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Chemistry, General Information, Immunochemistry

Test Update: Rubella IgG Antibody Testing

UPDATE 1/7/2022: This has been delayed until February 2022

On January 24th, 2022 Rubella Antibody, IgG, Serum (LAB496) and Rubella IgG Antibody Quantitative (LAB3544) will be combined as LAB496 and moved to the Immunochemistry laboratory due to reagent constrains with the current vendor.

Testing will be available Monday-Friday with a turn-around-time of 1-3 days. Results will be reported qualitatively as Immune or Not Immune.  If quantitative results are needed, please fax Immunochemistry at 616-267-2771 or call 616-267-2770. Continue Reading

General Information, Hematology

Test Update: Cell Count with Differential, Body Fluid

Beginning Tuesday, January 4, 2022, Spectrum Health Laboratories will include an automated neutrophil (PMN) count on Cell Count with Differential, Body Fluid (LAB210) orders for peritoneal body fluids.   This component will be displayed in Epic as an absolute PMN count, body fluid.

• The absolute PMN count in the peritoneal fluid is calculated by multiplying the total nucleated cell count by the percentage of PMNs in the differential.

• This calculation aids in the diagnosis of spontaneous bacterial peritonitis (SBP).

• The diagnosis of bacterial peritonitis is established by a positive peritoneal fluid bacterial culture and an elevated peritoneal fluid absolute PMN count (≥250 cells/uL).

• Epic will automatically calculate the absolute PMN count in peritoneal body fluids based on the manual differential data.

• This component ONLY calculates for Cell Count with Differentials (LAB210) on PERITONEAL BODY FLUIDS Continue Reading

Chemistry, Immunochemistry, Main lab

Supply Update: Mono Kit Replacement

Spectrum Health and Spectrum Health Medical Group (SHMG) Supply Chain Update:

AbbottTM has discontinued their Mono Test Kit. The identified replacement product is from Cardinal HealthTM. This product is already in use in some spaces throughout Spectrum Health. Please see ITM number for the replacement product below and update your ordering processes accordingly.

Discontinued Product: ITM-1002651 Kit Test Mono CLIA Waived (Abbott 92407)

Replacement Product: ITM-1049839 Test Mono II Rapid (Cardinal Health CH1145) Continue Reading

Microbiology, Test Spotlight

Influenza Testing Recommendation Update

The mitigation strategies enacted during the COVID-19 pandemic to reduce the spread of this virus led to essentially non-existent influenza prevalence during the 2020-2021 winter season. However, influenza has now returned and case numbers are increasing throughout West Michigan.

Influenza prevalence guides the most appropriate testing approach and sufficient prevalence has now been reached for influenza rapid antigen testing (e.g. Sofia instrument) to have improved performance. The use of rapid antigen testing as a screening method during high prevalence reduces both the cost to the patient and turn-around-time as compared to lab-based molecular methods. Rapid antigen tests generally have high analytical specificity, but lack the sensitivity of nucleic acid amplification methods (e.g. PCR). For this reason, PCR testing is still recommended for hospitalized patients and for outpatients with a negative antigen result if influenza is still suspected and if the result will impact clinical decision making. Continue Reading

General Information, Hemostasis/Coagulation

Test Update: Prothrombin Time (Protime/PT)

Effective December 6, 2021, Spectrum Health Reference Laboratory (SHRL) Coagulation department will go live with a new lot of Prothrombin Time (Protime/PT) reagents. The reference range for the PT will be adjusted to reflect this reagent lot change and align with our Regional Laboratories. The new reference range will be 9.5 – 12.0 seconds. There will be no change to the INR ranges.

Test Current Reference Range New Reference Range
Prothrombin Time (PT) 9.7 – 12.6 seconds 9.5 – 12.0 seconds

Continue Reading

Chemistry, General Information

Test Update: Thyroglobulin Antibody

Effective immediately, Thyroglobulin Antibody will be performed at Spectrum Health Reference Laboratory (SHRL, Grand Rapids, MI) and will no longer be a sendout to Mayo Clinical Laboratories. Collection instructions and other information may have changed, please visit the lab catalog for more information.

