What do you do with critical lab values when they are called from the lab dept?

[pk1]

Looking for what other hospitals are doing when the lab calls with a critical lab value. After you read back the value, then what? Where do you document what you did with it? Do you call the doctor with improving criticals? Do you save them until the MD rounds? I'm in a small rural hospital that the docs only round once a day, unless there are problems. I have one week to come up with a solution to as what we will do, so we can change our policy to say what we want it to say. HELP!

[stidget99]

Looking for what other hospitals are doing when the lab calls with a critical lab value. After you read back the value, then what? Where do you document what you did with it? Do you call the doctor with improving criticals? Do you save them until the MD rounds? I'm in a small rural hospital that the docs only round once a day, unless there are problems. I have one week to come up with a solution to as what we will do, so we can change our policy to say what we want it to say. HELP!

Always call and inform the docs about critical lab values. When they get irate w/ u for making that call.......remind them that this is a reportable situation. Then, always always always document that you reported the value to the doc and that no orders were received. It's always a matter of CYA.

[zambezi, BSN, RN]

Truthfully, I rarely call critical lab values unless it can't wait (I work nights)...really it just depends on what is going on with the patient. I work in a cardiac unit so many of our critically high values are high CKs, Trops etc...which we are just monitoring and can't do anything to fix...I only call those if there is a direct order to call results...We have a standing KCL protocol so I would replace per protocol and only call if 6...

I agree with those that say it comes down to thinking about the situation and knowing your docs (not that that would help you in court, I suppose). If my patient has an instability relating to a lab value I will call asap, if I am even questioning it I will call...but I certainly don't call every critical value (if fact, it seems that I rarely call when I think about it...we do have a lot of standing orders though).

[jeepgirl, LPN, NP]

if its an improving critical value, i don't call. we just document the panic, person and time they called it, and why we aren't calling the dr.

[rstewart]

It is difficult to argue with those who advocate the use of critical thinking in deciding whether or not to call critical/panic lab values. But keep in mind the original poster apparently does not have a policy in place and is attempting to formulate one.

But for you critical thinking advocates out there.....I suspect that YOUR facilities do, in fact, have policies regarding the reporting of panic values. No disrespect intended, but are you all clear as to what those policies actually say? Have you read them?

Theoretically, I support your viewpoints; but I would hate to have you discover the hard way that your facility's written policy in this regard is substantially more concrete than is your practice.