MAP 228 - Med Lab Procedures II

1. Comply with OSHA regulations and protective practices
   1. List safety items that should be available in the medical laboratory
   2. Follow Standard Precaution guidelines when handling laboratory specimens
   3. Explain terms relating to OSHA guidelines
   4. Select appropriate barrier/personal protective equipment
   5. Perform handwashing
   6. Demonstrate proper disposal of biohazardous material: sharps and regulated wastes
   7. Recognize the implications for failure to comply with CDC regulations in healthcare settings
   8. Comply with: safety signs, symbols and labels
2. CLIA and Quality Assurance
   1. Identify CLIA waived tests
   2. Obtain specimens and perform: CLIA waived hematology test; CLIA waived chemistry test; CLIA waived immunology test
   3. Identify quality assurance practices in healthcare
   4. Perform a quality control measure
   5. Follow CLIA regulations for performing controls run on automated laboratory equipment
   6. Determine acceptable ranges for control specimens
   7. Analyze control specimens
   8. Record control results on quality control logs
   9. Graph control results on quality control graphs
   10. Interpret results for accuracy, precision, and reliability
3. Blood collection: perform venipuncture
   1. Follow identified safety precautions when drawing blood
   2. Select appropriate needle gauge for venipuncture
   3. Select appropriate vacutainer tube for tests ordered
   4. Select appropriate site for venipuncture
   5. Obtain blood using proper technique
   6. Label specimen properly
   7. Dispose of used equipment according to OSHA regulations
   8. Document procedure
   9. Take appropriate measures if patient becomes faint during procedure
   10. Obtain specimen using a butterfly needle
   11. Obtain specimens for testing on whole blood, serum and plasma
4. Blood collection: perform capillary puncture
   1. Follow safety precautions when performing a capillary puncture
   2. Select appropriate site for capillary puncture on an adult
   3. Obtain specimen using a lancet
   4. Properly fill required collection device for test ordered
5. Perform microhematocrit testing
   1. Use appropriate terminology related to hematocrit testing
   2. State pathological conditions that will increase the hematocrit
   3. State pathological conditions that will decrease the hematocrit
   4. Follow guidelines to prevent technical errors that could affect hematocrit
   5. Fill microhematocrit properly
   6. Read hematocrit using the readocrit scale
   7. Chart hematocrit results
   8. State normal range for hematocrit values
6. Perform automated white blood cell (WBC)counts
   1. Record the WBC count properly
   2. State normal range for WBC counts in adults
   3. Use appropriate terms related to WBC testing
   4. State 3 conditions that could cause an increase in the total WBC count
   5. State 3 conditions that could cause a decrease in the total WBC count
7. Perform a white blood cell differential count on a normal blood smear
   1. Identify the five types of white blood cells
   2. Recognize the morphological characteristics of neutrophils (segmented and bands), basophils, eosinophils, monocytes and lymphocytes
