Critical Lab Value Notification Procedures

BLUF: Provider will be notified regarding critical lab value of first positive blood culture. ALL BCID results are also reported to provider. Documentation of these notifications is made by the lab (see images below for where to find who and when the notification was made).

Email from Dr. StoneGarza:

I want to provide some [clarifying] details on critical values to pass along to the housestaff.

• Critical lab results are outlined in our local SOP.  Most recent update Jun 2024 

• Critical lab results require notification of ordering provider or designee within 60 minutes of identification and verification of critical lab result.

• A designee if the ordering provider is not available is a clinical team member that has the ability and authority to initiate appropriate clinical intervention in a timeframe to avoid an adverse outcome. This means results are NOT read back to ward nurses, corpsmen, clerks, etc. It’s directly to a physician/LIP.

• The SOP has an escalation matrix for communication if the ordering provider is not available.

• Critical lab results are all documented and at minimum includes the date, time, test results and person reporting and receiving the test results.

Blood cultures notification:

• First positive blood culture w/in 48 hours for adults unless subsequent blood cultures have different gram stain morphology.

• All BCID (e.g. rapid blood culture PCR testing) results. Documentation of notification is found in the comment section of the abnormal result or under BCID2 Interp (if no targets found) and is usually denoted with an asterisk. See below for example.

If notifications are not happening, make sure to check if there were any documentation and let us know so we can bring this up to micro.