Ascend Clinical, LLC is pleased to provide you with the Specimen Uniformity Performance Evaluation Report (SUPER). The SUPER is a Quality Assurance tool for monitoring the integrity of the samples you submit for testing. Proper specimen collection, preparation and transport are critical in providing you with accurate test results. These results add value in managing and treating your patients. With the SUPER you will be able to quickly see how your facility is doing compared to other dialysis facilities we service. You will immediately know the areas your facility does well in and the areas where improvement is needed. Your staff can access Ascend University (www.Ascend- U.com) to complete tutorials on proper specimen collection, preparation and transport to improve in these areas.
HOW TO RUN YOUR SUPER
From LabCheck (www.LabCheck5.com), click General from Reports menu. Type SUPER in the search area. Click on SUPER Report. Select the month from the drop-down menu. Click Generate Report. *TIP- Add to favorites to quickly run from the home screen.
HOW TO READ YOUR SUPER
The bar graph helps you track your progress throughout the year and provides a benchmark against the average independent dialysis facility.
The table lists the reasons why tests were canceled or compromised by an incident and as a percentage of the requisitions you submitted for the month. Here you can quickly see how your facility is doing compared to other dialysis facilities. If your percentage of requisitions canceled or compromised is lower than the average of all other dialysis facilities or lower than 2.5% you will receive a “Satisfactory” grade. If your percentage is higher, you receive a grade of “Needs Improvement.”
The Comment Codes for Tests Canceled or Compromised lists some of the common reasons why tests are canceled or compromised and briefly explains how to avoid these problems.
Poorly spun or Unspun specimens: The number of specimens that were received unspun. The following tests will be compromised and will be canceled: AST, Ionized Calcium, Chloride, CK, Glucose, Iron, LDH, Potassium, PSA, Transferrin and B12. Improper centrifuging (RPMs too low or spin time not long enough) or specimens allowed to sit for more than 2 hours before centrifuging will compromise these results.
Hemolysis: The number of specimens received with any degree of hemolysis. The following tests will be seriously affected by gross hemolysis and will be canceled: AST, LDH and Potassium. The following tests will be noticeably affected by hemolysis but will be reported: ALT, and Iron. The following tests will be slightly affected by hemolysis but will be reported: Albumin, ALP, Calcium, Magnesium, Phosphorus, Total Bilirubin and Total Protein. Partially restricted blood access, difficult venipuncture, unbalanced centrifuges or placing the specimens directly on ice are the usual causes.
Clotted EDTA or Citrate specimens: The number of clotted Lavender or Light Blue Top tubes. CBC, Hemogram, Platelets, Hemoglobin and Hematocrit, Reticulocyte and Prothrombin Time will be canceled. Inadequate mixing of the specimen immediately after drawing is usually the cause.
Mislabeled or Unlabeled specimens: The number of specimens mislabeled or unlabeled. Specimens must be labeled with the correct collection label generated when orders are submitted. It is extremely important to verify that the patient name on the label matches the name of the patient the specimens are collected from, to correctly label PRE and POST samples and to correctly identify timed fluid and urine specimens so that accurate calculations can be provided. For example, be sure to use the 24 HOUR FLUID label on the 24 Hour Fluid (Dialysate) specimen and the URINE label on the 24 Hour Urine specimen.
Quantity Not Sufficient (QNS): Quantity Not Sufficient for analysis. For example, specimens collected in the Light Blue Top tube need to be filled to the nominal fill range indicated on the tube. Specimens filled with levels below or above this gauge will be canceled.
Specimen Too Old: The number of specimens past stability. For example, CBCs received after 72 hours will result in a “Collection Date” comment on the final lab report. Also, for Friday draws, please indicate “Saturday delivery” for the courier to ensure prompt and accurate testing. Specimens for LAL’s and Colony counts must be received by the lab within 24 hours of collection.
Incorrect Temperature: The number of specimens sent at the wrong temperature. Many specimens must be shipped with ice packs to stabilize the tests. Other tests like the Prothrombin Time and Blood Cultures must be shipped at room temperature. Consult the Specimen Handling posters for more information.
Other: A broad category that counts a number of miscellaneous errors such as: needle found in bag, specimens that leaked in transport, collection errors resulting in specimens diluted with saline, heparin, priming or rinsing solution.