Mercy Medical Center-North Iowa Laboratory
Laboratory Test Index
1000 Fourth Street
Mason City, Iowa 50401
Table of Contents
Following the Mercy Health Services mission of sharing in the healing ministry of Jesus Christ by striving to improve the health and well being of those we serve, Mercy Medical Center - North Iowa Laboratory strives to provide the utmost in quality laboratory and diagnostic services to our clients.
The Laboratory is accredited by The Joint Commission.
Over one hundred laboratory employees analyze, assess, and report findings on a 24-hour per day basis. Five board certified pathologists oversee the quality and performance of the technical areas, including Hematology, Clinical Chemistry and Toxicology, Blood Bank, Serology, Microbiology, Anatomic Pathology, and Cytology.
By serving our patients, we display the Mercy values of Mercy, Human Dignity, Justice, Service, and Preference for the Poor. We welcome you to the services and benefits of Mercy Medical Center - North Iowa Laboratory, and appreciate the opportunity to assist in your therapeutic and diagnostic quests.
Steven P. Goetz, M.D.
Mercy Medical Center - North Iowa Laboratory
Mercy Medical Center - North Iowa Laboratory
CLIA number 16DO384014
Reference Laboratories used by Mercy
Mayo Medical Laboratories, Rochester, MN
CLIA number 24DO404292
CAP number 55901-002
University Hygienic Laboratory, Iowa City, IA
CLIA number 16DO648109
University Hygienic Laboratory, Des Moines, IA
CLIA number 16DO709301
University of Iowa Hospitals/Clinics, Iowa City, IA
CLIA number 16DO648109
CAP number 52240-002
Specialty Laboratories, Inc., Los Angeles, CA
CLIA number 05DO550302
Viromed Laboratories, Minnetonka, MN
CLIA number 24DO400424
MedTox Laboratories, St. Paul, MN
Marshfield Laboratories, Marshfield, WI
CLIA number 52DO663760
CAP number 17885-01
United States Drug Testing Lab, INC.
2201 W. Campbell Park Drive
Chicago, IL 60612-354701
CLIA number 14D0712964
Mercy Medical Center - North Iowa
Mason City, IA 50401
All procedures performed or processed by Mercy Medical Center - North Iowa Laboratory (Mercy) are listed alphabetically in this index along with cross indexing of tests known by multiple names or abbreviations. The test will be followed by the Hospital Information System (HIS) mnemonic, Laboratory Information System (LIS) test name and mnemonic, and specific test information. All times will be given utilizing the 2400 clock. Updates to the Lab Test Index webpages will be updated and listed on the website. Because of the wide variety and often complicated nature of procedures, patient preparation and handling of specimens are of utmost importance. To avoid specimen rejection and prolonged turnaround time, it is imperative that all instructions outlined in this test index be followed. Please call the Laboratory for assistance if any questions arise concerning patient preparation or specimen handling.
All specimen containers delivered to the Laboratory must be labeled with patient name, second patient identifier, (medical record number or date of birth) date and time of collection and collectors initials. All non-blood specimens must include the source. This includes stool, urine, nasal wash specimens. Source information must include the main source (leg, BAL, etc.) and any other descriptive information (left, right, upper, etc.) is useful.
Identification must be placed directly on the portion of the container which contains the specimen. Labeling the lid, wrapper, cardboard slide container, or any attached order form is unacceptable for specimen identification. NOTE: It is recommended that any specimen container/tube delivered to the laboratory, should have all the tests requested written on the container. It is especially helpful with CSF and body fluids.
Blood Bank Testing: Identification will also include the patient's Medical Record number (confirmed with a check mark by the number) and initials of the person collecting the specimen. The patient will have a hospital band or emergency identification band in place.
Cytology Slides: For slides, identification will be on the frosted end of the slide, not on the container. ThinPrep vials and any other fluid containers must be labeled with patient name and a second form of identification.
The following are instructions for proper specimen collection and handling.
|Tube Type:||The proper collection tube will be used for each specimen. Tube stoppers are color-coded to indicate tube contents (anticoagulant or preservative) to facilitate drawing the correct tube for each test. The following chart will serve as a guideline for tube usage and handling:|
|Order of Draw:||Trace-meta Non-additive Tubes (Navy Blue)
Citrate Tube (Blue)
Gel/nongel Serum Tube (Red/Yellow glass and/or plastic)
Heparin Tube (Green)
EDTA Tube (Purple)
Oxalate/Fluoride Tube (Gray)
ACD Tube (Yellow glass solution A or B)
FDP Tube (Navy Blue with blue ring)
|Note: If blood cultures are ordered this testis always drawn first before any specimen tube.|
|Navy Blue||None||Draw and allow to clot.|
|Blue||Sodium Citrate||Draw and gently invert 3 to 4 times. Note: This must be filled with the volume indicated on the label.|
|SST (Red/Yellow)||Clot Activator||Draw and gently invert 5 times. Allow to clot 15 minutes|
|Draw and allow to clot 15 minutes|
|Green||Lithium Heparin||Draw and gently invert 8 to 10 times. Place immediately on ice if an ammonia is ordered.|
|Purple||EDTA||Draw and gently invert 8 to 10 times.|
|Pink (Blood Bank)||EDTA||Draw and gently invert 8 to 10 times.|
|Draw and gently invert 8 to 10 times.|
|Yellow (Glass)||Acid Citrate||Draw and gently invert.|
Tube inversion ensures mixing with clot activator and the different anticoagulants that may be in the tube.
Plasma or serum should be separated from cells as soon as possible, and certainly within 2 hours.
