Patient data and specimen information workload

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Patient Data and Specimen InformationWorkload ManagementConnections to: Electronic Medical Records (EMR)Healthcare Providers and Other Departments (i.e.: Billing)Automation / Equipment / InstrumentationOther Medical FacilitiesMedical RecordsThird Party Agencies
???????????????????????Define each of the following:STATASAPRoutineTimed
Pre-Analytical PhaseIssues - Quality AssuranceRegulationsTurn-around-timeSTATASAPRoutineTimedOrdersSingle Orders vs. Menu Batch OrdersPatient and Sample Identification - Patient DiversitySpecimen Collection and Transport and Handling / ProcessingTechniquesSOPCentrifuge - Aliquot Specimen
Pre-Analytical – Turn Around-TimeSTAT (statim means immediately)Emergency SituationNo delays tolerated – highest priority15 minutes from collection to result reportingASAPQuick turn-around-time30 minutes from collection to result reportingTimedNon-emergency but sample must be collected at a specific timeGlucose - Fasting vs. PostprandialCardiac MarkersPre and Post TransfusionTherapeutic Drug Monitoring – trough vs. peakRoutineNon-emergency situation
Pre-Analytical – Specimen Collection TimingAlso consider diurnal variations (i.e.: cortisol)PostureLying to sitting to standing - shift in body water from blood to interstitial spaces in tissue (hemoconcentration or venous stasis)i.e.: Blood components such as albumen, calcium, bilirubin and drugs concentrations are lower in bed-ridden patients (therefor, sitting / standing collection shows “higher concentrations” in blood)
???????????????????????Describe the CLIA regulations in:Identifying patients at the time of collection Supplying the information needed on a doctor’s order Supplying the information needed on the specimen.
Pre-Analytical PhasePatient Identification RequirementsAt least 2 patient identifiers Full NameDate of BirthMedical Record NumberArm Bracelet (Heel Bracelets on Babies)Have patient restate / spell nameAll discrepancies MUST be investigated / reported
Pre-Analytical – OrdersPhysician’s OrdersPatient IDPatient gender, DOB / agePhysician NameTest RequestTime / date of sample collectionSpecimen type
Pre-Analytical PhasePatient Diversity Risk Factors in VenipunctureAlzheimer’s/dementia:solicit caregiver’s assistanceArthritis:never use force to extend arm or open handCoagulation issues:hold firm pressure to stop bleedingCataracts/dim vision:guide, escort patient as neededHearing loss/stroke:take extra time to communicateFragile skin and veins:anchor veins securely, gentlySlower learning/reaction time:speak clearly, slowlyParkinson’s:help patient hold arm still
Standard Precautions
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