News:

 September 25^th, 2008

 Attention: Administrator, Director of Nursing and Medical Directors

 Reference: Ova and Parasite examinations and Collection of all Stools 

****Notice of Immediate Laboratory Changes**** 

In an effort to provide the highest quality lab service CHC is changing its protocol for stool collection. All stools (except Occult Blood) must be collected in Cary Blair Transport Media (see page 2 for appropriate collection methodology). The lab will supply you with the new collection material. This change is a quality measure which will lead to increased accuracy in identifying bacterial organisms as well as properly identifying Giardia and Cryptosporidium.  

Effective October 6^th, 2008, when an O&P is ordered, the laboratory will perform a Giardia/Crypto antigen test. Turn around time is same day, Monday-Saturday. Specimens must be collected in Cary Blair Transport Media and sent to the main lab.  This is not a STAT test. 

This change is supported by the results of a recent review of 1,970 Ova and Parasite test reports. Of the 1,970 reports, there were four patients positive for Entaoemba coli and eight patients positive for Giardia. Giardiasis is the most common parasite infection in the U.S. and antigen test for Giardia are more sensitive than the traditional O&P.  

If you want a Manual Ova and Parasite (O&P) you must write “Manual O&P “in the notes section of the requisition.  Additionally, the specimen must be collected in a sterile container and will be sent out to a reference laboratory wherein the turnaround time will vary, minimum 2 days.  

Current medical data suggest a manual O&P may be appropriate in the following patient situations: (1) if patient was a traveler outside the U.S. (2) new immigrant, or (3) transplant patient

**These situations will be limited in most Skilled Nursing Home populations.

Patients, who acquire diarrhea after Day 3 of hospitalizations, are not acceptable for O&P or stool culture testing. The likely hood of acquiring diarrheal infections caused by Giardia or bacteria during hospitalization is extremely low. Patients who develop diarrhea during hospitalization are more likely to have C. Difficile Toxin. 

The intent of this document is providing informational guidance on CHC internal Lab Policy.  CHC will perform all lab orders from Medical Providers and we are available for consultation should any questions arise. 

Please direct questions or concerns to any of the following: Lab Supervisor, Joe Collins, Lab Supervisor, Robert Maass, or the CHC Microbiology department 

This information should be discussed with your medical director 

Attention: All Nursing Staff 

** Immediate Laboratory Changes** 

As of October 6^th, 2008, when stool testing is ordered, please follow these collection guidelines: 

Test                                                           Media 

Culture                                                 Cary Blair Transport Media 

O&P                                                     Cary Blair Transport Media 

C-Diff Toxin                                           Cary Blair Transport Media 

Occult Blood                                          Sterile Container 

Manual O&P                                           Sterile Container 

For questions or comments about this site, please contact  webmaster@chclabs.com
^©2008 Covenant Health Care LLC. All Rights Reserved