The following information was updated in the Spectrum Health Laboratory Catalog.
Education & Training, General Information, Immunochemistry, Main lab, Toxicology
Browsing Category
Education & Training
Spectrum Health Regional Laboratory is committed to the safety of our patients, and the accuracy and quality of the testing we provide. In order to do that, we need your help to ensure that patient specimens adhere to our internal policies and quality checks.
THE DETAILS
To that end, we are asking for your help in the process of labeling specimens before they are sent to our laboratory. It is our policy at Spectrum Health Regional Laboratory that the routine labeling of laboratory specimens MUST INCLUDE FULL LEGAL NAME and DATE OF BIRTH, and if possible, additional identifiers such as medical record number, specimen number, etc. If this information is missing, incomplete or incorrect, the specimen is considered a mislabeled specimen, and will be canceled upon receipt. (The only exception to this is “precious specimens,” ex. cerebrospinal fluid or surgical specimens, which can sometimes be given an opportunity for relabeling after correct identification).
If a patient specimen is labeled with a NICKNAME instead of the FULL LEGAL NAME, this specimen would be considered a mislabeled specimen and have to follow the above process, which will delay patient care and/or employee eligibility to work.
EXAMPLES
| “Alli” Smith Unacceptable | Allison Lynn Smith Acceptable |
| “Johnny” D Parker Unacceptable | John David Parker Acceptable |
| “Dan” Stevens Unacceptable | Daniel Stevens III Acceptable |
WHAT WE NEED YOU TO DO
Please review this notice with your collecting/labeling staff as soon as possible to ensure proper labeling practices. Though not new, this policy has been reviewed by our team members in central specimen processing, and will be strictly adhered to going forward. Please feel free to forward this notice to anyone involved in the collecting or labeling of laboratory specimens that are sent to Spectrum Health.
Thank you for continuing to trust Spectrum Health Regional Laboratory for your testing needs, and thank you for partnership in attention and commitment to quality and safety!
For questions or concerns regarding this policy, please use the “Contact Us” link above.
RESOURCES
Spectrum Health Labeling Guide
The Joint Commission 2021 Patient Safety Goals
Clinical Laboratory Standards Institute
Spectrum Health Laboratory Policy #9955
Self-collected vaginal swabs may be used for testing as opposed to provider-collected swabs. Self-collected swabs are supported by current clinical guidelines as recent studies have shown their equivalence, if not superiority, in quality and their association with increased patient satisfaction.
NOTE: Self-collection must still take place in a healthcare setting and is not approved for at-home collection.
Effective immediately there has been an update to scheduling breath testing. Both the Bacterial Overgrowth and Lactose Intolerance breath tests must be scheduled through Epic or via Spectrum Health MyChart app.
Leaky specimen containers may cause compromised test results and it is also a hazard to lab couriers and registration personnel. Leaky specimen containers are not acceptable and may be rejected.
In order to prevent leaky containers, please be sure to:
-
Pay close attention to the lid, making sure the screw-cap lids are fastened evenly and securely, with the threads aligned. If a patient has challenges with tightening the lid, please have them notify lab staff when they return to drop off their container.
-
Containers should be upright at all times, with lid on the top during transport. If container is placed in a biohazard bag, please maintain in the upright position by gripping the cup or the handle and not by the top of the bag.
The Laboratory provides a brochure “Laboratory Specimen Home Collection” for patient collection instructions. Internal offices (i.e. SHMG) may order these from Document Services using the order number X17776 (X19611 for the Spanish version). External offices may order these from Laboratory Courier Services using the Supply Order Form.
Advanced Technology Laboratory, Compliance & Safety, Education & Training, General Information, Main lab, Microbiology, Molecular Diagnostics, Test Utilization
REMINDER: Herpes Simplex Virus (HSV) PCR and HSV Culture Orders
As of January 13, 2020, the Spectrum Health Microbiology Laboratory will switch any viral culture orders placed on cutaneous or mucocutaneous lesion specimens to molecular PCR testing as the preferred diagnostic method.
Please refer to these documents for specimen collection information and appropriate ordering codes:
Compliance & Safety, Education & Training, Microbiology, Molecular Diagnostics, Referral/Sendouts, Test Utilization
Herpes Simplex Virus (HSV) PCR Testing Update
Click on images for printable pdf version.
Education & Training, General Information, Test Utilization
Appropriate Thyroid Peroxidase Antibody Ordering
The most conclusive evidence for using thyroid peroxidase antibody (TPO) is predictive in nature when evaluating possible subclinical hypothyroidism. If this test is positive, hypothyroidism occurs at a rate of 4.3% per year versus 2.6% per year when the antibody is negative. While this scenario does not cover all clinical indications for ordering TPO, there is no definitive evidence that repeat TPO testing provides additional information.1
Based on this information the ordering of TPO within Spectrum Health is being modified. If the test is ordered more than once on a patient, a screen will appear in EPIC indicating the following: “This test should typically only be resulted once per lifetime. The duplicate checking indicates that this patient has already had this testing performed. Please see chart review for results.” This is not a “hard stop” but providers will need to click “Continue” to proceed with the order.
Chemistry, Compliance & Safety, Education & Training, General Information, Referral/Sendouts
Preservative For 24 Hour Urine Collections
In both the inpatient and outpatient settings, the laboratory has supplied 24 hour urine containers with preservative such as acetic acid, sodium hydroxide, and boric acid. Upon review of specimen stability requirements, it has been determined that a preservative is not needed prior to collection of most 24 hour urine tests as long as the 24 hour container is kept refrigerated or on ice during the collection period.
Blood Bank, Compliance & Safety, Education & Training, Test Utilization
Reminder: Choosing Wisely Recommendations for Blood Products
As part of the Choosing Wisely campaign, the American Association of Blood Banks (AABB) released five recommendations for transfusions: