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Education & Training

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

Chemistry, Compliance & Safety, Education & Training, General Information, Referral/Sendouts

Preservative For 24 Hour Urine Collections

In both the inpatient and outpatient settings, the laboratory has supplied 24 hour urine containers with preservative such as acetic acid, sodium hydroxide, and boric acid.  Upon review of specimen stability requirements, it has been determined that a preservative is not needed prior to collection of most 24 hour urine tests as long as the 24 hour container is kept refrigerated or on ice during the collection period. Continue Reading

Compliance & Safety, Education & Training, General Information

Maintaining Specimen Integrity – Purple Priority Bags

purple priority bagSpectrum Health Regional Laboratory supplies purple priority bags for specimens that must be handled and processed immediately upon receipt in the laboratory. The purple color priority transport bag will be a visual cue to the receiving laboratory that the specimens inside the bag need to be handled or processed immediately at the time of arrival in the laboratory or the integrity of the specimen will be compromised.

Use these bags for transporting specimens to the laboratory when: Continue Reading

Compliance & Safety, Cytology, Education & Training

Appropriate Labeling of Specimens

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.

Compliance & Safety, Education & Training

Zero Tolerance Specimen Labeling

All specimens submitted to Spectrum Health Laboratory for testing must be appropriately labeled to assure positive identification and optimum integrity of specimens. In accordance with standards issued by The Joint Commission, at least 2 patient identifiers should be used when providing care or treatment of services (National Patient Safety Goal, NSPG.01.01.01). If 2 patient identifiers are not used on the specimen, the specimen will be rejected, the order will be cancelled and a request for recollection will be made. This includes Gyn Cytology (i.e. Pap) specimens.

What are acceptable Patient Identifiers?

  • Patient Full Legal Name
  • Date of Birth
  • Spectrum Health Medical Record Number (MRN)

 

Education & Training, General Information

Summer Lockbox Preparation

Follow these steps for loading your outdoor lockbox during the summer months to prevent overheating of refrigerated and ambient specimens:lockbox summer

1. Place a frozen cool pack in the bottom of the lockbox.

2. Layer 3 – 4 paper towels over the cool pack for insulation.

3. Place refrigerated temperature specimens on top of the paper towels.

4. Layer 3 – 4 paper towels over the refrigerated specimens for insulation.

5. Place ambient temperature specimens on top of the paper towels.

Frozen specimen should not be left in the lockbox for after-hours pickup. These tests may be better preserved in the office freezer until the next day’s courier pickup.

Spectrum Health Laboratory is committed to specimen integrity. The specimen transport integrity guide is available in the online test catalog. If you have further questions please contact Laboratory Services at 616.774.7721.

Education & Training, General Information

Reminder: Fasting Tests

Several tests performed by Spectrum Health Laboratories and our Reference Laboratories (Mayo Clinic Lab) require and 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.

List of fasting tests

updated: 12/27/2021