Chapter 14 - Laboratory and equipment safety. After you have mastered the material in this chapter, you will be able to: Describe the purpose of the physician’s office laboratory, list the medical assistant’s duties in the physician’s office laboratory, identify important pieces of laboratory equipment, operate a microscope,...
CHAPTER 14 Laboratory and Equipment Safety © 2011 The McGraw-Hill Companies, Inc All rights reserved 142 Learning Outcomes 14.1 Describe the purpose of the physician’s office laboratory 14.2 List the medical assistant’s duties in the physician’s office laboratory 14.3 Identify important pieces of laboratory equipment 14.4 Operate a microscope © 2011 The McGraw-Hill Companies, Inc All rights reserved 143 Learning Outcomes (cont.) 14.5 Identify the regulatory controls governing procedures completed in the physician’s office laboratory 14.6 Identify measures to prevent accidents 14.7 Describe the goal of a quality assurance program in a physician’s office laboratory © 2011 The McGraw-Hill Companies, Inc All rights reserved 144 Learning Outcomes (cont.) 14.8 Identify the medical assistant’s recordkeeping responsibilities 14.9 Describe correct waste disposal procedures 14.10 Describe the need for quality assurance and quality control programs © 2011 The McGraw-Hill Companies, Inc All rights reserved 145 Learning Outcomes (cont.) 14.11 Maintain accurate documentation, including all logs related to quality control 14.12 List common reference materials to consult for information on procedures performed in the physician’s office laboratory 14.13 Communicate with patients regarding test preparation and follow-up © 2011 The McGraw-Hill Companies, Inc All rights reserved 146 Introduction • Laboratory testing – integral part of patient care • Medical assistant must know – Common laboratory equipment – Safety in the laboratory • CLIA ’88 – impact on laboratory setting – Quality assurance – Quality control procedures – Required record keeping – Steps to prevent accidents © 2011 The McGraw-Hill Companies, Inc All rights reserved 147 Role of Laboratory Testing in Patient Care • Analysis of blood, urine, and other body fluids – Regular monitoring to identify diseases or other problems – Confirm initial diagnosis – Determine and monitor dosage of a medication © 2011 The McGraw-Hill Companies, Inc All rights reserved 148 Role of Laboratory Testing (cont.) • Kinds of laboratories – Reference laboratory • Owned and operated by an organization outside the practice – POL • Quicker turnaround • Eliminates need for patient travel to other test location • Have technological resources beyond the POL Some managed care companies require their subscribers to use a specific reference laboratory © 2011 The McGraw-Hill Companies, Inc All rights reserved 149 Role of Laboratory Testing (cont.) • Purpose of POL – Accurate and timely processing of routine tests – Reporting test results to physician – Tests • • • • Chemical analysis Hematologic tests Microbiologic tests Urinalysis © 2011 The McGraw-Hill Companies, Inc All rights reserved 1410 Apply Your Knowledge Compare a reference laboratory and the POL ANSWER: A reference laboratory is a lab facility usually run by an organization separate from the practice It has technologies beyond the POL Patients have to travel to this facility A POL provides quicker turnaround on results but is limited in the testing that can be performed Patients are able to have testing done during an appointment without leaving the office Super! © 2011 The McGraw-Hill Companies, Inc All rights reserved 1439 Proficiency Testing • Proficiency testing program – Accuracy of test results – Adherence to standard operating procedures • Control sample, documentation sent to proficiency testing organization – Pass – continue performing test – Fail – discontinue performing tests © 2011 The McGraw-Hill Companies, Inc All rights reserved 1440 QA Programs • Training, continuing education, and documentation – Employer responsibility – Reference material • MSDS/safety manuals/SOPs • Manufacturers’ user or reference guides • Clinical Lab Technical Procedure Manuals • Regulatory documentation (OSHA, CLIA ’88) • Maintenance and housekeeping schedules © 2011 The McGraw-Hill Companies, Inc All rights reserved 1441 QA Programs (cont.) • Requisition forms – Medical assistant’s responsibility – Complete information – Include with specimen or send with patient to laboratory © 2011 The McGraw-Hill Companies, Inc All rights reserved 1442 Apply Your Knowledge What is the purpose of a quality assurance program for a laboratory? ANSWER: The purpose of a QA program for a lab is to monitor the quality of patient care, ensure safety of workers, and assess the quality of tests performed Quality Answer! © 2011 The McGraw-Hill Companies, Inc All rights reserved 1443 Communicating with the Patient • Before testing – Patient preparation – Verification of patient preparation • During specimen collection – Proper patient identification – Verbal and nonverbal • After specimen collection – Postprocedure instructions – Schedule for further testing, if needed © 2011 The McGraw-Hill Companies, Inc All rights reserved 1444 Communicating with the Patient (cont.) • Test results – Report to physician for interpretation – Report