What does STAT mean to your Lab?

[sharann]

To our lab it seems to mean anywhere from 20 mintues to 1 hour from the original call order. This is crazy. I know they can be there fast(see it for ER)but from the ICU or the floor I noticed they take longer than acceptable.Maybe they are understaffed, don;t know, but I know that when I have a stat H/H on a bleeding post-op in PACU I want it drawn within 10 minutes.

AM I being too harsh?

[canoehead, BSN, RN]

I love my lab people!

In the ER we were told to always order everything as stat, which seems dumb to me, but apparently the labels come up in a different place, instead of the printer that's only checked every few hours. So if I have a real stat I just call and let them know, and they are here within minutes.

I've also hand delivered special specimens like CSF, or urine that I had to cath a 3 year old for, and explain why it was tough to get, and show off my bruises. They've always given me a bit of sympathy, and VIP status for those specimens. In return I always draw a rainbow if I start an IV and save it for when the doc does his orders. They come over to the ER when their machines break down and we give them coffee, and candy, and an encouraging word.

I'm at a small hospital, and it makes a difference when lab staff know you and the way you practice, as opposed to one of many anonymous voices over the phone.

[ICRN2008, BSN, RN]

I have 5 years experience as a medical technologist, and in my organization the standard "Stat" turn around time is 1 hour. for most tests (less for blood gases). This does not mean that it always takes an hour to receive a result, but there are many variables in the testing process.

There are a number of factors that affect turn-around times (how long it takes from the sample's arrival at the laboratory until results are released to the chart). For example, my 40 bed hospital only staffs with one technologist at night, including blood bank. There are no phlebotomists on staff; the patient care technicians are expected to call the ER for help if they cannot obtain a sample. The technologist is expected to remain in the laboratory to perform testing because leaving to draw samples will adversly affect the lab's ability to perform testing in a timely manner. If someone is bleeding out in the ER or in surgery, the technologist may be occupied for quite some time, and testing will be delayed. However, every effort is made to adhere to the one hour turn around time even in the worst of circumstances. During the days there is more capacity to handle emergencies and turn-around times tend to be better.

All instruments need to be taken down for maintenance at least once a day, and often once a shift. If the laboratory only has one chemistry, hematology or coagulation analyzer, then the nurses might be waiting a while. In addition, there are times when instruments go down completely because of mechanical, electrical or quality control problems, and then the samples are sent by courier to another laboratory. (Of course, there is always the capacity to run hemoglobins and electrolytes on the blood gas analyzer).

Not all testing is performed on-site as a general rule- some tests are sent to outside facilities because of relatively low test volumes. Thyroid testing, HgbA1C, and other non-critical tests are some examples.

When I work in the laboratory I make a concerted effort to keep the nursing staff informed about any delays in testing, because I have been on the other end of those delays myself :) If you have any questions, please let me know.

[classicdame, MSN, EdD]

60 minutes or less.

[BlueDevil,DNP, DNP, RN]

this lunar phase

[AlsgalRN]

I worked telephone triage for my clinic while I was undergoing chemotherapy. It was much more convenient to have my blood drawn in my clinic instead of driving to the oncologist's office.

The lab tech called with critical results. Of course, I accepted those results. The tech asked for my full name. I gave it to her. She laughed when she noted that the patient and I had the same name. When I let her know that we were one and the same, she did not know what to do. I told her about the chemo and absolutely, positively promised to call my oncologist. I think she wanted to give those results to another nurse, just in case, but she did not insist.

We draw all of our labs. At our lab, STAT is about an hour. Of course it depends on what is happening. If there have been several traumas called, we try to be patient. Our lab folks do their best.

[JZ_RN]

Called for stat labs at 6 pm once... they were there at 4 am. Nice. They also come at 5 for regular labs, shoulda just saved the trip. Especially after being called 3 times for "stat" labs.

[turnforthenurse, MSN, NP]

Lab can come within 10 minutes to draw....sometimes up to an hour In that case (if I have time), I'll just draw my own labs and send them and get my results immediately.

[beckster_01, BSN, RN]

I am amazed at the number of people that have to call someone else to draw labs? If I have the skill to start an IV, I most certainly have the skill to draw a lab. And if I can't get it, then 98% of the time someone else on the floor can get it. If they can't, and the lab is truly stat, then I will ask my NP (who is great at phlebotomy), CRN, or ICU nurse before I will bother the phlebotomist, simply because I know that it will take them a while. As far as running the lab stat, the lab has a special stat tube station, so they get run pretty quickly.

[amoLucia]

This is to JZ re: your lab delay --- did you notify your supervisor to intervene? That delay could be considered a treatment error and the MD would need to be notified (and some type of incident report, too). To all, depending on facility P&P, direct venous sticks by nursing for bloodwork may not be permitted. Specimens from a PICC or other line may be allowed, if... In LTC, a lab tech may have to come in. And accd'g to the facility's contractual agreement with the lab provider, after hours may not be covered, so a PICC line specimen may just sit around for a while. At my last LTC facility, we were very cautious about STAT lab orders because of all the fluff. If you're a hospital or have in-house lab, what a luxury! Also there's the liability of not performing an ordered task in a timely fashion -- it could have an impact on a timely diagnosis with approp treatment. Something State surveyors and lawyers love to see!

[Guest 360983]

In my hospital, we draw all non-scheduled labs. That's why the patient has an IV upon admission.

STAT labs are supposed to be in the machine 15 minutes from arrival if sent by tube or immediately if hand delivered (I work in the ER so we run up labs for patients who need things like tPA). Of course, this doesn't help when the lab looses stuff. I don't mind lost specimens so much as when the lab lies to cover it up. "One of your blood culture bottles from the left hand was empty." No, I'm 99% sure it wasn't, since I remember watching that bottle drip ever so slowly above the minimally acceptable line because the vein was so dang fragile and half infiltrated. Just tell me you lost it.

[JZ_RN]

beckster- I am more than happy to draw my own labs but with 50 patients and no in-house lab.... Yeah. They gotta get sent out anyways and I can't leave to drive them across town with no nurse left on the floor. LOL

[JZ_RN]

Yeah I called the on-call manager (none on duty at midnight when the lab promised to arrive be) and I documented the heck out of it, that I called an hour later and again an hour after they said they'd arrive and still they showed up when they pleased.