Frequently Asked Questions for Practitioners
Where is my specimen right now?
Click on Chart Review in EPIC and look at ‘Status’ column: Standing = Ordered but not yet released; Ordered or Needs To Be Collected = ordered and released but not collected; Collected (Date/Time) = collected but not in lab yet; In Process = specimen in the lab system; Final result = Test completed and verified; Edited = result updated, after going to ‘final’ status. Open an order for more details.
How do I see all results in EPIC?
In Chart Review mode, check both LAB and MICRO tabs. Also, deselect ‘hide cancellations’ box.
How do I add-on a test to an existing sample?
BNP, lactate and ammonia cannot be ordered as add-ons. For other routine chemistry tests, add-ons can be placed up to 5 days after receipt of the sample. Add-ons for coagulation testing should be requested within 4 hours of original draw. Specimen type of add-on must match specimen type in the lab. Add-ons can be requested in EPIC [new order-priority “add-on”], or faxed to 212-987-0038 (ATTN: ADD-ONS), or phoned in to 4LABS.
Why is my test canceled? How do I avoid sample rejection?
- Quantity not sufficient (QNS): Always allow tubes to fill completely. Collect a tube for each label generated. If blood volume drawn is small, clearly indicate the order of priority for tests - if ordering on paper - otherwise call 4LABS.
- Clotted: Draw blood into tube with proper anticoagulant and mix immediately by gently inverting ten times.
- Hemolyzed: Increase needle gauge if possible. If transferring from syringe to tube, inject blood slowly into tube.
- Contaminated: Draw specimen from arm not used as IV site. Follow correct order of draw (blood culture bottles, gold, blue, green, lavender, pink, pearl, grey). Use correct tube type. Tests results are not valid if sample is drawn in an incorrect tube and switched to the correct tube. Prior to collecting blood for culture, follow correct skin cleaning procedures using chlorhexidine-swabs; do not repalpate vein.
When and how do I collect blood for culture?
Obtain sample before starting antibiotic therapy, or just before the next scheduled dose. Send two blood culture sets from two separate venipunctures, 15-60 min apart. Standard blood culture bottles will grow bacteria and yeast. If suspecting mycobacteria or dimorphic fungi, use an Isolator™ tube or an SPS containing collection tube.
Should I send an aspirate/fluid or a swab?
For organism recovery, aspirates/fluids are best. Send swabs for throat, surveillance, nasal, ear & genital specimens ONLY.
When should I order Antibiotic susceptibility testing?
When a culture is positive, AST is performed when feasible. An MIC and interpretation is provided if criteria exist for that organism/antibiotic/body site. Susceptibility tests on yeasts and anaerobes are by request only.
When do I need to order a stool culture?
Stool culture for enteric pathogens is performed only during the first 3 days of admission. Stool specimen for Ova & Parasites accepted only during the first 3 days of admission, unless the patient is immunocompromised.
How do I order testing for C. difficile?
This test is performed only on loose stools (stools that take shape of container). Testing is not repeated within 7 days of a negative specimen and within 14 days of a positive specimen. Send directly to Microbiology Tube Station 74.