General Information
Requisition Forms  l  Courier Services  l  Client Supply Order Form  l  Specimen Collection & Identification  l  Specimen Rejection  l  Transfusion  Services  l  Reflex Testing  l  Stat Testing  l  Alert Values  l  Results Reporting  l APPA Stain Form

Requisition Forms
St. Elizabeth provides requisitions forms. Please fill out the form completely. Include the appropriate numeric ICD-9 codes next to each test ordered. There are separate forms provided when requesting biopsies or cytology. Be sure that the requisitions are legible and the tests requested are clearly marked.

The Advanced Beneficiary Notice (ABN) form is provided for use when it is likely that Medicare will deny payment for a particular lab test. The form must be completed prior to the service being performed, therefore this form must be completed by the doctor’s office staff if specimens are being sent to St. Elizabeth Laboratory.

Please call (859) 301-2170 to request requisition forms.

Courier Services
Courier Pick-up
A Laboratory Courier will pick up any specimens from your office Monday through Friday form 8:00 am to 8:00 p.m., Saturday from 8:00 am to 2:30 p.m. Please call 301-2170 for courier service. If service is required outside these hours, please call and we will make the necessary arrangements. 

Supplies
If you require supplies, complete the Laboratory Client Supply Order Form. You may leave the complete sheet in the lock box or may fax a copy to 301-5560. Please do not phone supply requests into the office. We will try to deliver supplies within 1 week of receiving your request.

Client Supply Order Form

Specimen Collection & Identification
The container, tube, cup, bottle, etc., for each specimen must be clearly and accurately labeled with the patient’s full name, date of birth, date and time collected and the initials of the person collecting the specimen. In the case of specimens for culture, the label should also include the source of the specimen.

The subsection entitled Specimen Collection as well as the section entitled Test Descriptions provides more detailed collection information.

After collection and labeling, place the specimen inside a biohazard ziplock bag and place the requisition form inside the pocket. Use a separate bag for each patient’s samples. Biopsies must be placed in individual biohazard ziplock bags due to possible leakage of formalin.

Unlabeled specimens sent to the laboratory cannot be accepted. Specimens may be rejected by the laboratory under other circumstances. See the subsection entitled Specimen Collection for further details regarding specimen rejection. If a specimen is rejected for any reason the physician office will be notified as to why the specimen is unacceptable and a new specimen will be requested.

See the test descriptions for information on which tube should be drawn for each test. Please note that these are the tubes we supply, you may have other tubes supplied by different manufacturers that have different sizes, color tops and anticoagulants.

Specimen Rejection
Specimens will be rejected by the Laboratory under the following conditions:

1. Improper labeling: The Laboratory will not accept unlabeled or incompletely labeled specimens. Each specimen received in the lab must be labeled to include the full first and last name; date of birth, date and time of collection and initials of the person collecting the specimen.

Unlabeled specimens that cannot be recollected (i.e. spinal fluid, aspirates, and specimens drawn before therapy that significantly alters results after drawing) will be handled as follows:

The person responsible for the specimen will be requested to properly label it. This person assumes the responsibility that the specimen is the correct one for the patient and so indicates on the requisition form.

2. The Laboratory will not accept specimens that are collected in a wrong tube or with incorrect preservatives. Clotted anticoagulant tubes, inadequately filled tubes, the presence of hemolysis, icterus or lipemia may invalidate certain tests and may be cause for rejection. Special instructions are listed under each test in the Test Description section.

3. Specimens that are leaking, where the outside of the container is grossly contaminated, or needles left on the syringe are examples of specimens to be rejected. Please close containers tightly and remove needles from syringes before transporting specimens.

4. It is very important that microbiology specimens must be appropriately selected, collected, and transported. This is critical for recovery of organisms. Please refer to specific culture test description for more information or call the Microbiology Department at (859)301-2074.

5. Drug Screen specimens must also be submitted in the proper container using the appropriate chain of custody form. Specific instructions for specimen collection and completion of chain of custody form is printed on reverse side of the form.

If a specimen is rejected, a laboratory representative will contact the physician’s office and inform them that the specimen is unacceptable and request a repeat specimen.

Transfusion Services
Blood and its components are provided to St. Elizabeth Medical Center by Hoxworth Blood Center.

Request for Transfusions

A physician order requesting a type and crossmatch is required. The request should include the number of units to be transfused and the expected date of transfusion.

For pre-op patients with a potential for transfusion, a type and screen order is required. The request should include the expected date of surgery.

Autologous Transfusion

The patient’s physician must fill out a Hoxworth form “Request for Autologous Blood Donation”. The patient must then set up an appointment with Hoxworth Apheresis Recruiter (558-1322). First and final donation should be no later then 72 hours prior to date of surgery. Multiple donations should be seven days apart.

Autologous donation appointments are made by the Hoxworth Blood Center, 3130 Highland Ave., Cincinnati, Ohio. Their hours are Monday through Friday 8:30 am to 4:30 pm. Please remember appointments are made with Hoxworth. Hoxworth may have several locations available for the convenience of the patient donations.

Directed Donations

A Directed Donation allows patients who need blood or blood components to designate or direct who their donors will be. All Directed Donations must be made at least three business days (Monday through Friday) prior to surgery or routine transfusion and not more than 14 days prior to date of expected use.

Hoxworth charges a fee to patients requesting Directed Donations. Paperwork must be filled out by both the physician and patient. For more information contact the Donor Coordinator at Hoxworth (558-1323). Their hours are Monday through Thursday, 10:30 am to 5:30 pm. and Friday, 8:30 to 3:30 pm. Please remember all donations are made at the Hoxworth Blood Center, 3310 Highland Ave., Cincinnati, Ohio.

Outpatient Transfusions

To schedule Outpatient Transfusions at North or South Unit, contact the Central Scheduling department at 301-3881. North Unit Outpatient transfusion are provided by the I.V. Therapy department 292-4063. South Unit outpatient transfusions are provided by the Cancer Care Department 301-2237.

Reflex Testing

Stat Testing

Alert Values
An alert value is an abnormal result that may reflect a serious health problem or life threatening situation.  Once these values are verified in the Laboratory, the results are called to the nursing unit or physician as indicated.  They are used as informational data only and not to dictate treatment of any kind.

Any positive bacterial growth from blood cultures, spinal fluid, AFB or sterile fluids will be called immediately. Positive AFB smears and/or culture results will be called immediately.

ABNORMAL PRE-OP RESULTS - These coagulation results will be called during 1st and 2nd shifts to the physician with the understanding that the result may not be life threatening, but may reflect an increased risk of bleeding to the patient if surgery is performed.

abnormal bleeding time
platelets < 100,000
PT prolonged > 2 sec above Normal Range
PTT prolonged > 5 sec above Normal Range

URINE ALERT VALUES
Infants (<1 yr. old) - Any positive glucose with positive ketones (alert value).

Notify physician of positive clinitest with negative glucose (not an alert value).

Peritoneal Fluid - Neutrophil counts of >250/mm3 (based on total WBC count and percentage of neutrophils on the differential).

The pathologists also call all malignant diagnoses.

Results Reporting
Laboratory reports can be distributed in several ways. You can choose to have your reports delivered by courier, via fax or U.S. Postal Service and Healthbridge.