Tag Archives: lab

MRSA Isolates and E Test

Centegra lab will now perform an e-test on all MRSA isolates obtained from a sterile site with microscan mic >=2.

With additional testing e-testing many isolates may have lower had mic of <1.5 expanding options for treatment.

This additional step will take an additional day to report out.

New PTT Goal Range for All Campuses

Starting at 00:00 on Monday, October 2, 2017, the PTT Goal Range for patients at all Centegra hospital campuses will be 45 to 70, with alerts being triggered for values greater than 100.

All “Per Pharmacy Heparin” will be adjusted to the new range with PTT draws after this time.

New – Interpretation of Clostridium difficile testing

Sometimes interpretation of Clostridium difficile testing can be confusing. See this page which helps interpret the test.

It will be located under “Infection Prevention” => Interpretation of Clostridium difficile testing.

Oral and Nasopharyngeal Specimen Collection


This is a brief list of oral and nasopharyngeal specimen collection procedures.

MRSA

  • Location: Anterior nares
  • Swab: Routine cotton culture swab

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Influenza

  • Location: Posterior nasopharynx
  • Swab: Routine cotton culture swab
  • Wear a surgical mask, protective eye wear and gloves while collecting the specimen
  • Place the patients head on the bed pillow or against a wall so that they do not move backwards
  • The swab will go straight backwards like placing an NG tube, it should go the distance between the nostril and the ear into the throat.
  • The swab is rotated for a bout 5–10 seconds to get enough epithelial cells on it
  • Remove the swab and place it in the transport media and sent it to lab

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Pertussis

The PCR assay reuires a special swab, made of aluminum with a nylon tip. Traditional cotton tip swabs interfere with the test

  • Location: Posterior nasopharynx
  • A special transport media is needed- call the lab for it
  • Wear a surgical mask, protective eye wear and gloves while collecting the specimen
  • Place the patients head on the bed pillow or against a wall so that they do not move backwards
  • The swab will go straight backwards like placing an NG tube, it should go the distance between the nostril and the ear into the throat. This is different from a nasal swab for MRSA or influenza
  • The swab is rotated for a bout 5–10 seconds to get enough epithelial cells on it
  • Remove the swab and place it in the transport media and sent it to lab

Pertussis-2

Here is a video on specimen collection

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Mumps

  • Location: Specimen is collected from the parotid duct secretions preferrably within 9 days of symptoms.
  • Swab: Routine cotton swab. Specimen is sent in a viral transport media.
  • Steps
    • Massage the parotid gland for 30 seconds. Note that it is just in front of the ear lobe. CDR742039
    • Specimen should be collected from the parotid duct opening just next to the second molar.
      mumps-cavity

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Ordering Labs: Getting the AM labs ordered

Please refrain from putting in frequency instructions in the instruction box. Instead, choose the appropriate frequency from the “Frequency” drop down box.

In AM 05 tomorrow only:

For a lab that you want to order for the next morning, please pick the “In AM 05 tomorrow only” frequency. This will ensure that the draw happens the next morning. Adding instructions in the “Instructions” box for the lab to be done the next morning does not guarantee the lab will be drawn at that time unless the frequency is changed. Please pick the frequency “In the AM 05 tomorrow only” for a lab you want for the next day.
LabDaily1

Daily in AM:

For a lab that you would like daily, please pick the “Daily in AM” frequency. When selecting the “Daily in AM” frequency, please DO NOT edit the start date and time. The start date will default to the next morning and the time will default to 0500. Editing the start date and time when selecting Daily in AM may result in a delay in the lab being carried out. If you would only like the lab to be carried out a specific number of days, please enter the number of days you would like the lab to be carried out in the “# Days:” section.
LabDaily

For a printer friendly version of these lab tips click here

Michael Millare and Prapti Desai are available for any questions via email or phone (815)759-4330.

Duplicate Labs

Providers will receive a Duplicate Order message when they order certain labs that have already been ordered within a specific period of time under the same visit ID.

The duplicate message does not appear if the test is ordered under a different visit. For example, if a patient has a Hepatitis Panel test done today and comes in again after getting discharged within 2 months, a duplicate message will not show up if a Hepatitis Panel is ordered on that next visit.

The list below displays the test and the frequency timeframe for the Duplicate notification to occur.

Duplicate Labs

If a caregiver ordered HGBA1C on 5/6/14 and if the same lab is ordered within 30 days under the same visit, a “Duplicate Interaction Found” message window is displayed.

Duplicate Labs1

Because HGBA1C was already ordered within a 30 day period, the message below appeared. The caregiver has the option of Overriding or Correcting the order. The Caregiver can also Cancel the order by clicking “Correct Order.”

Duplicate Labs2

By clicking “Correct Order”, the original order will show up. The caregiver then can edit the date for the order and submit it, or “Cancel Order”.

Duplicate Labs3

The screen below will appear when “Override” is selected. The caregiver should type in the reason for Override and click “Save”. Clicking “Save” will submit the order.

Duplicate Labs4

For a printer friendly version Click Here

cluster of staphylococcus aureus

Wounds: when and how to culture them

Wound cultures are important to assist in the diagnosis of infection in a wound. An improperly collected they can create more problems than solve by:

  • Making an inaccurate diagnosis – calling a case a surgical site infection when it is not
  • Leading to unecessary admission, treatment and potential side effects and complications of treatment

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Interpreting gram stains

Do you ever wonder what a gram stain is suggesting? Check out this helpful list of gram stain interpretation.

This page will be available under Departments → Infection Control.