Module 7 Flashcards
What information has to be documented when inputting data?
Initiation of test request
Patient info
Collection/draw list and schedules
Preparation of labels
Verification of specimen collection
Accession records/log sheets
Creation of work lists
Test results
Storage of test results
Dissemination of test results
Billing
Work unit tabulation
Supply inventory/ordering
How are requests initiated?
Outpatients- paper req, staff enters data
Hospitals- req is entered into the system and will appear in the lab data files
STAT and ASAP tests are printed automatically
What is necessary when entering data regarding collection lists and schedules?
Prioritize, decide when to collect what.
Draw list indicates collection requests.
When should specimens be collected?
Outpatients- collect ASAP
Hospital- early morning, collect a specific test on a number of patients all at once
How is collection verified?
Date, time and initials or collection code is recorded on the tube and req.
Collected code can be entered to patient’s data.
How are accessions recorded?
Log sheets record collections.
Who is responsible for work lists?
Each department
How are results recorded?
On department-specific reqs.
How are results stored?
Copy of the req and results are retained by the lab.
How are results delivered?
By hand
Couriers or porters
Telephoned reports are followed up with a written report
What is work unit tabulation?
Each procedure is designated a certain number of work units depending on the complexity and time required.
How is specimen identification verified? What has to be checked?
Must ensure the specimen is suitable.
Check for correct: Patient info Type of specimen Volume of specimen Collection date and time
What makes a specimen unacceptable?
Inadequate ID
NSQ sample
Incorrect collection- may be able to use an alternate test
Hemolyzed blood samples- usable unless grossly hemolyzed
Incorrect transportation- usually performed but not with leaking specimens
What is the rejection process?
Notify supervisor
Recollect
Notify unit/physician
Enter comment
Don’t discard sample until problem is resolved
Urine and serum samples that can’t be frozen should be refrigerated for up to a week
How are STAT specimens handled?
Have priority, must be processed immediately.
Warn tech, use special centrifuge or STAT flag.
How are tubes centrifuged?
EDTA- placed on mixer, sedimentation within 12hrs, reticulocyte counts within 72hrs, refrigerated up to 24hr
Plasma- spun immediately, PST for 10min at 1000-1300G, NaCit for 15min at 1500G
Serum- allow adequate time for coag prior, red top 30-60min wait, SST 30 min wait for 10min at 1000-1300G, clot activator 5-15min wait, 37°C to speed coag
How are specimens received on ice centrifuged?
Precooled 4°C centrifuge
What do delays in separation result in?
Falsely increased serum/plasma values due to more K in RBCs (diffuses out).
Accelerated by refrigeration.
Serum and plasma should be separated within 2hrs, kept at room temp for no longer than 8hrs.
What do tubes have to be inspected for after centrifugation?
Red tube- separation of clot and serum, free cells or fibrin strands, hemolysis
SST- barrier appearance, RBC/fibrin strands, visible hemolysis
Plasma- clots/fibrin strands, RBCs, visible hemolysis
How are tubes handled after centrifugation?
Stoppers are pulled straight off.
Separation within 2hrs.
Can use direct sampling equipment or sampler devices (through stopper).
What is aliquoting?
Moving a sample to another tube.
Can’t mix serum and plasma in the same tube.
How is aliquoting organized?
Cross check info
Determine number of aliquot tubes, label
Remove stopper
Cross check labels on specimen and aliquot tubes
Use a fresh Pasteur pipette to aliquot
Replace tubes in proper rack position
Stopper aliquot tubes
Double check labels and distribute
How are micro specimens collected?
In capillary or microtainer tubes.
1.5x the required volume.
How are micro specimens centrifuged?
Microcentrifuge
3min at 2000G
How are chilled specimens handled?
Refrigerated centrifuge and chilled tubes.
What are lipemic samples?
Chylomicrons are fat particles in blood, make the specimen appear cloudy.
How are lipemic samples centrifuged?
Ultracentrifuge
What are examples of light sensitive specimens?
Neonatal bilirubin, carotene, Vit A and B6, methotrexate.
How are light sensitive specimens stored?
Amber tube or wrapped in foil or brown paper bag
How must frozen specimens be treated and what happens if they are not?
Must be mixed well before aliquoting.
If unmixed, aliquoted tests give low analyte values and remaining specimen gives high values.
How long are general documents stored for?
Worksheets and QC records- 2yrs
Workload management data- 5yrs
Maintenance records- life of instrument plus 2yrs
Reqs- 1 month min
How long are patient reports and charts stored for?
10 yrs
Paediatric- til the age of majority plus 2yrs or 10yrs (whatever’s longest)
How long are specimens kept for?
Chemistry- one day after final report
Hematology- blood specimens one day after final report, normal slides after one week, abnormal slides and bone marrow after 10yrs
Transfusion medicine- specimens for 7 days after post transfusion, transfused units/segments for 7 days after post transfusion, patient data file is kept indefinitely
Microbiology- specimens for one day after final report, CSF for one week, gram stains after reading
Autopsy records- paraffin blocks/slides for 10yrs, wet tissue for 8wks after final reports
What is the best way to perform data entry?
Computerization- streamlines and simplifies procedures and reduces the number of errors.
