[MT-L] Client Server and Lactic acid protocols - automatic reflex orders

[Freeman, Gale via Meditech-L]

Have any sites out there used reflex orders to repeat high Lactic acid levels for sepsis protocols ?

Our scenario is a patient comes in and has a Lactic acid drawn. If it is >2.0 , we have a reflex test that is auto resulted as Y.
That auto result kicks off at 3.0 hours from completion time. That reflexes an followup Lactic acid at 3 hrs (it is same test , but different mnemonic) .
If that test is >2.0 another reflex is auto resulted as Y at 3 hrs again. It orders another followup Lactic acid at 3 hrs .
This continues until the Lactic acid value is 2.0 or less. The followup tests are generating from the time the auto resulted test is resulted, not from the
time the lactic acids are collected.

Is any one doing this type of thing ? If you are, have you had any issues ?

We have issues with floors being confused and wanting the reflexes canceled, or drawing the patient at the wrong times.
Part of the issue is when you reflex orders based on times, the reflex order does not appear until it is time to collect it. We use Mobilab for collections.

Now nursing has requested it be reflexed at 12-18 hours.

Thoughts / Comments welcome.

Gale Y. Freeman
MIS IT Systems Analyst
Samaritan Medical Center
830 Washington Street
Watertown, NY, 13601
gfre...@shsny.com<mailto:gfre...@shsny.com>
315-785-5751
samaritanhealth<http://www.samaritanhealth.com/>.com<http://www.samaritanhealth.com/>

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