to patient, if instructed to by the physician – Patient questions • Answer if within your scope • Refer to physician © 2011 The McGraw-Hill Companies, Inc All rights reserved 1445 Record Keeping • Quality control and equipment maintenance • Inventory control • Record test results in patient records Tracking of specimens â 2011 The McGraw-Hill Companies, Inc All rights reserved 1446 Record Keeping (cont.) • Patient records – Identify unusual findings – Follow office procedures • Specimen identification – Patient information – Person who collected specimen – Physician Patient: Jason Jones DOB: 10/22/0000 Date / time: 04/14/0000 @ 9:00 AM Collected by: shf Physician: M Welby © 2011 The McGraw-Hill Companies, Inc All rights reserved 1447 Apply Your Knowledge Bravo! Mr Jones called for his laboratory results but the physician has not reviewed the results What should the medical assistant do? ANSWER: The medical assistant should tell Mr Jones that the physician has to review the results before releasing them to the patient She should also tell Mr Jones that she or the physician will call with the results once they are reviewed When she reviews Mr Jones’ laboratory results, she notes that his glucose is elevated What should the medical assistant do? ANSWER: She should identify the test result that is out-of-range by circling or underlining it based on office policy © 2011 The McGraw-Hill Companies, Inc All rights reserved 1448 In Summary 14.1 The physician’s office laboratory (POL) is responsible for accurate and timely processing of routine tests and for reporting test results to the physician 14.2 The medical assistant’s duties in an office laboratory include preparing the patient for the test, collecting the sample, completing the test, reporting the results to the physician, and communicating information about the test to the patient 14.3 Common laboratory equipment includes autoclaves, centrifuges, microscopes, electronic equipment and software, and equipment used for measurement © 2011 The McGraw-Hill Companies, Inc All rights reserved 1449 In Summary (cont.) 14.4 Follow specific steps for operating a microscope, including plugging it in, cleaning the lenses, placing the slide on the stage, adjusting the focus, examining the image, and cleaning the lens before storage 14.5 Regulatory controls governing the physician’s office laboratory include Standard Precautions, Hazard Communication Standard, OSHA Bloodborne Pathogens Standard, Hazardous Waste Operations and Emergency Response Final Rule, and the Needlestick Safety and Prevention Act © 2011 The McGraw-Hill Companies, Inc All rights reserved 1450 In Summary (cont.) 14.6 Preventing accidents in the physician’s office laboratory should include physical, fire and electrical, chemical, and biologic safety measures 14.7 The goal of a quality assurance program in a physician’s office laboratory is to monitor the quality of the patient care that a medical laboratory provides 14.8 The medical assistant might be responsible for recording information about quality control and equipment maintenance, inventory control, test results in patient records, and tracking every specimen that he or she handles © 2011 The McGraw-Hill Companies, Inc All rights reserved 1451 In Summary (cont.) 14.9 Hazardous waste must be disposed of in properly constructed and labeled containers Containers for sharps must be puncture-proof, leak-resistant, and rigid, and needles should be dropped into the sharps container without bending, breaking, or recapping them 14.10 Quality assurance and quality control programs serve to reduce testing errors and provide for the safety of laboratory personnel 14.11 Accurate quality control documentation in a physician’s office laboratory includes a reference laboratory log and a daily workload log © 2011 The McGraw-Hill Companies, Inc All rights reserved 1452 In Summary (cont.) 14.12 Common reference materials used while performing procedures in a physician’s office laboratory include Material Safety Data Sheets, standard operating procedures, safety manuals, equipment manufacturers’ user or reference guides, Clinical Laboratory Technical Procedure Manuals, regulatory documentation, and maintenance and housekeeping schedules 14.13 It is the medical assistant’s responsibility to ensure that patients understand what is expected of them before a test Providing clear pretest instructions in both oral and written form is an essential part of the test procedure © 2011 The McGraw-Hill Companies, Inc All rights reserved 1453 End of Chapter 14 Quality is not an act, it is a habit ~ Aristotle © 2011 The McGraw-Hill Companies, Inc All rights reserved ... body – Focus controls – used to focus the object • Stage and substage – Stage – platform for slide – Substage – condenser • Specimen slides/ coverslip • Light source – Under stage and substage –. .. reserved 14 30 Safety in the Laboratory (cont.) • Chemical safety – MSDS – PPE • Biologic safety – Standard Precautions – Disinfection – Waste disposal • Accident reporting – Office procedures – Ensure... Equipment used for measurement – – – – Pipettes Flasks or beakers Hemocytometer Thermometers – Photometer – measures light intensity © 2011 The McGraw-Hill Companies, Inc All rights reserved 14 22 Apply