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The NANOGRAM

Martha Jefferson Hospital Laboratory Services

Spring 2019

Quarterly Newsletter on Charlottesville Pathology Website

This newsletter is from the Laboratory and will be distributed on a quarterly basis. It contains important information and news briefs concerning laboratory services. In addition to normal distribution, each issue will be posted at www.cvillepathology.net under the News Brief section.

New Interference Claims for Total Bilirubin, Lactic Acid, Creatinine and IgM Assays

On January 8, 2019, Sentara Laboratory Services received two bulletins regarding new claims for endogenous interferences for the following lab tests: Total Bilirubin, Lactic Acid, Creatinine and IgM. A summary of the effects of the interferences for each test is listed below:

Total Bilirubin: An interference with IgG was observed for total bilirubin, which may lead to an overestimation of total bilirubin in serum/plasma.

Lactic Acid: Ditaurobilirubin (a conjugate between bilirubin and the organic compound taurine) interference was observed for lactic acid in CSF. This interference may lead to an underestimation of lactate in CSF.

Creatinine in serum/plasma: Glucose and pyruvate interferences may result in an overestimation of creatinine and ascorbate interference may result in an underestimation of creatinine, in serum/plasma samples. An erroneous elevated or decreased creatinine result can affect the interpretation of the glomerular filtration rate.

Creatinine in urine: Urea interference was observed for creatinine in urine samples. The interference may cause an underestimation of both the urinary creatinine results as well as the creatinine clearance results thus potentially affecting the interpretation of the glomerular filtration rate.

IgM: IgM values may be overestimated in hemolytic samples and underestimated in lipemic samples.

Please contact the laboratory for additional bulletins from Roche Diagnostics on each of the interferences or contact the Medical Director of SMJH Laboratory Services, Laura Spinelli, MD at 434-654-7170.

Fibrinogen Reference Range

Effective Tuesday, February 5th, 2019 Sentara Martha Jefferson Hospital Laboratory changed the current reference range for fibrinogen from 181-405 mg/dl to 246-478 mg/dl for patients ages 1 year old and up. This range more accurately reflects the normal values obtained using the 2019 reagent lot.

Please contact Laboratory Services at 434-654-7170 if you have any questions

CAP Off-Site Inspection By SMJH Lab Services

As part of the CAP accreditation Program, SMJH Lab Services has to perform an off-site inspection. Our lab inspection team consisted of senior technologists and managers with inspector training. The team inspected Salem VA Medical Center in Salem, Virginia on March 13, 2019. As always, the inspection was complete and an overall learning experience.

CAP Accreditation Continues at SMJH Laboratory Services

Once again, the accreditation Committee of the College of America Pathologists (CAP) has awarded accreditation to Sentara Martha Jefferson Laboratory Services based on the results of a recent on-site inspection as part of the CAP’s Accreditation Programs. The management team of the laboratory was advised of this national recognition and congratulated for the excellence of services being provided.

The US federal government recognizes the CAP Laboratory Accreditation Program, begun in the early 1960s, as being equal-to or more stringent-than the government’s own inspection program. During the CAP accreditation process, designed to ensure the highest standard of care for all laboratory patients, inspectors examine the lab’s records and quality control of procedures for the preceding two years. CAP inspectors also examine laboratory staff qualifications, equipment, facilities, safety program and record, and overall management.

The Laboratory is very proud of this achievement and we continue to work diligently to maintain this accreditation for the next inspection period in two years. Sincere appreciation goes out to every person on the lab team that has helped over the years to ensure that quality is maintained in the laboratory and all the regulatory standards are completed regularly.

GREAT JOB!

Lab Week is Coming

National Medical Laboratory Professionals Week (NMLPW), April 21-27, is a time to honor the more than 1000 Sentara medical laboratory professionals and support staff throughout Virginia and Northeast North Carolina who perform and interpret the testing that saves lives and keep patients healthy. Sentara’s reference laboratory and community laboratories are Improving Health Working Together as One to perform more than eleven million tests annually, serving providers and patients throughout Virginia and North Carolina. Sentara laboratories pathologists, technologists, technicians, clinical lab assistants, and phlebotomists are among the many unsung heroes of healthcare. Employing state-of-the-art technology and a sharp attention to detail, laboratory professionals help prevent disease by detecting unknown health problems and by aiding in the diagnosis and treatment of existing conditions with accurate and timely test results. Please take a moment this week to thank all laboratory staff you encounter for the vital work they perform each day.

Sentara Safety Habits

Always good to remember your safety habits. 

1. Pay Attention to Detail: STAR

  • Stop-Think-Act-Review

2. Communicate Clearly

• Repeat Backs & Read Backs,Clarifying Questions.

• Phonetic and Numeric Clarifications

• Briefing: SBAR (situation-background-assess-recommend)

3. Have a Questioning Attitude

• Validate & Verify

• Know Why & Comply

• ARCC (Ask a question, Make a Request, Voice a Concern, Use the Chain of Command) 

4. Handoff Effectively: 5 P’s

• Patient/Project–Plan-Purpose-Problems-Precautions 

5. Never Leave Your Wingman

• Peer Checking & Peer Coaching

 

 

 

o Need lab results from the Clinical Lab call 654-7170 or fax 654-7164.

o Need lab results from the Anatomic Pathology Lab 654-7955 or fax 654-7944.

o AP Client Services Representative, Noel Jorgensen, at 654-5525.

The next Nanogram newsletter will be Summer 2019 distributed in Jul 2019.