Lab results reporting

If I do a POC test and it's abnormal, I call the MD or find him/her and report it. We have at least one MD on 24/7. We have a place to document that we've notified the MD or NNP of _____ and what their response was ("orders received" or something)

When I know I've sent labs over, I make a mental note to check them later on. Then I look them up on the computer (the lab calls over crisis values) and if one is abnormal, again, I will call the MD or find him/her and report it.

Otherwise, all POC and lab-run labs are in the computer and available for the MD's to look up at any time.

Our lab calls and reports it to an RN, if it is something urgent we tell them, otherwise, the residents look them up. I will check on them myself if I have a really sick kid and I need to know something right then. We have a place on our flowsheet for abnormal labs.

The lab in our unit runs all ABGs, drug levels, and serum labs-electrolytes, gluc, Na, K, etc. The med tech walks back a hard copy to the bedside for all our lab before it is even ready in the computer. Anything that goes to the main lab-cultures, csf, cbc etc. will show up on the computer although they will call with alert levels. We keep a bedside flow sheet for all labs separate from the kardex. Nurses alert the MD to any abnormal lab when it reaches the bedside.

Am finding the responses very helpful...anyone else want to reply? I am trying to get a feel for what is standard practice in NICUs across the country with regard to hand-transcribing of lab values.

If they were done in our own lab, we get hard copies moments after the test is done, and these go in our chart, plus we write the results on our flowsheets. If they go down to the main lab, it's the RN and MD's responsibility to look the results up in the computer and alert each other that they've seen the labs. If it's a critical result, the RN is called by the lab before it's even in the computer, and we tell the docs.

We usually just call the docs with our lab results, and they just write them down on their papers that they carry around each day/night. They note everything about the babies on those papers (vent settings, IVs, meds, labs, any changes or issues they're having, etc.) and it's what they use to do rounds and give their sign-out. We write all the lab results on our nursing flowsheets, plus official reports are available in the computer at all times, and we also print out daily hard copies to keep in the charts.

We'll report the labs (normal or abnormal) ASAP to the docs, especially during the day. At night, all blood gasses and CBCs are reported ASAP to the docs. If the docs are sleeping, we won't wake them up for routine things like medication peaks and troughs, bilirubin levels, lytes, glucose, etc. - IF there is no change that's going to be made (ex. med that was tested for peak and trough isn't due again until noon the next day, bili level was normal, lytes and glucose were normal, etc.). Usually with labs like that, at night, we'll wait until someone has to call the doc and then we'll all report at the same time, rather than calling every 10 mintues.

Am finding the responses very helpful...anyone else want to reply? I am trying to get a feel for what is standard practice in NICUs across the country with regard to hand-transcribing of lab values. [/QUOTe

One unit worked on had an ABG machine there, the lab drawed the baby, gave us a hard copy,in 5 minutes or so, the RN evaluated and showed the resident/fellow as urgent as the gas dictated... other labs were called to the RN if critically high and not improving, and the RN would alert the doc...otherwise they were computerized, the RN looked it up and they had a lab log in the chart to put it in, kind of at your own convenience.......

The other place, it was the RN's sole responsibility to look up all labs, alert the critical ones to the doc, (who NEVER LOOKED UP THEIR OWN LABS) tHE lab would call with critically high ones, to the RN. All daily labs had to be plotted on the 24hr flow sheet. Both were hard copied on the cpu, we didnt have to print it out..

you should find out first what is the definition your hospital is using wih regards to critical/panic results coz it all depends on what your policy is. in our hospital, all panic or critical value result should be communicated to the provider within 30 minutes from the time you receive the result same thing with POC result and don't forget to document it.

Lab calls the assigned Rn to notify of any "critical" results, and the RN has 15 minutes to notify the neo and chart the critical value. Non-critical values are not reported to the neo, as they can look them up at their leisure.