have been found on the same culture. These antibiotics are highlighted in blue and are displayed at the top of the list to bring them front and center, drawing immediate attention for quick action to enhance patient care.

Susceptibility Panel Table

The table displays a list of all antibiotic tests associated with all susceptibility panel tests across all isolates on the work card. Each susceptibility panel test on the work card has its own column on the table.

Susceptibility Panel Table Header

Displays one column per Isolate. The column headers display the current Organism, Isolate Number, and a lock.

Select the lock to sort the selected column to the left and rearrange the Antibiotic, Susceptibility Panel, and Cross-Isolate rows. The Cross-Isolate row header is added when the same antibiotic appears on multiple Isolates.

Cross-Isolate rows appear blue and sort to the top of the Susceptibility Panel. When an antibiotic only appears on one Isolate, the Susceptibility Panel row header displays, and it displays after the Cross-Isolate rows if Cross-Isolate rows exist.

Lock icon

Each susceptibility panel defaults to being unlocked. Select this icon to move the susceptibility panel to the right of the Antibiotic column.

Locked susceptibility panels stack to the right of each other. The first panel locked is the first panel to the right of the Antibiotics column. All unlocked panels appear in isolate number order.

If more than one susceptibility panel test is on one isolate, they appear in the order they were added to the isolate.

The locked position is not saved.

The lock icon only appears if there is more than one susceptibility panel on the tab.

Susceptibility panel test name

Displays the susceptibility panel test name.

Review results checkbox

Hover over the checkbox to see "Review results."

Select this checkbox to mark this susceptibility panel as reviewed. When marked as reviewed, the susceptibility panel turns yellow until the change is saved.

All previously reviewed susceptibility panels have a blue background and do not include this checkbox.

Ellipsis button

Select this button to view several options:

Select the Select panel option to select the checkbox.
Select the Deselect panel option to clear the checkbox.
Select the Lock panel to left dock option to set the lock in the locked state and stack this column to the right of the Antibiotic column.
Select the Unlock panel from left dock option to set the lock in the unlocked state and return the column to its original position.
Select the View cascade rules option to expand the Cascade Rules vertical tab.

Instrument

Displays “Manual” until results are received from an instrument.

Organism abbreviation

Displays the organism abbreviation.

Isolate number

Displays the isolate number.

Susceptibility Panel Table Columns

Each susceptibility panel column displays the results and interpretations for each antibiotic on the susceptibility panel test.

All antibiotic tests have an enterability set to Enterable as numeric and choice list. If a choice list exists, only the choice list appears on the table for this antibiotic’s enterability. If no choice list exists, this antibiotic’s enterability is a numeric field.

Entering numeric results on the table automatically sets the interpretations based on the susceptibility panel test’s susceptible, intermediate, and resistant ranges for the antibiotic.

Antibiotic tests set up with a choice list do not set the interpretations.

If a susceptibility panel test does not include an antibiotic that another susceptibility panel test includes, it displays an empty row for that antibiotic.

If the instrument specified for the susceptibility panel test has not been set up for one of its antibiotic tests, that test displays an empty row.

Antibiotic

Displays the antibiotic name or abbreviation.

Blue corner arrows indicate modified antibiotic results whereas red corner arrows indicate corrected antibiotic results.

Antibiotic correction messages are added to Amendment reports when suppressing an entire Isolate or Susceptibility Panel.

Select

Select the checkbox to choose the appropriate antibiotic from the table.

Review

Select the checkbox to review results.

When results have not been viewed/reviewed/selected by a user, the Review checkbox appears next to the result on the panel.

The Review checkbox is automatically selected once the panel is viewed. Results that have not been viewed/reviewed/selected are not added to any reports and are not sent in HL7 results.

If a result has already been viewed/reviewed/selected, the checkbox does not appear in the Select column. Any changes made to the Susceptibility Panel Results redisplays the Review checkbox and automatically selects it.

Antibiotic results that are not reviewed/viewed/selected when a final report is created become cleared when the locked panel is viewed.

If this panel is viewed, the cleared checkboxes for the antibiotics remain cleared if user reopens for amendment. Since they were viewed as cleared, they remain cleared and should be manually selected, if needed.

However, if the Microbiology Work Card pop-up is reopened for amendment before viewing the panel, the cleared antibiotics become selected as normal.

Rerun (icon)

Select to send another HL7 message for the selected panel to be reran.

If a Susceptibility Panel is rerun, all of its previous antibiotics displays with a gray background indicating they have been rerun. Manually changing the antibiotic results turns the background yellow and allows the antibiotic to go on a report.

Supp.

Select this checkbox to the left of the Result column to disable the result’s enterability and suppress this result from the report.

Prefix

Select an option from this drop-down list: <, <=, >, or >=.

This option specifies the result symbol for numeric antibiotic results.

Antibiotics enterable as choice list only do not display this drop-down list. Instead, the prefix can be included in the choice list text.

Result

Enter the result in this field.

Supp.

Select this checkbox to the left of the Interpretation column to disable the Interpretation drop-down list and suppress the interpretation on the report.

Interp.

Select an option from this drop-down list: S (Susceptible), I (Intermediate), R (Resistant).

If you've defined custom antibiotic interpretations on the test's Microbiology Settings, those interpretation codes will also display in this drop-down list for selection.

After you select an interpretation option, you can hover your mouse pointer over the interpretation code to see the full description text.

Cross-Isolate

When cross-isolate antibiotics exist, this Cross-Isolate vertical header appears in blue on the left of the table. All cross-isolate antibiotics sort to the top of the list and have a blue row.

The Cross-Isolate header does not appear when there is only one susceptibility panel on the work card.

Antibiotics considered “cross-isolate” include any antibiotics on more than one susceptibility panel.

The more the antibiotic appears on the susceptibility panels, the higher the antibiotic will appear on the table.

Antibiotics that are on all susceptibility panels are sorted to the top of the list.
Antibiotics that are on only one susceptibility panel are sorted to the bottom.
Antibiotics that appear the same number of times across all susceptibility panels are sorted based on the order specified on the susceptibility panel test.

A left-positioned susceptibility panel’s sort order is applied over a right-positioned susceptibility panel’s sort order.

Left-docking a susceptibility panel with the lock button can change the sort order of the antibiotics.

Buttons

Next	Select Next to advance to the next selected culture when multiple cultures are requested in sequence.
Previous	Select Previous to return to the previously selected culture.
Save	Select this button to save the work card and remain on the opened culture.
Save and Close	Select this button to save the work card and return to the Work in Progress page.
Cancel	Select this button to return to the Work in Progress page. Any unsaved changes will be cancelled.