The following is a list of reflexive testing practices at St. James Healthcare.
Urinalysis
If a routine UA is ordered, dipstick screening is done. If positive results are obtained on certain tests (contact UA department for listing) a microscopic is performed and charges.
Children under the age of 5 will have microscopic done.
All catheterized urines will have microscopic done.
BB
When a patient has a positive antibody screen, we will attempt to identify the antibody.
Type and Screens with a positive antibody screen are converted to a type and cross. The antibody is identified, units typed and a minimum of 2 units set.
+ Direct Coombs on adults > 1+ = identification is attempted when appropriate.
+ Direct Coombs on cord bloods are worked up as appropriate. Contact BB for workup.
Microbiology
Organisms grown in microbiology are identified and sensitivities are performed as indicated by source and diagnosis.
If a C. Difficile toxin test is ordered and the patient has not had a stool culture in the last 30 days a stool culture is added.
If a Rapid Strep test is negative, a beta strep culture is set.
If an Anaerobic Culture only is ordered and aerobic (Miscellaneous) culture is set.
On gall bladder specimens, if a grams stain is ordered and organisms are seen an aerobic and anaerobic cultures are set.
Hematology and Serology
CSF cell count will have differentials if > 5 WBC's are counted.
Positive D- Dimers will have titers done.
Positive HIV screens will automatically be sent for confirmation (initial specimen).
Chemistry
Cord blood pH < 7.20 are converted to cord blood gases.