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General Information

Compliance & Safety, Education & Training, General Information

Leaky Specimen Containers

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.

September 18, 2020 by
Hemostasis/Coagulation, Test Spotlight

New Reference Range: APTT and APTT Assay

Beginning September 8, at approximately 2PM, Spectrum Health Laboratories will go live with their new lot of APTT reagent.  This lot change triggered a new therapeutic curve resulting in new heparin nomograms for the system.  The standard heparin therapeutic range will change from the current 45-65 seconds to a new range of 37-52 seconds based off the new curve.  Reference ranges for the APTT assay will also be updated.  Grand Rapids APTT reference range will be 21-27 seconds and the Regional Hospitals will be 21-31 seconds.

APTT specimens that are unable to reach an endpoint (no clot is detected), will reflex to the Unfractionated Heparin (UFH) (Test Code LAB3389) anti-Xa assay.  To accommodate this change, UFH values have been added to heparin nomograms. The UFH anti-Xa assay is currently only performed in the Grand Rapids labs and valid only for unfractionated heparin.  Any questions concerning these changes may be directed to the Spectrum Health Regional Laboratory Coagulation department at 616-267-2740.

September 8, 2020 by
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:

HSV PCR Epic Codes

HSV PCR Interface Codes

Continue Reading

June 12, 2020 by
General Information, Hemostasis/Coagulation

Test Update: D-Dimer

Effective April 30, 2020, Spectrum Health Laboratories will no longer be performing the D-Dimer Semi-Quantitative assay. D-Dimer (quantitative) will be the only orderable for the D-Dimer assay. This D-Dimer will be reportable up to 35,000 ng/mL FEU. The cut-off value used in the diagnosis of venous thromboembolism (VTE), deep vein thrombosis (DVT), or pulmonary embolism (PE) remains at 500 ng/mL FEU. It is important to note inpatients can be (falsely) elevated in many underlying non-thrombotic conditions common in hospitalized patients.

Questions and inquiries regarding this change may be sent to the Coagulation Department using the “Contact Us” link above.

 

TEST INFORMATION

D-Dimer – [Epic Code: LAB313, Interface Code: 10123, CPT 85379]

Discontinued: D-Dimer Semiquantitative for DIC [Epic Code: LAB760, Interface Code: 10122, CPT: 85378]

May 1, 2020 by
General Information, Immunochemistry

Immunochemistry ANA (Antinuclear Antibodies) Testing Name Update

Effective April 22nd, 2020, the following ANA (Antinuclear Antibodies) Tests’ name will be updated.  The change in naming convention comes in hopes of enhancing proper test utilization.  This update includes only the name change with no changes in laboratory testing workflow.

Old Test Name New Test Name Test Code Clinical Utility
ANA (Antinuclear Antibodies) Screen, Double Reflex to ANA IFA Hep2 Titer and Pattern, and if positive to ANA antibodies ANA screen LAB1230491 Preferred initial ANA screen for autoimmune connective tissue diseases.
ANA (Antinuclear Antibodies), Hep2 Substrate IFA with reflex to Titer and Pattern if positive IFA ANA (Rheumatology)

 

 LAB3540 Preferred confirmatory ANA test for autoimmune connective tissue diseases.  With ordering recommendations for rheumatology only.
April 22, 2020 by
Advanced Technology Laboratory, Cytogenetics, General Information, Referral/Sendouts

Test Update: Chromosome Analysis Breakage Study

Effective immediately, due to low test utilization and the high cost of maintaining proficiency, the Chromosome Analysis Breakage Study will no longer be offered by the Spectrum Health Cytogenetics Department.

If need arises for this test, please place an order for a Reference Miscellaneous (EPIC# LAB848) and enter “Test 140 DEB Breakage Study to Integrated Genetics” in the comments.  The testing will be sent out through Spectrum Health Referrals Department to Integrated Genetics. Continue Reading

March 19, 2020 by
General Information, Toxicology

Test Update: Cystatin C

Effective Wednesday, December 18, 2019, Cystatin C will change from a sendout reference test performed by Mayo Clinic Laboratories to an in-house test performed by Spectrum Health Regional Laboratory. This test will be performed in the Toxicology Laboratory and will include a new reference range (please see link in Test Information below).

Questions may be directed to Toxicology via the “contact us” link above.

TEST INFORMATION

Cystatin C – Epic Code #LAB3226, Interface #11631, CPT #82610

December 17, 2019 by
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. Continue Reading

December 9, 2019 by