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Part 2: Drawing Labs and Entering Results

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REGULAR LABS:

1) Review In Basket Orders folder on left-hand side of screen for messages of laboratory orders that have already been signed by the attending.

2) Collect lab labels for tubes from the SCC label printer. (NOTE: any IMA Firm D labs orders (EHHOP Mental Health Clinic) made on the same day will have labels printed over at the IMA Firm D nurse's station on the MHC side of clinic.

3) Draws labs in correct tube noted on labels or use the tube color guide here: Tube colors; if in doubt about which tube to use, call 4-LABS.

4) Label tubes with appropriate labels. Place labels as high up on the tube as possible so as to not obscure the bottom fluid level.

5) Document completed blood draws:

You may done the order AFTER you have 1) collected and 2) documented/added additional info

6) Store specimen until end of day and then deliver all blood tubes to East Building, 8th Floor. Make a left out of the elevator and then turn right. Go to the window on the left at the end of the hall that says “Drop off specimens here.”

POINT OF CARE TESTING (POCT)

Examples = glucose fingersticks, u dip, pregnancy test, HIV testing All POCT need orders!! Clinician teams MUST verbally inform the TS of ALL POCT ORDERS.

1) Review In Basket Orders folder on left-hand side of screen for messages of laboratory orders that have already been signed by the attending.

2) Make sure the lab has been ordered as a Point of Care Test (has to say POCT next to the ordered lab); if it doesn’t, tell the clinician team or the attending to re-order the lab as a POCT and cancel the original lab order.

3) Perform the test (pregnancy test, urine dipstick, etc.)

4) Click the POCT lab in the In Basket

5) Click on the Edit Rslt button located on top bar in the In Basket

6) Double click on the order to open it.

7) Enter the value/result and today’s date and time.

NOTE: If you forget to document before clicking “DONE” on the order, you need to search for the DONE order. Go to In Basket –> Orders –> Click Search –> Under Statuses, uncheck everything except for Done –> Click Search. (Before clicking Search, You may also search for specific patients if you do not want to pull up all the recent Done orders from Saturday — just click on the magnifying glass to do so)

This should take you do the Ad Hoc search results. The Done results are all greyed out but you can still edit the result. Click on the patient and the test you want, and click Edit Result.

SPECIAL NOTES

URINE DIPSTICK

Sterile cups/dipsticks are found in the cabinet above the sink. Use a single-wrapped, sterile, vacuum transfer to move the urine from the cup to the yellow-topped tube. MAKE SURE TO LABEL THE URINE SPECIMEN CONTAINER BEFORE GIVING TO PATIENT!!!

1) It is best to do the Udip under sterile conditions until it is determined that a UA is not needed. You can transfer the sample to a yellow-topped tube to perform the dip, as listed above. SAVE THE URINE SAMPLE UNTIL THE TEST AND RESULT ANALYSIS IS COMPLETE!

2) UDips should be developed and interpreted MANUALLY. You can find a bottle of UDip test strips in the other Nurse's/phlebotomy room on the opposite end of clinic (where the Mental Health clinic rooms usually are). The bottle should be in one of the cupboards. Follow the instructions on the bottle to interpret the Udip results.

3) Please share any abnormal results IMMEDIATELY with the team and Attending. Make sure to document the results in Epic, too.

4) Consider adding on a UA for any abnormal results (you can use the same urine sample)

5) Enter the test information as shown above (Enter/Edit Results)

POCT GLUCOSE : We CAN do point of care glucose testing!!! Please use the GLUCOMETER and TEST STRIPS reserved for LABS TS USE ONLY in the HIV testing bin (under the preceptor desk in the preceptor room; make sure to keep the glucometer here, as it is now designated the "POINT OF CARE TESTING BIN".

FOBT Stool Cards For Patients:

1) Must have THREE (3) cards.

2) Stool must come from THREE (3) different days.

3) Write your name and date on the cards BEFORE collection.

4) Collect Stool (options):

  1. Place a clean container in the toilet bowl to collect a sample of stool.

  2. Cover the toilet bowl with saran wrap to collect a sample of stool.

  3. Just before finishing a bowel movement, use a piece of toilet paper to collect a small sample of stool.  

5) Applying Stool:

--- use a stick to collect stool from the container or toilet paper

--- apply thin layer to one collection box in the stool card

--- use stick to collect stool from another section of your stool

--- apply thin layer to other collection box in the stool card

6) Close card, place in envelope or plastic bag.

For TS:

  1. Developer is in top drawer of labs room

  2. Take cards and follow instructions on the card - make sure to open the flap on the BACK of the card where the controls (+,-) can be found.

  3. Develop stool sample AND controls (+,-).

HIV TESTING: See the full protocol on future page. Tests are located in the “EHHOP HIV” bin in the preceptor room.

RAPID STREP KITS: Located in the Nurses Station of Area D and the back supply closet.

URINE PREGNANCY TESTS: Located in accessory gray drawers in Labs room. Follow the enclosed instructions.!