Effective August 8th, Spectrum Health Laboratory will ask all patients to indicate how long they have been fasting (regardless of whether they were fasting or not) when they present for Lipid testing. In light of recent discussions in the literature that debate the utility of fasting prior to lipid testing; we recognize that some clinicians may now not require their patients to be fasting and hope that reporting out length of fasting (hours) with each lipid result will allow all clinicians to better interpret their patient’s lipid results. If fasting is desired; Spectrum Health Laboratory recommends no caloric or caffeine intake for at least 8 hours. The patient is not to drink (other than water), eat, smoke, chew gum, candy, cough drops, etc. for at least 8 hours prior to their blood tests. Prescribed medications are allowed.
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Effective October 15th, 2017, all specimens collected for Blood Bank must have two signatures on the specimen written in ink that is resistant to smearing after a patient has been identified according to the Patient Identification Policy.
One of the two collectors/witnesses must be a lab staff member, unless specimen is collected in Spectrum Health Surgery, Infusion Center, Special Care Hospital, Cardiac Cath Lab Procedure Room, or a cord blood in Labor and Delivery. For Outpatients, the patient may serve as the witness and initial the tube label.
On June 27th, the name of the current order “Respiratory (non-sputum) Culture without Gram stain” will change to “Throat Culture Comprehensive.” All other specimen collection details and culture workup will remain the same. Given the fact that there are currently several similarly named tests, this change is being made to reduce confusion regarding test selection and to clarify acceptable specimen types.
Immunochemistry, Test Utilization
Utility of specific IgE (sIgE) testing to foods and food allergen components
The diagnostic evaluation of allergic disease occurs in the context of a patient’s complete clinical presentation. Important factors include, age, clinical signs and symptoms, relevant allergen exposures, and the performance characteristics (sensitivity, specificity, and predictive values) of the allergy tests themselves. Allergy tests yield information about sensitization to allergens, which is not always equivalent to allergic hypersensitivity (i.e., sensitivity); thus, interpretation in the context of clinical history is essential for accurate diagnosis.
Safety of our patient and quality of care are of utmost importance. For this reason we require specimens sent to the Spectrum Health Cytology Laboratory be labeled with at least two patient identifiers, (i.e., patient legal name, birth date and MRN.) We will no longer return to the collection site, unlabeled, mislabeled specimens lacking two patient identifiers or specimen containers with multiple different patient labels. These specimens will be discarded and repeat collection will be necessary.
Procedures to verify correct labeling of patient specimens at the time of collection are recommended. Specimen containers should not be pre-labeled. Variation of the “time-out” procedure used in the hospital and surgical center setting is an excellent way of confirming that the specimen is correctly labeled. This can easily be achieved by having the patient verify his or her name and birth date, by reading the label placed on the specimen container at the time the specimen is collected. This “time out” should occur before the specimen leaves the examination or treatment room.
It is our mission to provide the best and safest care we can to our patients. We know that physicians and other practitioners are required to see patients more efficiently and at times with less than adequate time allowed. Following a “time out” procedure and not pre-labeling specimen containers will prevent errors that may lead to diagnoses being assigned to wrong patients, hence, unnecessary procedures and lack of follow-up for the appropriate patient.
In anticipation of “Flu season”, it is valuable to revisit available testing methods for influenza and discuss when each test should be ordered. Though generally a self-limited infection for otherwise healthy individuals, influenza can be particularly severe for high-risk populations including infants, elderly, pregnant women, and immunocompromised hosts. Influenza incidence is largely seasonal with the majority of cases occurring between December and April of each year.
Spectrum Health Laboratory strives to ensure that all marketing of laboratory services is honest, straightforward, fully informative and non-deceptive. The Spectrum Health’s Code of Conduct dictates that quality laboratory practices are followed and laboratory marketing activities must meet all government laws and regulations.
As of January 12, 2016, pathologist review of peripheral blood smear ordered without accompanying CBC with differential will reflex to adding on a CBC and/or differential in the laboratory. Blood specimens that do not have a slide prepared need to be less than 6 hours old for a pathologist review to be added on.
This is due to the fact that older blood does not smear well and morphology is compromised, especially red cell morphology. This allows for a complete documentation of the patient’s CBC and differential findings in the electronic medical record and standardizes our process among the regional hospitals.
Any questions concerning Peripheral Blood Smear reflexes should be directed to Dr. Jennifer Stumph, Director of Hematology.
As of March 1, 2016, Spectrum Health Laboratory, Grand Rapids, will no longer draw or send a courier for outpatient Ammonia testing (#8074). If outpatient Ammonia testing is needed, the patient must be collected at the 35 Michigan Draw Site. If outpatient Ammonia testing is needed and the patient cannot be drawn at the 35 Michigan Draw Site, approval must be obtained from Dr. David Alter or the Clinical Pathologist on-call, prior to ordering the test.
There will be no changes to inpatient collection. Note: Inpatients are patients who have been admitted to a hospital in the Medical Center (HDVCH, Butterworth, and Meijer Heart Center) or Blodgett Hospital.
Any questions concerning these changes may be directed to the Pathology Department using the Contact Us link above.