Thyroglobulin Tumor Marker will continue to be a sendout. If a Thyroglobulin Antibody is ordered with a Thyroglobulin Tumor Marker, then the Thyroglobulin Antibody will automatically be canceled as Mayo Clinic Laboratories will perform the Thyroglobulin Antibody as well as the Tumor Marker.

For questions and inquiries, please use the “Contact Us” link above.

 

TEST INFORMATION

New test: Thyroglobulin Antibody [LAB1230840] 

Former test: Thyroglobulin Antibody, Serum [LAB1230457]

Mentioned Test: Thyroglobulin, Tumor Marker, Serum [LAB864]

Advanced Technology Laboratory, General Information, Main lab, Test Utilization

Outpatient Respiratory Viral Testing

Spectrum Health Lab has noticed an increase in outpatient orders for Respiratory Pathogens by Film Array [LAB3359].  This may be due to a shortage of supplies for some Point of Care (POC) testing platforms.  Film Array is typically used for emergency and high acuity patients and therefore has a high cost that may not be covered by most patients’ insurance.  To lesson out of pocket costs for your patients, please order the below for RSV, COVID, or Flu testing. Continue Reading

Chemistry, General Information, Test Spotlight

Sysmex Urinalysis Series Go Live

In continued pursuit of alignment, regional market hospital labs have adopted the Sysmex-Siemens automated urinalysis system. This advanced platform elevates analytical control and automation, eliminates manual steps previously required from former systems, and offers the latest in digital particle imagery. Combined with exceptional service engineer support, this system represents a notable step forward in urinalysis performance. Continue Reading

Hemostasis/Coagulation

aPTT Range Update for Heparin Nomograms

On Tuesday October 26, 2021, a new lot of aPTT reagent will go live for the Spectrum Health Laboratory Information System starting at 10:00 AM.

• The aPTT therapeutic range for ADULT patients on continuous heparin infusions will be updated to reflect the new reagents.  The therapeutic range, for most indications, will be changed from 37 to 52 seconds to a new range of 42 to 57 seconds. UFH anti-Xa therapeutic ranges will remain unchanged (0.3 to 0.7 units/mL).  All ADULT nomograms will be adjusted to reflect the new therapeutic ranges.

• For PEDIATRIC  patients, aPTT nomograms will no longer be used in this population. Only the unfractionated heparin (UFH) anti-Xa nomograms will remain for PEDIATRIC patients, again with no changes made to their current UFH anti-Xa nomograms.

The aPTT reference range remains unchanged. Continue Reading

Main lab, Microbiology, Test Utilization

Influenza Testing Reminder

The mitigation strategies enacted during the COVID-19 pandemic to reduce the spread of this virus have also impacted the transmission of other respiratory viruses. Influenza is typically prevalent during the winter months (December through March), however, influenza cases were essentially non-existent during the 2020-2021 season and influenza is not currently circulating in our community.

In the absence of circulating influenza activity, it is recommended to use the most sensitive diagnostic test in order to obtain accurate and actionable results. Influenza antigen testing (e.g. Sofia instrument) is not appropriate at this time. More detailed information can be found as published by the CDC: Algorithm to assist in the interpretation of influenza testing results and clinical decision-making during periods when influenza viruses are NOT circulating in the community

Low Influenza
prevalence
High influenza
prevalence
Recommended order Influenza PCR (LAB3255) Influenza Rapid Antigen (LAB2111530)
or
Influenza PCR (LAB3255)

TEST INFORMATION

Test name Epic code Interface EMR Code CPT Code
 Influenza PCR  LAB3255 11594 87502
 Influenza Rapid Antigen  LAB2111530 11208 87804 x4