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Section 1 : Communicating Laboratory Needs

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Abstract:

Open, active communication is one key to successful cooperation among all members of the health care team. The complexities of modern laboratory technology demand use of the most cost-effective methods that will provide all the information requested. In fact, the laboratory's needs should be clearly documented in the section on specimen collection and handling in its microbiology procedures manual. Communication within the health care environment is essential for optimum patient care, but communication is often difficult at best and is occasionally nonexistent. The microbiology division is different from other sections of the laboratory. A policy for handling and reporting stat or urgent specimens is not only essential for good patient care but is also required by the Clinical Laboratory Improvement Amendments (CLIA) of 1988. The policy should specify which specimens are considered urgent by the microbiology laboratory, whether or not they are labeled as such. The procedures manual for every microbiology laboratory is required by licensure agencies to include a section on the rejection of specimens submitted for examination. The laboratory doing the test must be identified on the report. Even when hospitals consolidate and there is one central laboratory for most microbiology testing, with some testing done by associated hospitals, the specific testing laboratory must still be identified on the report to the physician.

Citation: Miller J. 1999. Communicating Laboratory Needs, p 1-31. In A Guide to Specimen Management in Clinical Microbiology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818234.ch1
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Figures

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Figure 2

The laboratory can provide clinically significant information when skilled workers follow approved guidelines for culture workup. The laboratorian, however, must have rapid access to pertinent patient information.

Citation: Miller J. 1999. Communicating Laboratory Needs, p 1-31. In A Guide to Specimen Management in Clinical Microbiology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818234.ch1
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Figure 3

The physician may need some clinically relevant information within 30 min to 1 h of specimen arrival. Final reports may require 24 to 72 h for completion.

Citation: Miller J. 1999. Communicating Laboratory Needs, p 1-31. In A Guide to Specimen Management in Clinical Microbiology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818234.ch1
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References

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Tables

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Table 1

Storage conditions for various transport systems and suspected agents a

a CSF, cerebrospinal fluid; IUD, intrauterine device; BG, Bordet-Gengou medium; RL, Regan-Lowe medium.

b Stuart's, charcoal-impregnated swabs originally formulated for N. gonorrhoeae transport; Amies, modified Stuart's but with charcoal incorporated in medium instead of swab; Cary and Blair, similar to Stuart's but modified for fecal specimens and with pH increased from 7.4 to 8.4.

Citation: Miller J. 1999. Communicating Laboratory Needs, p 1-31. In A Guide to Specimen Management in Clinical Microbiology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818234.ch1
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Table 2

Color codes for vacuum tubes

Citation: Miller J. 1999. Communicating Laboratory Needs, p 1-31. In A Guide to Specimen Management in Clinical Microbiology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818234.ch1
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Untitled

Citation: Miller J. 1999. Communicating Laboratory Needs, p 1-31. In A Guide to Specimen Management in Clinical Microbiology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818234.ch1
Generic image for table
Untitled

Citation: Miller J. 1999. Communicating Laboratory Needs, p 1-31. In A Guide to Specimen Management in Clinical Microbiology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818234.ch1
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Table 3

Specimen priority for processing a

a Adapted from Ellner (1978), Current Procedures in Clinical Bacteriology. CSF, cerebrospinal fluid; Ob/Gyn, obstetrics and gynecology; ICU, intensive care unit; OR, operating room.

Citation: Miller J. 1999. Communicating Laboratory Needs, p 1-31. In A Guide to Specimen Management in Clinical Microbiology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818234.ch1
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Table 4

Criteria for rejection of a specimen

Citation: Miller J. 1999. Communicating Laboratory Needs, p 1-31. In A Guide to Specimen Management in Clinical Microbiology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818234.ch1
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Table 5

Specimens to be discouraged because of questionable microbial information

a Specimens from oral lesions are best processed by laboratories equipped to provide specialized microbiologic techniques for detecting and enumerating specific pathogens.

Citation: Miller J. 1999. Communicating Laboratory Needs, p 1-31. In A Guide to Specimen Management in Clinical Microbiology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818234.ch1
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Table 6

Suitability of various clinical materials for anaerobic culture

a IUD, intrauterine device.

b There are a few exceptions, namely, botulism (especially infant botulism), Clostridium perfringens food-borne disease, and C. difficile antibiotic-associated pseudomembranous colitis; some maladsorption syndromes may require detection of over colonization of the upper intestine.

Citation: Miller J. 1999. Communicating Laboratory Needs, p 1-31. In A Guide to Specimen Management in Clinical Microbiology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818234.ch1

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