REVIEW OF TEST RESULTS

Effective Date: 
Tue, 05/01/2012
Reviewed: 
Mon, 11/06/2017
Policy: 

Orchard Harvest

PURPOSE

Laboratory test results must be entered correctly to provide optimal patient care. Results that are entered incorrectly may cause unnecessary treatment or loss of life. Mechanisms must be in place to assure that results are reviewed before being transmitted to the medical staff.

Procedure: 

PROCEDURE

A. Routine Testing

1. The operator will enter laboratory results into the Harvest Computer System in one of two ways; either by manual entry directly into the computer or through an interface with the Laboratory Information System, where results are transmitted from the analyzer and after review are verified and a completed reported is sent to the Electronic Medical Record, Point and Click. The steps for manual entry or transmission from the interface are outlined in the Harvest Manuals.

2. The computer will identify whether a result entered is "low" or "high" and if the value is a critical or "panic/critical" value. In addition, the Harvest System will individually display each result that falls outside the reference range, and display a complete listing of data including reference ranges before the operator verifies the results.

3. The operator may also consult the original instrument printout and compare those results with the results displayed in the computer. Any discrepancies between the instrument printout and the results displayed on the screen must be corrected or reconciled before processing the data.

B. Critical Values

1. The operator will process and document all critical values in the Harvest Computer Systems as described in the “Critical Values" policy and procedure.

2. The supervisor or designee will counsel any staff who does not follow policy for critical values and will re-educate staff according to policy.

C. Corrected Reports

1. If a test performed on—site is found to have erroneous results reported through the Harvest system, a corrected report must be generated.

2. Edit the report following the Edit Results protocol in the LIS procedure manual. This will create a corrected report which will contain a footnote indicating "Corrected from previous result ____". The ordering provider must then be notified and a comment entered documenting the notification.

3. Under no circumstances is a reference lab report ever to be revised or corrected by anyone within this facility. If a reference lab report is found to be in error, contact the reference laboratory. Ask for an amended report from the specific reference laboratory, with a comment stating that a previous report was sent or transmitted in error, and that the new report contains corrected information.  Notify the ordering physician or attending nurse. Retain copies of the original and the corrected report in the general quality assessment log for documentation and corrective action review.

D. Manual Differentials and Urine Culture

1. After review of the CBC and automated differential, the physician will determine if a manual differential is warranted, based on both the laboratory results and the patient’s clinical picture. If a manual differential is requested by the physician, it will be performed.

2. After review of the urinalysis dipstick results, the physician will determine if a urine culture is warranted, based on both the laboratory results and the patient’s clinical picture. If a urine culture is requested by the physician, it will be performed or depending on the day of the week, sent to the appropriate reference laboratory.