2012 Blood Waived Testing

8/2/2019 2012 Blood Waived Testing

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In addition to this module, will need to review:

** OUMC Policy 11-03 Waived Testing** OUMC Policy 11-20 Identification and Labeling of Specimens** Manufacturers Guide for each test


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Always make sure when performing any of

these tests that you: Check two patient identifiers.

Ensure QC has been completed prior to performing

the test. Use standard precautions when performing test and

obtaining the specimen.

Check expiration dates on material that you will be

using for the test or QC. Explain the procedure or test to the patient.


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Urine Dipstick/Ketones QC must be completed each time a new bottle of strips is

opened.

KOVA Liqua-Trol is to be used to test for normal and abnormal

readings on first strip of each new bottle and then monthly. Remove test strip from bottle, check expiration date on bottle.

Completely immerse reagent area in FRESH urine, ensure goodsaturation and remove.

Use the specific color chart to visually interpret test results at the

appropriate time as indicated by manufacturers instructions. Record test results in the patients medical record.

Always follow the manufacturers recommendation whenperforming QC or test.


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Urine Pregnancy Test (HCG)Allows quick qualitativemeasurement of HCG atbedside from a urine

specimen. To be performed if patient

could possibly be pregnant.

External controls must beperformed every time a newbox of test packs is opened.


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Urine Pregnancy (HCG)

Every test pack has a control line thatmust be present for the test to be valid.This is not the same as a positive result.If no control line appears the test is

invalid and must be discarded.Allow test to stand per manufacturers

direction. A positive result will have twolines, the control line and another

indicating the presence of HCG. Look on the package for expiration dates

and discard expired packages.


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Nitazine paper to

check pH Used to check pH in body fluids

such as semen, amniotic fluid,and gastric aspirates. Use standard precautions.

Collect fresh specimen. DipNitrazine paper into specimen,

shake excess fluid off of paper.Refer to color chart to interpretpH.

Dispose of specimen and paperproperly.

Do not use expired paper. Donot use specimens inpreservative solution. Do not usea towel or paper napkin to blot

excess fluid.


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Fecal Occult BloodUsed for detection of blood in feces.

Hemoccult card, Hemoccult developer,and stool specimen required.


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Fecal Occult Blood Obtain stool specimen. Smear a small amount of stool

onto the Hemoccult card in the boxes marked A and B.Close the flap and allow the Hemoccult card to sit for3-5 minutes to allow penetration through the paper.On the other side of the card, apply 2 drops ofHemoccult developer to each area over the smears.Apply 1 drop of Hemoccult developer between thepositive and negative controls near the bottom of thetest area. Read results in less than 60 seconds. Anytrace of blue on or at the edge of the smear is a positiveresult.


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Fecal Occult Blood Both Hemoccult card and Hemoccult developer

must not be expired. Control positive must be

positive and control negative must be negative. Ifnot, test is invalid and must be discarded. Use onlyHemoccult cards and Hemoccult developer.

Gastroccult, Hemoccult ICT, and Hemoccult

SENSA cards and developers are notinterchangeable for this test.


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Glucometer QC must be done every 24 hours.

QC solution is good for 90 days

after opening and should belabeled with expiration date whenthe vial is opened.

Assure that strips and code key lot

number match. Strips are good until the date on

the side of the strip vial.


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If the meter displays HI, glucose isgreater than 600. If it displays LO,glucose is less than 10.

OUMC Normal range is 70-110.

OUMC critical range is 450.When the circumstances indicate that

you should contact a physician, ensurethat you document the results and full

name of the physician that younotified.


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Strep Group A Test

Used for quick diagnosis at bedside ofStreptococcus Group A infection of thethroat.

Reagents, tube, tray, and swab provided bymanufacturer.


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Strep Group A Test Obtain pharyngeal specimen from patient using sterile

rayon swab provided by manufacturer. Test specimenimmediately or prepare for transport in modified Stuarts

liquid transport media. Place test tube into tray, keepingtube upright. Add four drops each of Reagent 1 and Reagent2. Insert specimen swab into mixed reagent and twirl swabto mix. Let stand for 1 minute to ensure saturation. Remove

swab while squeezing tube to drain specimen from swab.Insert test strip into tube. Let stand for 5 minutes. Twored/pink lines indicate a positive result. One red line nearthe C indicates a negative result. One red/pink line nearthe T indicates an invalid result and must be discarded.


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Strep Group A Test False positives/negatives can be caused by:

Using swab other than the provided rayon swab

Obtaining specimen from source other than the back ofthe patients throat

Using non-approved transport media,

Using expired equipment,

Using incorrect reagents,

Incorrectly mixing reagents, or Removing swab or test strip before the proper amount of

time has elapsed.

Positive and negative controls must be tested with

every kit. Equipment must be stored at 15C-30C.


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I-Stat Quality Control with the electronic simulator must be

performed every 8 hours.

Aqueous cartridge QC must be done monthly. Individual cartridges must be at warm to room

temperature for 5 minutes. An entire box must be atwarm to room temperature for 1 hour.

Cartridges are good once brought to room temperaturefor 2 weeks. The expiration date should be writteneither on the box or the individual cartridge.


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I-Stat Care should be taken not to contaminant the specimen

during collection. Make sure that sample is free fromIV fluids and that the sample is mixed well to prevent

separation. If sample is taken outside of the patients room it must

be first labeled with a patients label.

Each staff member will receive their unique operator

ID after training. This will be used when running a testor QC.

The I-Stat should be docked and download aminimum of once a shift.


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Biosite The BioSite allows blood to be quickly tested for

cardiac markers at the bedside.

Anyone with suspected cardiac issues will be tested bythe BioSite.

Most commonly, Myoglobin, CK-MB, and Troponinare tested all at the same time. BNP can also be

checked simultaneously to evaluate CHF.


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BiositeThe most common problems are using

the wrong tube for blood specimens

(purple/lavender must be used) andallowing the calibration to lapse.

The machine must be calibrated with aspecial cartridge every 24 hours.


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Biosite To use the BioSite, collect a specimen in a purple

topped tube. Enter the patients account number

into the BioSite machine. Use the provideddropper to put blood into the test area of thecartridge. Insert the cartridge and press the blueenter button.

The cartridge will automatically eject after the testis complete. Press the red cancel button to eject acartridge currently being tested.


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References: OUMC Policy 11-03 Waived Testing

OUMC Policy 11-20 Identification and Labeling ofSpecimens

Manufacturers Guide for each test.

Core Lab Policy: Point of Care

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2012 Blood Waived Testing

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