c6-REPORTING AND DISTRIBUTING LABORATORY RESULTS.docx

REPORTING AND DISTRIBUTING LABORATORY RESULTS ============================================= Point-of-care (POC) tests are laboratory tests performed close to the site of patient care (such as the patient\'s bedside or the examination room of a provider\'s office). When performing POC testing, be aw...

REPORTING AND DISTRIBUTING LABORATORY RESULTS ============================================= Point-of-care (POC) tests are laboratory tests performed close to the site of patient care (such as the patient\'s bedside or the examination room of a provider\'s office). When performing POC testing, be aware of values that indicate a potentially life-threatening or health-endangering situation. A critical value is a test result that is significantly above or below the expected reference range. It could indicate a potentially life-threatening situation for the patient and requires an immediate response. When a critical value occurs, report this result promptly and directly to the ordering provider. Not all laboratory values have a critical level, but each laboratory or facility has a list of tests that require monitoring patients\' results for critical values. Learning the difference between an elevated or decreased value and a critical value is important. Depending on the nature of the test­ from simple screening to complex profiles-a change in a patient\'s homeostasis will result in an abnormal test value in either a quantitative numeric value or a simple positive or negative outcome. The specific critical values can differ by facility and can change over time. Become familiar with the general tests that providers monitor for critical values and learn the values for your organization. For example, if the laboratory\'s expected reference range for a fasting blood glucose level is 70 to 100 mg/dL and a patient\'s result is 464 mg/dL, that is a critical value that warrants immediate reporting to the provider. With POC and CUA-waived testing, collect and prepare specimens to insert immediately into automated clinical analyzers for fast and accurate results. These tests include the following: - Electrolytes (sodium, potassium, chloride, calcium, magnesium) - Hematology (WBCs, RBCs, Hct, Hgb) - Glucose, hemoglobin Ale - Cholesterol (HDL, LDL, total cholesterol, triglycerides) - Blood coagulation (PT, international normalized ratio \[INR\]) Microbiology and toxicology testing, including the rapid antigen detection test (for identifying streptococcal pharyngitis), fecal occult blood studies, chemical reagent strip testing, and urine pregnancy testing provide positive or negative results or-with reagent strip testing-a variety of numeric values or ranges for interpretation. A common POC test is a blood glucose level. Patients who have diabetes mellitus routinely have results greater than the high limit of the reference range. Sometimes these results are within normal limits for those specific clients. You need to know when a high result is normal or expected for patients due to their condition, and when to notify the provider. When using a coded glucometer, compare the code on the glucometer with the code on the strips prior to each patient\'s testing. Complete quality controls with a control material when opening a new package of test strips, when several tests have been significantly out of range, or when changing the glucometer\'s batteries. You will collect and handle specimens, perform some POC and CUA-waived tests, identify abnormal and critical values, and report results. However, a licensed health care professional must then review and evaluate those results. Results to providers -------------------- In reference laboratory facilities, laboratory personnel (including phlebotomists) are responsible for ensuring correct and timely delivery of laboratory test results. For POC testing, provide the results to clinical staff directly or by logging the data in the electronic health record system. Confirm and date-stamp all laboratory results and submit them via a secure method of distribution (verbal, telephone, written, computer reports), depending on the urgency the values warrant. Report stat and critical results immediately with a telephone call or in person, requesting a verbal read- back of the results to reduce risk of communicating incorrect information. When sharing verbal results, document the following information. - Patient\'s name - Patient\'s identification number - Name of the person receiving the report - Date and time - Detailed result information - Origination of the report or results Written and electronic reports are less prone to error than verbal or telephone reports of laboratory results. Regardless of the type of report, always maintain patients\' privacy and confidentiality in compliance with HIPAA guidelines. Most providers\' offices use electronic medical records that can link to laboratories to receive patients\' results automatically. With this technology, electronic reports are the most common and secure means for transmitting laboratory test results to providers. Phlebotomists can e-mail or upload test results for immediate access by the ordering provider. These systems help track results, trigger alerts for laboratory changes or urgent results, help with correct and efficient billing, and save time and costs.