SBH 3 G 05 12 Crisis Recovery Unit
Purpose: To provide uniform procedures for ordering, collecting, handling and reporting
1. Behavioral Health Medical Practitioner (BHMP) determines what Clinical Laboratory
Testing is indicate to support and safely treat the consumer.
A. BHMP orders lab tests on physician order sheet.
B. BHMP gives order to RN.
C. All medication blood levels should be presumed as 12-hour post dose levels
and should be drawn accordingly unless ordered otherwise by the BHMP.
D. RN or staff completes label, lab request form.
E. RN or trained staff identifies consumer and obtains specimen using Universal
F. If RN or trained staff person is unable to draw blood specimen after two
attempts another RN or trained staff person will attempt no more than two
times. If the specimen is still not obtained the BHMP is notified and the
attempts to draw and the notification are documented in the chart.
G. The BHMP may attempt to draw the specimen or order that the person be taken
to the contracted laboratory’s location to be drawn if it is safe for them to leave
the CRU site.
H. RN or staff places specimen in lab specimen bag with the lab request form in
nursing station, refrigerating if indicated after completing any on-site processing
of the specimen required for a specific test.
I. RN or staff arranges for transportation of the specimen by contacting the lab
1. Inpatient Lab Reports
A. All new lab results received by fax are to immediately be given to the RN on
duty who reviews them. If the BHMP is on site the results will be given to them
to review and evaluate. If the BHMP is not present they will immediately be
notified by phone of any abnormal values. The RN will make a notation in the
progress notes of the call, the abnormal values reported to the BHMP and any
follow up action that is ordered.
Revised: 26 Aug 02; 5 Jul 11
B. All calls from the lab reporting Critical values are to be given immediately to
the RN on duty who immediately informs the BHMP whether on site or on-call.
The RN will then meet with the consumer to determine if any symptoms are
present related to the Critical value and will check vital signs. The RN makes a
notation in the progress notes of the telephonic notification from the lab
including the reported value, that the BHMP was notified, the time of the
notification, the findings from the RNs examination of the consumer and any
follow up action that was ordered by the BHMP. The printed/faxed report from
the lab after the phone call will be handed to the BHMP who, if on site will initial
and date it and then it is filed in the chart. If the BHMP is not present at the
time, the results will be made available to them when they arrive, to be initialed
and signed by them before filing.
C. The BHMP is responsible for making sure that they have received the results of
all lab tests that they have ordered and initiating follow up if they have not. The
BHMP must acknowledging they have reviewed all results received by initialing
and dating the results and documenting the significance of results outside the
normal ranges and any planned follow up.
2. Inpatient responsibility for SBH Outpatient Programs Critical Lab Values After
Regular Business Hours, Weekend Days and Holidays (CRUs will not receive
critical lab information for Apache Junction and Payson programs)
A. Lab will contact CRU RN after hours (5 pm – 8 am), weekend days and
holidays to report a critical lab value.
B. Lab will fax critical lab results to CRU RN. Typically this is related to
electrolytes, glucose and/or toxic medication levels (i.e., Lithium).
C. CRU RN contact crisis line to call client at home (i.e., 3-way conference call
facilitated by crisis). This is a “transferring or relaying of information” to the
client. I.E., “there is a potential problem with your lab results; we are
recommending that you go to the ER to get redrawn”. For NARBHA programs,
RN communicates information to the SBH crisis staff person on call who will
relay information to the individual in service.
Crisis Phone Numbers
Bullhead Flagstaff Maricopa Prescott
City (NARBHA) County (NARBHA)
928-542-8924 928-600-8389 602-222-9444 928-710-1708
Revised: 26 Aug 02; 5 Jul 11
D. Report above information to Guardian / parents for minors.
E. If client doesn’t answer the phone then you request crisis to do a home visit /
F. If client address and phone number are not documented on the lab slip then
O/N staff to assist RN to secure client information so that appropriate follow up
care can be coordinated.
G. RN documents 2 progress notes (one for t/c taken from the lab and one for the
t/c made to report the information) that includes: time of service, service
duration, billing code, service description, brief description of service, staff
signature and date. When applicable (see chart) one SAL is completed and
both billable services are documented on the same SAL.
H. Email sent to the VP of Outpatient Services, the VP of SBH in northern Arizona,
the VP of CRS and the Medical Director; CC the Director of Nursing reporting
incident. Attach to the email a scanned copy of the lab slip, progress note and
SAL (if applicable) and add to the email any pertinent information that you
secured from ECR, CMHC, HMS (i.e., if there was inaccurate information on the
lab slip, client wasn’t able to be reached, etc…).
SAL Billing Code / Service
ECR BHP(RN) Yes 5234 RN services out of
HMS BHP(RN) No No code
Retrieval of Client Address and/or Phone Number:
ECR: Client intake / summary page or in the scanned documents (client cover sheet).
HMS: Look at the client contact information. It is the responsibility of Sue Ann, Doctor
Kilgore and Doug Barshter to follow up with the designated OP site to: 1) ensure that all case
management billing for these clients gets entered into ECR, HMS or paper charts and 2)
is completed by the designated OP Program staff person, assigned to the client.
Revised: 26 Aug 02; 5 Jul 11