YNHH Laboratory Manual

The results of all laboratory tests ordered on the CCSS tab of the SCM application are available from any Clinical Workstation. Ordering of tests and retrieving results are covered as part of SCM/CCSS training. Below are some reminders to help avoid misunderstandings and delays.

ORDERING Most tests are found on the COMMON LAB TESTS screens. Less common tests can be light-pen selected from the alphabetic listings. Infrequently ordered tests must be typed-in. Do NOT use the type-in method for tests that are in the alphabetic listings, as this can cause difficulties and delays

TOMORROW SCHEDULE; Outside of ICU's, use selections that schedule tests for TOMORROW whenever possible. This allows tests to be batched together into a single venipuncture

ACCEPTABLE LABEL; CCSS label must contain patient name, unit number, specimen (spm) number, date, time of collection, and the initials of the person obtaining the sample. Specimens submitted without a visible name are unacceptable

EXTRA LABELS; If more labels are printed than are needed for the number of tubes drawn, place the extra labels on an index card and send them along with the specimen. THEY CONTAIN SOME OF YOUR TEST REQUESTS. If the label does not accompany the specimen, the lab cannot connect the tests on the label with the specimen, and they will not be completed

LABEL LENGTHWISE; Put labels lengthwise along the length of the tube directly over the manufacturer's label, close to the stopper end of the tube. (The patient's name should run along the tube, NOT around it.) Misoriented labels prevent reading the barcode, and this causes delays

COLLECTION TIMES; Collection times are required for some tests, and should be given on all bloods drawn. The most reliable way to identify the date and time is to STATUS it as COLLECTED in the CCSS terminal. At the very minimum, write the time and date on the label!

SPECIAL HANDLING; Information for special handling for some laboratory tests is printed on the CCSS specimen pick-up sheets, e.g., placing the sample on ice or in warm water

EXTRA TUBES; If multiple tubes are required for testing, each tube submitted must have patient identification. One specimen must have the CCSS label and the remaining containers must be labeled with the patient name and unit number, either handwritten or addressograph stamp

BACK-UP PROCEDURE (CCSS DOWN); When the CCSS system is down, use the multi-part, 8 1/2 by 11 CCSS Down Time Requisition. Stamp the Down Time Requisition with patient Addressograph plate. Specify tests needed, floor, and physician's name. One copy of the Down Time Requisition is required for each laboratory receiving specimens. Make sure the physician's name is clearly readable. Without this, patient results will not be available through CCSS terminals

CODE 5/CODE 7 REQUISITIONS; Requisitions for requesting tests during a code situation are located on the code carts. Print patient's name, unit number, and location clearly on the card. Since these requests are considered SUPER STAT, a phone number should be provided to facilitate reporting of the results

ADDING TESTS; Once a specimen has reached the laboratory, tests can be added only by telephone. Federal regulations, however, require written confirmation within 30 days, either on a general or lab-specific requisition slip, or electronically through CCSS verification of unsigned orders. Therapeutic drug assays on plasma may be added up to 12 hours after draw. These drugs include: Overdose panel, TCA screen, amytriptyline, nortryptyline, desipramine, imipramine, phenytoin, phenobarbital, carbamazepine, amiodarone, lamotragine, and chloramphenicol

TEST INFORMATION; Information concerning the tests offered by the laboratory is available through the Clinical Workstation. Choosing the alphabetic option "L" and then selecting the "Lab Manual List of Diagnostic Tests" will place you directly in the Lab Medicine list of lab tests and reference documents.

DIRECT LAB ACCESS; Direct access to the laboratory's computer system is available when the SCM/CCSS system is down, allowing for retrieval of results for outpatients or previous admissions and graphing of recent patient data. This is available Clinical Workstations with pull down menus identified as Clinical Labs. You must know the patient's unit number. See below for further information.

QUESTIONS/PROBLEMS These are usually handled by the Help desk (8-4357). In addition, the individual laboratories can provide help on specific problems.

Updated: Oct-2007