Actions by the laboratory
Identify the critical results
Critical results to be phoned to the prescriber
Contact the responsible physician
When to contact
As soon as the critical result is confirmed, ideally within 30 minutes.
How to contact
- Use the direct line (mobile phone, dedicated number)
- If the primary physician is unreachable then notify the on-call medical team
- Document the name of the physician, time of contact and details of the communication
Communicate the results
Provide essential information clearly and concisely
- Bacteriological results (identified pathogen, antibiogram if available)
- Patient status (based on available information)
If only partial results are available (e.g., Gram stain) then specify when results will be provided
Documentation
Record in the laboratory system
- Time of communication
- Physician or service informed
- Summary of information transmitted
Actions by the physician
When prescribing a bacteriological exam
- Inform the lab of the urgency of the situation (risk of sepsis, septic shock, immunocompromised patient)
- Complete the request form with the necessary clinical information and, where applicable, the mention of urgency
Receive the result
- Acknowledge receipt of the laboratory’s message
- Evaluate the patient’s clinical condition considering the results (severity, progression)
Analyze and interpret
- Verify if the results correlate with clinical signs
- Compare with clinical data and other tests (e.g., CBC, CRP, other cultures)
Therapeutic decision-making
For unstable patients
- Initiate or adjust empirical antibiotic therapy based on the identified pathogen and antibiogram
- Assess the need for intensive care or critical care interventions
For stable patients
- Modify antibiotic therapy if needed based on the results
- Decide on the continuation or cessation of further investigations
Medical documentation
- Incorporate results into the patient’s record.
- Note the decisions made, including justifications for treatment changes.
Follow-up
- Plan close clinical monitoring, including tracking of infectious and hemodynamic parameters.
- Organize follow-up cultures or additional tests if necessary.
Coordination between laboratory and physician
- Maintain open communication for updates (e.g., final identification, complete antibiogram)
- Apply the same procedure for any additional critical results