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.
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 following information was updated in the Spectrum Health Laboratory Catalog.
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 |
Effective September 15, 2021, Spectrum Health’s Epic will contain new ask-at-order questions to help improve clinical decision support and appropriate utilization of stool ova and parasite (O&P) testing. O&P testing may be used to diagnose several parasitic infections, though the staining of stool smears and their microscopic review is very labor intensive for laboratories. Historically, O&P testing has been widely ordered for patients with diarrhea, however, there are now other testing options able to detect the most common pathogens associated with community-acquired diarrhea. While Enteric Pathogens PCR and Giardia/Cryptosporidium testing is more appropriate for the identification of common bacterial/viral and parasitic pathogens, respectively, O&P testing should be reserved for patients with specific exposure or immune status criteria.
The Pharmacy and Infectious Disease Stewardship Committee has endorsed the following order criteria for O&P testing. If any of these criteria are met, then then order can be placed.
♦ Past foreign residence or recent foreign travel followed by at least 2 weeks of diarrhea.
♦ Immunocompromised status.
♦ Unexplained microcytic anemia or peripheral eosinophilia.
♦ Unique exposure (daycare, MSM, waterborne outbreak, etc.)
Note: If no criteria are met, cancel the order and consider Giardia/Cryptosporidium Screen (LAB258) or Enteric Pathogens PCR testing (LAB3618).
Please direct question to the Contact Us link above.
TEST INFORMATION
Ova and Parasites, Complete – Epic: #LAB9550, Interface Code #50033, CPT #87328, 87329, 87177, 87209
Enteric Pathogens by PCR – Epic #LAB3618, Interface Code #55078, CPT #87506
Giardia/Cryptosporidium Screen – Epic #LAB258, Interface Code #50025, CPT #87329, 87328
Due to a shortage of testing supplies, Spectrum Health Reference Laboratory (SHRL, Grand Rapids) will be limiting testing methods that utilize dry swabs.
For COVID tests collected in the ambulatory (outpatient) setting, a COVID PCR (LAB1230607) should be ordered and collected on a swab placed in liquid transport media.
The following information was updated in the Spectrum Health Laboratory Catalog.
September 1, 2021
There continues to be a global shortage of sodium citrate (“blue top”) blood collection tubes used for coagulation testing as a result of unprecedented demand, in part due to COVID-19 surges, vaccine and treatment development. This was anticipated to last through August 2021, but now, due to continued unprecedented demands, there is no end date in sight. Please take this into consideration when ordering coagulation testing (i.e. Protime, aPTT, Fibrinogen, D-dimer, Lupus Screens, Factor Assays, Mixing Studies, von Willebrand testing, etc.).
Advanced Technology Laboratory, Education & Training, General Information, Immunochemistry, Microbiology, Test Utilization
Reminder: COVID Orders and Scheduling
Effective July 1, 2021, Spectrum Health no longer offers patient self-screening through MyChart or telephonic COVID screening appointments to patients. Patients will need an order from their provider prior to scheduling a COVID-19 test. Patients should be symptomatic or have a recent exposure, all other visit types should go through Michigan.gov (travel, athletic, or return to work or school, etc.)
If the patient does not have a provider, they may utilize the SHNow On Demand Visit via MyChart or find testing site options on Michigan.gov.
Once the order is placed, patients may schedule an appointment through MyChart or calling the Covid Hotline (for paper orders).
For more information:
Education & Training, General Information, Immunochemistry, Main lab, Toxicology
Specimen Collection Updates – July 2021
The following information was updated in the Spectrum Health Laboratory Catalog.