Culture and sensitivity test involves growth and identification of pathogenic microorganisms.
OSHA provides guidelines and regulations for healthcare facilities' exposure control plans.
Waived tests are exempt from proficiency testing.
Specimen Handling
Urine must be used for urine pregnancy tests as specified by the manufacturer; serum cannot be substituted.
Proficiency testing involves testing outside specimens to compare results with other laboratories.
Treat all samples as if they contain infectious agents.
Store rapid Strep A test strips sealed in the pouch at room temperature or refrigerated (2-30 °C).
Urine samples for drug screening should follow chain of custody procedures.
Don't touch the inside of the sterile container or its lid when collecting a mid-stream urine sample for bacterial culture.
24-hour urine sample may require a preservative.
Quality Assurance and Control:
The Safety Data Sheet (SDS) provides chemical properties of reagents.
Frequency of instrument calibration is determined by the manufacturer.
To determine the acceptable control range, an aliquot of the control should be tested daily for 15-25 days.
Standard precautions are observed when handling all patients and specimens.
A shift in control data is indicated by a sudden change in control values from the mean.
A trend in control data is indicated by five consecutive control results falling on the same side of the mean.
QA monitors activities throughout the total testing process, while QC evaluates the analytical phase.
Quality assurance is a comprehensive set of policies, procedures, and practices that ensures a laboratory's results are reliable.
CMS identifies companies that provide proficiency testing; The Joint Commission's inspection exemplifies external quality control.
Appropriate handling and disposal of regulated medical waste is a component of OSHA's Bloodborne Pathogens Standard.
The GHS system allows for consistency in hazard identification internationally and uses SDSs.
Performing quality control daily is required to ensure the reliability of test results for a point-of-care instrument.
Testing and Results
Molecular testing provides specific and sensitive results for influenza in a timely manner.
Molecular diagnostic testing platforms often group tests together in panels such as COVID-19, Influenza A, Influenza B, and RSV.
Positive Streptococcus sp. can be identified with a throat culture
The mathematical average of a set of values is called the mean value.
If laboratory assay results are directly proportional to the concentration, the assay is said to show linearity.
The accuracy of an obtained result describes how close the result is to the actual value.
Drug screen confirmation requires GC/MS testing where 'MS' stands for Mass Spectrometry.
RPR test detects nonspecific antibodies that may indicate current or past syphilis infection.
A diabetic patient may present urine positive for both ketones and glucose
ESR stands for Erythrocyte Sedimentation Rate
Specimen Collection
No, the specimen indicated in the manufacturer's directions must be used when testing a patient who has a skin lesion suspected of being streptococcal cellulitis.
Only a person with an associate or bachelor's degree in biological science can perform testing using a waived test for a patient population that was not included in the manufacturer's instructions.
An example of off-label use of a waived urine pregnancy test is testing patient serum.
Sterilization is the technique of killing or destroying all microorganisms including bacterial spores.
Venipuncture in isolation room: Read the posted isolation requirements as the first step.
Standard deviation is (variance) of values in a series of test results.
Place red-top tube in a cooler with ice packs when preparing a blood sample for a reference lab test that requires whole blood.
A syringe can be used with a winged infusion set if the multisample adapter is removed.
Expired supplies should be removed from storage locations and disposed of
Serum is the liquid portion of blood after it has clotted.
The median cubital is considered the vein of choice for venipuncture.
The blood sample drawn using a syringe and safety needle should be added to the tubes using a transfer device.
Safety needles have a shield attached to them.
If the tourniquet is on the patient's arm for greater than one minute, hemoconcentration can occur.
To mix the anticoagulant with the blood drawn in a lavender top tube, the tube should be gently inverted 6 to 8 times.
Patients should remove food or chewing gum before venipuncture because having food or chewing gum in the mouth could be a choking hazard
The bleeding must stop before the bandage can be applied after venipuncture
Medial and lateral portions of the plantar portion of the heel is the preferred site to collect samples for newborn screening.
Nerve damage is the most likely complication when a patient experiences sudden, sharp pain and tingling during venipuncture.
