Effective May 16, 2022, Platelet Aggregation Studies will no longer flag abnormal in Epic for elevated aggregation for ADP, epinephrine, collagen, and arachidonic acid. These elevated result components are not clinically abnormal and may cause unnecessary concern if flagged as abnormal.
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General Information
Compliance & Safety, Education & Training, Microbiology
Update: Swabs for Cultures without a Source and Order
Effective May 9th, 2022, Spectrum Health Laboratory’s Microbiology Department will no longer be preemptively setting up cultures on swabs without a source and order, when received on Thursdays through Sundays and Holidays. Note: The specimen will still be held, but cultures will not be set up in anticipation of the order.
Compliance & Safety, Education & Training, General Information, Test Utilization
Specimen Collection and Test Updates – April 2022
The following information was updated in the Lab Catalog.
During the week of April 24-30, 2022, we celebrate our Laboratories! Medical Laboratory Professionals Week occurs each year in the last full week of April since 1975.
Spectrum Health Laboratories is a wonderful collection of over 1,000 employees. Our CAP accredited laboratories consist of Pathologists, PhD Clinical Advisors, Lab Scientists, Techs, and Support Teams (includes Phlebotomy, Central Processing, Assistants, Outreach, Administrative and Management).
We have 13 hospital labs supporting 16 counties in West Michigan plus Spectrum Health Reference Laboratory and Advanced Technology Laboratory.
We performed over 8.9 million tests in 2021 of which 526,000 were COVID specimens.
West Michigan influenza infections peaked mid-March 2022 and have been declining in the weeks that followed. Now with a low prevalence of circulating influenza, using the most sensitive diagnostic test is recommended in order to obtain accurate and actionable results. Influenza antigen testing (e.g. Sofia instrument) is no longer appropriate at this time and Influenza PCR testing should be ordered when clinically indicated.
| Low Influenza Prevalence |
High Influenza Prevalence |
|
| Recommended Order | Influenza PCR (LAB3255) | Influenza Rapid Antigen (LAB2111530) or Influenza PCR (LAB3255) |
More detailed information can be found as published by the CDC:
TEST INFORMATION
| Test name | Epic code | Interface EMR Code | CPT Code |
| Influenza PCR | LAB3255 | 11594 | 87502 |
| Influenza Rapid Antigen | LAB2111530 | 11208 | 87804 x4 |
General Information, Microbiology, Test Utilization
Discontinuation of Placenta Microbiology Cultures
As of April 12, 2022, Spectrum Health Laboratory will no longer add microbiology cultures to placental tissues received based on paper requisition forms.
Viral and bacterial cultures from placental tissue are rarely clinically beneficial and are no longer the gold standard diagnostic approach due to the relative insensitivity of culture methods.
If viral studies are desired (possible indications could include known CMV exposure with positive IgM or intrauterine fetal demise at < 28 weeks), then molecular testing is the recommended diagnostic approach. HSV and CMV PCR tests may be ordered in Epic.
• Herpes Simplex 1/2 Qualitative PCR, Tissue (LAB1230413)
• Cytomegalovirus (CMV) Qualitative PCR, Tissue (LAB1230291)
Bacterial cultures are challenging to interpret since they typically grow normal genital flora and histopathological analysis used to diagnose acute chorioamnionitis correlates poorly with growth from bacterial placenta cultures. If indicated, culture and PCR tests may be ordered in Epic.
• Metamycoplasma hominis, Molecular Detection, PCR, Varies (LAB848)
• Ureaplasma species, Molecular Detection, PCR, Varies (LAB848)
Placenta tissues sent to the lab in formalin are not acceptable for PCR or culture orders.
Education & Training, General Information, Test Utilization, Uncategorized
Specimen Collection and Test Updates – March 2022
The following information was updated in the Lab Catalog.
Folate (aka Folic Acid) is a test that requires the patient to be fasting in order for the results be accurate. Results are falsely elevated if the patient is not fasting. Spectrum Health Laboratories recently updated our system to hard stop a test from being collected if the patient is not fasting. Please remind your patients to fast 8 hours prior to having their blood drawn.
Spectrum Health Laboratories recommends:
• No caloric or caffeine intake for 8-12 hours prior to testing. Do not eat or drink anything except normal amounts of plain water. This also includes no smoking, chewing gum, candy, cough drops, etc.
• Take normal dosages of medications unless the provider has instructed otherwise.
Click here for a list of tests the require or recommend fasting.
Several tests performed by Spectrum Health Laboratories and our Reference Laboratories (Mayo Clinic Lab) require or recommend fasting.
Please check the Lab Catalog prior to sending your patient to a draw site or sending a patient’s specimens to the lab. Help remind patients to arrive fasting if fasting tests are required.
Spectrum Health Laboratories recommends:
No caloric or caffeine intake for 8-12 hours prior to testing. Do not eat or drink anything except normal amounts of plain water. This also includes no smoking, chewing gum, candy, cough drops, etc. Some tests also require no alcoholic beverages for 24-48 hours prior to testing.
Take normal dosages of medications, unless the provider has instructed otherwise.
Results may be inaccurate if fasting was not done prior to the test and may lead to improper diagnosis or treatment. Testing will need to be repeated if patient was not fasting properly before testing.