In addition to drawing the correct tube(s) for the test, it is important to draw multiple tubes in a specific order to avoid cross-contamination between tubes with and without additives. Contamination can affect test results. To avoid contamination when drawing multiple blood samples from a single venipuncture, adhere to the following guidelines:
Trace-meta Nonadditive Tubes (Navy Blue), Citrate Tubes (Blue), Gel/nongel Serum Tube (Red/Yellow glass and/or plastic), Heparin Tube (Green), EDTA Tube (Purple), Oxalate/Fluoride Tube (Gray), ACT Tube (Yellow glass solution A or B), RDP tube (Navy Blue with blue ring)
B. Never draw tubes containing EDTA (purple top) before the chemistry tube (red top). Contamination will cause increased potassium and decreased calcium levels.
C. Heparin tubes should not be drawn before coagulation tubes since contamination from heparin may alter coagulation test results.
Tube Station Specimens
Specimens sent to the lab in the tube station must be placed in a specimen transport bag and sealed prior to placing in the tube station.
All urine specimens are to be double bagged prior to placing in the tube station.
Each blood culture bottle in a set must be wrapped in bubble wrap and then placed in a specimen transport tube prior to placing in the tube station.
Specimen types that CANNOT be placed in the tube station for delivery to the lab are:
Body fluids (CSF,joint,pleural etc.)
Surgical specimens (tissues, fluids, wounds,etc)
Fasting, for the Laboratory, means absolute restriction of solid and liquid food following the evening meal prior to the specimen collection. Water should be taken in normal amounts to prevent concentration of the blood constituents. Lipoprotein Analysis and Lipid Panels require further dietary restrictions. Nothing should be eaten 12 hours and no alcohol 24 hours prior to specimen collection. The evening meal prior to the test should contain no fatty foods and should be completed before 1800. Contact the physician if there is any question regarding administration of medication during a fast.
Random collections: For routine analysis and microscopic evaluation, provide the patient with a clean container. Midstream urine collection is recommended.
1. Hold the container by the outside surface and begin urinating into the toilet.
2. Place the container under the stream of urine after a good flow has started.
3. Fill the container half full and void remainder of urine into toilet.
4. Cap container, label, and deliver to Laboratory within 1 hour of collection.
Containers for 24-hour urine specimens are to be obtained from the Laboratory. The Laboratory will need to know which test is ordered so that proper preservative will be placed in the container. Instruct the patient to use caution when handling the container as it may contain an acid perservative. Orders are to be placed at the completion of the specimen collection period.When the 24-hour collection period is to begin, the patient should empty their bladder and discard that urine specimen. All urine collected in the next 24 hours is to be placed in the container. The container should be kept in a cool place during the collection period. At exactly 24 hours after the start of the collection, the patient should empty their bladder and place that urine in the container. Direction cards for collection of 24-hour urine specimens are available from the Laboratory. Additional urine containers may be obtained from the Laboratory, which is open 24 hours a day. NOTE: Creatinine Clearance Test requires that a blood specimen is drawn within 48 hours of urine collection.
Priority Code: Use of the correct priority is crucial with the Misys Laboratory Computer system.
Misys reads the priority code of the order and then assigns the order to the appropriate blood specimen collection list.
If the priority entered is Routine, the order WILL be assigned to the NEXT collection list, for the requested date.
Laboratory personnel will not be able to monitor the HIS orders for correctness of date, time, or priority.
Messages to change collection date and time will not be accepted. The test must be cancelled and reordered with the proper priority code.
The Cerner PowerChart priority codes are as follows:
|Routine||Specimen will be drawn with the next collection list and analyzed with the next scheduled run.|
|Timed||Specimen to be drawn for a specific time. Will be analyzed with the next scheduled run.|
|ASAP||Not used. See “Routine”|
|Stat||Specimen drawn and analyzed now. (Not available for all orders.)|
Collection lists are called every hour 10 minutes to the hour from 0300 to 2300 with additional lists scheduled as needed.
The use of the correct cerner PowerChart FREQUENCY is vital, as well as altering the pre-defined standard collection times associated with each frequency to reflect the desired collection times. Any ordering questions should be directed to a Project Genesis super user or the laboratory Information Staff at ext 6033.
"Next Scheduled Run” means that Chemistry test & profiles (gluc, panels, lytes, metabolic,etc.) and CBC's and Coag testing are normally completed within 2 hours of draw time. Please consult the test index for other tests.
The Laboratory has predefined the grouping code for all laboratory tests except Microbiology culture orders. No entry is necessary except for Microbiology culture orders. See Microbiology Section for further information.
The Lab Comment field should be used for other order information. This field is NEVER to be used to indicate date or time that specimens are to be collected. Only the first few characters of the comment appear on the laboratory collection lists. It is necessary to place the most important comment first.
The Universal Hospital Laboratory Order Form is to be used whenever ordering on Cerner’s PowerChart is not possible. Tests not found on this order form are to be written in, with the exception of the following:
Cytology studies will be ordered on for MH-321, cytology (PAP).
Surgical specimen testing will be ordered on form MH-1461, specimen.
Bone Marrow studies will be ordered on form MH-375, bone marrow surgical specimen.
The manual requisition must include ALL information and the form must be legible and accurate.
Results are available in PowerChart as soon as testing has been updated or completed.
Pathology documents are available after the document has been electronically signed by pathology.
Please note that all pathology documents will have a collect time of 0000.
The laboratory automatically performs additional testing on the specified assays when defined conditions are met.
Refer to the Special Helps section for a complete listing of reflex testing.