Module 7 Flashcards

(34 cards)

1
Q

What information has to be documented when inputting data?

A

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

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2
Q

How are requests initiated?

A

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

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3
Q

What is necessary when entering data regarding collection lists and schedules?

A

Prioritize, decide when to collect what.

Draw list indicates collection requests.

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4
Q

When should specimens be collected?

A

Outpatients- collect ASAP

Hospital- early morning, collect a specific test on a number of patients all at once

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5
Q

How is collection verified?

A

Date, time and initials or collection code is recorded on the tube and req.

Collected code can be entered to patient’s data.

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6
Q

How are accessions recorded?

A

Log sheets record collections.

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7
Q

Who is responsible for work lists?

A

Each department

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8
Q

How are results recorded?

A

On department-specific reqs.

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9
Q

How are results stored?

A

Copy of the req and results are retained by the lab.

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10
Q

How are results delivered?

A

By hand

Couriers or porters

Telephoned reports are followed up with a written report

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11
Q

What is work unit tabulation?

A

Each procedure is designated a certain number of work units depending on the complexity and time required.

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12
Q

How is specimen identification verified? What has to be checked?

A

Must ensure the specimen is suitable.

Check for correct:
Patient info
Type of specimen
Volume of specimen
Collection date and time
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13
Q

What makes a specimen unacceptable?

A

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

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14
Q

What is the rejection process?

A

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

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15
Q

How are STAT specimens handled?

A

Have priority, must be processed immediately.

Warn tech, use special centrifuge or STAT flag.

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16
Q

How are tubes centrifuged?

A

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

17
Q

How are specimens received on ice centrifuged?

A

Precooled 4°C centrifuge

18
Q

What do delays in separation result in?

A

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.

19
Q

What do tubes have to be inspected for after centrifugation?

A

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

20
Q

How are tubes handled after centrifugation?

A

Stoppers are pulled straight off.

Separation within 2hrs.

Can use direct sampling equipment or sampler devices (through stopper).

21
Q

What is aliquoting?

A

Moving a sample to another tube.

Can’t mix serum and plasma in the same tube.

22
Q

How is aliquoting organized?

A

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

23
Q

How are micro specimens collected?

A

In capillary or microtainer tubes.

1.5x the required volume.

24
Q

How are micro specimens centrifuged?

A

Microcentrifuge

3min at 2000G

25
How are chilled specimens handled?
Refrigerated centrifuge and chilled tubes.
26
What are lipemic samples?
Chylomicrons are fat particles in blood, make the specimen appear cloudy.
27
How are lipemic samples centrifuged?
Ultracentrifuge
28
What are examples of light sensitive specimens?
Neonatal bilirubin, carotene, Vit A and B6, methotrexate.
29
How are light sensitive specimens stored?
Amber tube or wrapped in foil or brown paper bag
30
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.
31
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
32
How long are patient reports and charts stored for?
10 yrs Paediatric- til the age of majority plus 2yrs or 10yrs (whatever's longest)
33
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
34
What is the best way to perform data entry?
Computerization- streamlines and simplifies procedures and reduces the number of errors.