   3. State the normal percentages for each of the 5 types of white blood cells
   4. Count 100 normal white blood cells on a blood cell differential slide
   5. Apply terms related to red blood cell morphology
   6. Identify normal red blood cell morphology
   7. Apply terms that relate to differential blood smears
   8. State pathological conditions that could affect the differential count
8. Perform an automated hemoglobin test
   1. Perform daily start-up procedures for analyzer
   2. Run controls
   3. Apply terms related to hemoglobin determinations
   4. Perform tests following manufacturer’s instructions
   5. Explain three basic causes of anemia
   6. State two primary functions of hemoglobin
   7. Identify normal hemoglobin values for adult male and female
   8. Calibrate hemopoint hemoglobinometer
9. Perform Blood Chemistry Analyses
   1. Determine if specimen is acceptable for blood chemistry testing
   2. Apply terms related to blood chemistry testing
   3. Recognize normal values for fasting blood sugars, cholesterol and triglycerides
   4. Explain significance of testing for glycosolated hemoglobin (Hb AIC).
   5. List the 4 primary electrolytes
   6. Explain the difference between direct and indirect bilirubin
   7. Explain the significance of testing for low density lipoproteins (LDL) and high density lipoproteins (HDL)
   8. Explain the purpose of tests for blood urea nitrogen and creatinine
   9. Explain the significance of elevated results in blood chemistries for Aspartate Transaminase (AST), Alanine Aminotransferase (ALT) and Troponin levels
   10. Perform blood chemistry tests
   11. Chart results of blood chemistry tests in proper format
10. Perform immunology tests for infectious mononucleosis
    1. Obtain appropriate specimen for testing
    2. Perform tests according to manufacturer’s instructions
    3. Identify sources of technical errors when performing tests for infectious mononucleosis
    4. Define heterophile antibody
    5. Recognize symptoms of infectious mononucleosis
    6. Run positive and negative controls
    7. State changes that would be seen on a differential count on a patient with infectious mononucleosis
    8. Interpret and record results properly
    9. State the causative organism of infectious mononucleosis
11. Perform electrocardiography
    1. Apply terms associated with electrocardiography
    2. Recognize the P,Q,R,S and T waves on the ECG
    3. Standardize the electrocardiograph
    4. Identify the standard rate that the ECG paper moves through the machine
    5. Place sensors on limbs and chest in proper positions
    6. Differentiate somatic interference from AC interference
    7. Correct problems caused by AC interference and somatic tremor
    8. Instruct the patient on steps involved in preparation for taking the ECG
    9. Record appropriate patient information on the ECG
12. Perform Erythrocyte Sedimentation Rate (ESR).
    1. Apply terminology associated with ESR testing
    2. Recognize normal values for ESR for males and females
    3. Explain the significance of the finding of an increased level of ESR
    4. Take precautions to ensure the ESR results are accurate
    5. Set up an ESR tube accurately
    6. Obtain reading from ESR tube
    7. Record the ESR results
13. Perform coagulation tests
    1. Define Prothrombin
    2. State the purpose of Prothrombin
    3. Define warfarin
    4. State 2 conditions that require coumadin therapy
    5. Define INR
    6. State the therapeutic range for INR
    7. State the procedure for using capillary puncture specimens in INR testing
14. Perform Hemoccult testing
    1. Define Hemoccult blood
    2. Define guaiac test
    3. State causes for blood in a stool specimen
    4. Describe the appearance of stool specimens that contain blood from the upper GI vs. lower GI system
    5. Instruct patient on dietary restrictions to be followed prior to collecting specimen for Hemoccult blood testing
    6. Instruct patient on proper collection of stool sample for Hemoccult testing
    7. Accurately develop and read the Hemoccult test
    8. Document results in patient chart and CLIA log
15. Utilize critical thinking skills
    1. Formulate questions to determine if important information is lacking
    2. Reject information that is not accurate, relevant, precise or clear
    3. Double check all facts
    4. Examine the situation and evaluate the problem without bias or judgement
    5. Assess the situation for reason and logic
    6. Determine the goal to be accomplished
    7. Follow steps for implementation/problem solving
    8. Evaluate outcomes
    9. Incorporate critical thinking skills when performing patient assessment
    10. Incorporate critical thinking skills when performing patient care
    11. Demonstrate knowledge of basic math computations
    12. Perform patient screening using established protocols
    13. Differentiate between normal and abnormal test results
    14. Document patient care accurately in the medical record
16. Communication and Diversity
    1. Report relevant information concisely and accurately
    2. Show awareness of a patient’s concerns related to the procedure being performed
    3. Reassure a patient of the accuracy of the test results
    4. Instruct and prepare a patient for a procedure or a treatment
    5. Demonstrate: empathy; active listening and nonverbal communication
    6. Demonstrate the principles of self-boundaries
    7. Demonstrate respect for individual diversity, including: gender, race, religion, age, economic status and appearance
    8. Explain to a patient the rationale for performance of a procedure
    9. Demonstrate sensitivity to patient rights
    10. Protect the integrity of the medical record
    11. Apply HIPAA rules in regard to: privacy and release of information