Plasma is the liquid portion of anticoagulated blood.
Pulse should be felt when selecting a site for venipuncture if a CMLA feels a blood vessel very close to a vein
Lancets are single-use devices used for capillary punctures.
A microhematocrit measures the proportion of Erythrocytes of blood .
Specific Gravity in urinalysis compares the weight of urine to the weight of an equal amount of water
Microscope
KOH prep: Method used to prepare a sample for viewing fungi under a microscope.
Beta hemolysis of the RBCs present in the agar media indicates a visible clearing around the organism on a sheep blood agar (SBA) plate.
Spores are the reproductive structure of molds that is easily transmitted by aerosolization.
Adjusting the diaphragm opens or closes a series of overlapping thin metal plates that control the amount of light that reaches the specimen.
Procedures
Fix the smear after making a smear on a glass slide, after the slides are prepared for Gram stain
During venipuncture, discontinue the draw if a patient begins seizing.
2 kidneys, 2 ureters, 1 urinary bladder, and 1 urethra are the main structures of the urinary system
Capped tightly and refrigerated is the best way to store urine if it cannot be tested immediately
There are currently no CLIA-waived tests in which Blood bank
Physician Assistant are considered PPM when it comes to performing microscopic examination under the CLIA category.
Run QC on the new shipment, even if QC was performed on the previous shipment for healthcare facility receiving new shipment of test kits with the same lot number as the test kits currently in use.
Greetings
"Can you tell me your name?" should the medical laboratory assistant ask the patient next after introducing themselves
"Hello, this is Joe, the medical laboratory assistant, how may I help you?" is the recommended greeting when answering the telephone in the laboratory?
"Hi, I'm Beth from the laboratory. I would like to collect a blood specimen, with your permission" should be used to address the patient.
Patient Care
Explain to the phlebotomist that the patient has the right to refuse, and to document as such for the missed collection is the best response to this issue
"Refuse to interpret the result because interpreting laboratory results is not within your scope of practice" should be used for answering a patient calling to ask for help interpreting their recent laboratory results.
"Privacy laws prohibit me from providing that information." should be used for answering a patient who asks for the name of another patient?
"Find another healthcare worker who speaks the language to interpret" should be when encountering a patient that does not speak English
"Log them off, log in with your credentials, then enter the result" should you do if a colleague leaves their computer terminal logged into the health information system, and you have an urgent result to enter.
In addition to the patient's name, Patient hospital number or date of birth, the data transmitted, and the names of the persons issuing and receiving the report is needed to document when calling a critical value result to a healthcare provider.
Have the person answering the call repeat the information back to the caller to ensure accuracy is recommended when a medical laboratory assistant calls a healthcare provider with a critical value report
The test is most reliable after the fast medical laboratory assistant should explain that when a patient asks why they need to fast for 8-12 hours for a glucose test
According to the AHA's Patient Care Partnership, Help with billing claims is what a patient should expect during their inpatient stay.
Other
Explain the phlebotomist that the patient has the right to reuse and document such for the missed collection
A complete and final laboratory report should contain the Patient's name and other identifying information, such as date of birth based an CMS requirement a healthcare facility must provide the laboratory test report to a patient within 30 days
A critical value is defined as a laboratory result that must be called to the physician because the test value an Advance Beneficiary Notice of Non- coverage (ABN) also known as Form CMS-R-131 informs individual that medical may not covered the specific test or procedure
ensure that the shoe is made of fluid impermeable material and close toed while choosing appropriate professional footwear for the laboratory
When a blood test requests the patient to fast, the patient should be instructed to abstain from food and beverages (except water) or 8-12 hours
When Medical Laboratory Assistant enters a patient's room for phlebotomy: Hi, I'm Beth from the laboratory. I would like to collect a blood specimen, with your permission is the appropriate professional greeting to be used to address the patient.
When Medical Laboratory Assistant enters a patient's room for phlebotomy: Hi, I'm Beth from the laboratory. I would like to collect a blood specimen, with your permission is the appropriate professional greeting to be used to address the patient.