Requesting
Tests
The
laboratory provides blood collection services for all
areas of the hospital. Orders for laboratory testing
must be received by an electronic or written request.
Electronic requests should be placed in the
laboratory information system (Sunquest). If
the system cannot be accessed, downtime procedures
must be followed. Requests for outpatient testing can
be done by written requisition from the physician,
faxed order from the physicians office or entered
directly into the Sunquest computer system. The
ordering physician’s office must provide the
appropriate ICD9 codes for all out patient
testing. If the ICD9 code is not provided,
testing can not be performed.
Collection Schedule and
Procedures
Routine A.M. collections start
at approximately 4:00 a.m. beginning with the
Neonatal and Pediatric Intensive Care units.
All orders scheduled for this time must be placed in
the computer prior to 3:30 a.m. in order to qualify
for collection before 7:30 a.m. Collection
reports are called starting at 3:30 a.m. through 7:30a.m.
From 7:30a.m. to 2:30a.m. the next morning,
collection reports are called at 1 hour intervals on
the half hour. Any orders placed after the half-hour
will not appear until the next hour’s collection
report is called. If a request is needed before that
time, the laboratory must be notified by phone after
the request is placed in the computer system. When
phoning the laboratory with collection requests,
please provide the patient’s full name and
medical record number.
All
inpatients must be wearing a patient identification
name band. The patient’s full name and medical
record number must be legible. The name band
for the E.D. population will have the patient’s
full name, account number and date. If the
patient is not wearing a name band or the
information is not legible, laboratory personnel will
not collect specimens until an accurate name band is
placed on the patient.
All
outpatients are identified by the phlebotomist
calling the patient to the drawing rooms using the
first and last name of the
patient and the patient's date of birth.
Laboratory
personnel are not permitted to collect blood
specimens from indwelling lines on patients located
on nursing units.
Priority
Procedure
The laboratory recognizes (6) six
prioritizations for specimen collection. The assignment
of testing priority should be made by the ordering
physician. The following is to serve as guidelines when
making this determination.
- STAT - An order for a
laboratory test whose result is necessary for the
immediate management of a life-threatening
situation. Phlebotomy response time for
collection should be no more than 10 minutes. Traumas
and codes will be
responded to immediately. All STAT requests
must be phoned to the laboratory.
- ASAP - An order for a
laboratory test whose result is needed as soon as
possible for the management of a serious,
but not life threatening situation. Phlebotomy
response time should be within (1) one hour of
the time the order is placed in the computer
system. The laboratory should be notified by
phone of ASAP requests. Requests for "now"
will be treated the same as ASAP.
- E.D. ASAP - An order
for a laboratory test whose timely evaluation is
necessary to manage the flow of patients in the
Emergency Department. Phlebotomy response time
should be no more than 10 minutes.
- Timed - An order for a
laboratory test whose collection and evaluation
at a specified time is necessary to determine the
patient’s course of therapy. Most timed
specimens will be collected within (15) fifteen
minutes of the time the specimen is ordered. Peak
medication levels and Q (1) one-hour orders
will be collected within (5) five minutes of the
time ordered.
- Routine and A.M. - An
order for a laboratory test which is needed for
the evaluation and management of the patients
ongoing treatment. A.M. requests will be
collected before 12:00p.m. Routine
requests will be collected the same day as
ordered.
Requests
that are not truly STAT, ASAP or TIMED should not be
ordered as such. Doing so could result in
delaying the response time to those patients that are
in need of immediate service.
Scheduled Testing
To ensure
adequate staffing and to accommodate the requirements
of reference laboratories, it is necessary to
schedule certain testing. To schedule the following
tests please call the Clinical Laboratory at (937)
641-5100.
Sweat
Chloride Testing - Available Tuesday through
Friday only.
- Outpatient: Requires a
minimum of 24-hour notice. Varied
appointments are available.
- Inpatient: Every effort
will be made to complete the test the day
after it is ordered. This is dependent on the
volume of previously scheduled tests.
Platelet
Aggregation - Testing must be scheduled through
the Laboratory Hematology Department.
Availability of testing is dependent on reference
laboratory specifications. Testing is performed on
Tuesdays and Thursdays only.
Neutrophil
Function Test and Platelet Antibody/Phenotype
Testing - Testing must be scheduled through the
Transfusion Service department. Availability of
testing is dependent on the referral laboratory
specifications.
NBT (Nitroblue
Tetrazolium) - Testing must be scheduled through the
Transfusion Service.
Nurse To
Collect Specimens
Orders for
specimens collected by nursing personnel should be
placed into the SunQuest system only after the
specimen has been obtained. This includes all
blood, urine, stool and other body fluid specimens.
The priority code “NC” (nurse
collected) should be placed in the SunQuest system
when the order is created.
An
appropriate label must be
attached to all nurse-collected specimens. The
label must include the
following:
- Patient name and medical
record number,
- SQ accession number,
- date and time of
collection,
- specimen source and
- Tech code of the person
collecting the specimen.
Labeled
specimens should be placed in a biohazard transport
bag. If multiple specimens are sent to the
laboratory in the same biohazard bag, each specimen
must be labeled.
Testing
Priorities in Emergency Situations
In response
to emergencies, patient census, variation in
workloads, and other unanticipated circumstances, it
may be necessary to prioritize specimen collection
and testing. Emergency staffing in these situations
will be determined at the discretion of Laboratory
management. Emergency examples: blizzards, external
disasters. The following guidelines will be utilized
for prioritization.
Patient care
units and priority codes will used to determine order
of collection/testing. Units will be serviced in the
following order:
- ICU/NICU
- ED
- Hematology/Oncology
- 3-4-floors
- OPS
- Outpatients/Clinics/Referrals
Limited
test menus may be instituted as follows:
- Chemistry
- Lytes
- BUN
- Creatinine
- Glucose
- Basic Metabolic
- Hematology
- Microbiology/Virology
- STAT gram stain
- Accession and
plating of cultures
- Pathology
- Transfusion Services
- STAT Crossmatch
- STAT RBCs
- STAT Platelets
- STAT FFP
- STAT Cryo
- Medical Genetics
- Staff may be
called in at discretion of laboratory
management.
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