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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Pediatrics
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.
Advanced Technology Laboratory, Cytogenetics
Discontinuation of Low-Volume and Individual Fluorescence in situ Hybridization (FISH) Probes
Effective immediately, due to low test utilization and the high cost of maintaining proficiency, the following FISH tests will no longer be offered:
• Prader-Willi/Angelman (15q11-q13) by FISH
Recommended test is Angelman/Prader-Willi mPCR
• Smith Magenis (17p11) by FISH
If need arises for this test, please place an order for a Send out Genetics Miscellaneous and enter requested test in the comments. The testing will be sent out through Spectrum Health.
Any questions about referral testing may be directed to the Referral Department. Any questions or concerns regarding these changes may be directed to Dr. Salah Ebrahim in the Cytogenetics Laboratory.
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 |
Effective February 10, 2022, Spectrum Health Regional Laboratory will offer Varicella Zoster Virus (VZV) PCR testing on swab specimens collected from cutaneous and mucocutaneous lesions (e.g. anorectal, genital, nasal, ocular, oral, skin, urethral).
PCR is the test method of choice for the diagnosis of VZV infection due to its enhanced sensitivity and speed as compared to traditional viral cultures, which should no longer be used for VZV detection.
Compliance & Safety, Education & Training, General Information
Appropriate Labeling for Shared Specimen – COVID-19 & FLU AB PCR
To provide efficient and safe testing for patient specimens, please review the following information when sending COVID-19 PCR and Influenza A/B PCR testing in the same encounter to Spectrum Health Laboratories.
Two labels will be available for this testing. Labels must be fixed so that
• The test and patient information are shown
• The barcode may be easily scanned by Lab staff or instruments
When this is not done correctly, Laboratory staff removes the labels and re-fixes or re-prints it, which obstructs workflow, causes delays, and could result in patient information being peeled off. With patient safety and efficient testing being two of the Lab’s top priorities, it is vital that specimens arrive in such a way as to best accomplish both.
Effective February 1, 2022, the Cystic Fibrosis (CF) Carrier Screen test, which includes the 23 common variants for cystic fibrosis recommended by ACOG/ACMG, will be discontinued as an orderable test at Spectrum Health Laboratory.
The recommended replacement test is the Cystic Fibrosis Mutation Analysis (Test ID: CFP) offered by Mayo Clinic Laboratories, a 106-variant panel which includes the recommended 23 common variants.
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)
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.
The supply of the Sofia Strep Test Kits (ITM-1052057) has returned to a stable level allowing the system to migrate back to this Strep Test kit solely. Please note once the remaining supply of the alternative strep test kit (Cardinal – ITM-1157857) is depleted, the item will be inactivated.
Due to this change, please ensure competencies are up to date for the Sofia Strep test kit.
Procedure Reference #17340, #24118.
Test Information: