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Stepwise Success

No Growth Cultures

Published October 16, 2013 6:01 AM by Scott Warner

How do you keep a physician in suspense? Ask him or her to order a culture. In small labs where most routine cultures are urine, sputum, blood, and surface wounds, there can be a daily battle between getting microbiology results in the hands of the docs when they need to treat the patients and getting the rest of the lab work done. Techs in microbiology often don’t know when physicians need information about cultures.

For example, if a urine culture is ordered on a symptomatic patient but the physician prescribes antibiotics, he or she might wait to see what happens. If the patient responds to treatment, the culture results are confirmatory. If not, there is a greater sense of urgency.

Blood cultures can generate more anxiety, particularly with septic patients, and a laboratory can receive multiple telephone calls asking about their status. In some cases, cultures following treatment are important to know if an infection cleared. As with many cultures, there is no “one size fits all.”

Laboratories can use a number of strategies to deal with these issues, including giving physicians online access to unverified results, creating preliminary reports, and telephoning prelims.

But no growth cultures, it seems to me, can be expedited most quickly. Urine cultures negative at 24 hours and blood cultures negative at 48 can be finalized and quickly available with a comment that these cultures are held, reviewed for any growth, and amended reports issued as appropriate.

Consistently reporting these negative cultures at 24 and 48 hours builds an expectation in the rest of the team that can reduce anxiety and improve care. Question is how?

Waiting for the morning review of cultures works for the laboratory, but of course all cultures aren’t plated or incubated in the morning. Since they arrive at all times, some kind of alert system to read and result the negatives makes the most sense. Most lab information systems, for example, can generate outstanding reports that can highlight overdue results.

How do you keep a lab tech in suspense? Ask him or her to report a culture.

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posted by Scott Warner


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About this Blog

    Scott Warner, MLT(ASCP)
    Occupation: Laboratory Manager
    Setting: Critical Access Hospital
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