Collection Guidelines

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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 appropriateICD9 codes for all out patient testing. If the ICD9 code is not provided, testing can not be performed.

Collection Schedule and Procedures

Routine morning 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 specimens
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:
 

  1. ICU/NICU
  2. ED
  3. Hematology/Oncology
  4. 3-4-floors
  5. OPS
  6. Outpatients/Clinics/Referrals
Limited test menus may be instituted as follows:
  • Chemistry
    • Lytes
    • BUN
    • Creatinine
    • Glucose
    • Basic Metabolic
  • Hematology
    • CBC
    • PT, PTT
    • UA
    • STAT UCG
  • Microbiology/Virology
    • STAT gram stain
    • Accession and plating of cultures
  • Pathology
    • Frozen section
  •  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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