medical office laboratory #1 chp. 39 &40
Terms in this set (146)
substance or constituent for which a laboratory conducts testing
a range established for test results assumed to be typical for a population asymptomatic for disease processes
a large facility in which thousands of tests various types are performed each day
POLs: physician office laboratories
the most common type of laboratory to do testing
what are the 3 kinds of laboratories?
POLS, hospitals, and referral laboratories
portions of the original patient specimen that have been placed into a separate container to be routed to the appropriate laboratory work station for testing
quality control (QC)
method to evaluate the proper performance of testing procedures, supplies, or equipment in a laboratory
is the largest facility in which thousands of tests of various types are performed.
can do most testings but can not with the not so common testings
medical assistant may be responsible sending specimens to??? rather than????
send it to the hospital laboratories rather than referral laboratories
what are the most common tests performed at a POLs?
urinalysis, blood cells counts, hemoglobin and hematocrit, pregnancy test, strep throat, quick screening tests for disease, and blood glucose levels
unitized test device
used to add a specimen and allow all steps of the testing process to occur in that container
a unitized test device must used how many times?
one times and be disposed after the usage
what is medical assistant's duties when performing in a laboratory?
collecting samples, performing tests, managing QC, maintaining instruments, keeping accurate records, and reporting results
is the study of blood and blood-forming tissues
the study and treatment of tumors.
Hematology testings on what type of disorders?
bleeding disorders: hemophilia and platelet disorders, malignancies: lymphoma and leukemia, bone marrow transplants
what are the most common testing Hematology do?
WBC, RBC, platelet count, hemoglobin, and hematocrit
a testing includes evaluating how well the body's blood clotting process is performing
Coagulation studies on what?
measurement of prothrombin time (PT) and activated partial thrombosplastin times (APTT)
activated partial thrombosplastin
PT and APTT tests are used to monitor levels for...
a familial disorder of blooding clotting
the diseases associated with abnormal blood-clotting functions
what are used for testing for coagulation process in the laboratory?
an area that analyzes body fluids
a device that separates the serum and blood cells
the study of immune system and antibodies
what is serum?
is the yellow liquid part of blood that is left after blood has been allowed to clot, and all blood cells have been removed
In a clinical chemistry, what are the subspecialities?
general or routine chemistry, endocrinology, immunology, pharmacology, toxicology
study of horomones
the study of drugs
the study of drugs and poisons and a branch of chemistry that studies the effects of chemicals, detects drug of abuse or poisoning
"for cause" scenarios
drug screening required by an employer following a questionable event
what specimens require a legal chain of custody
for cause and forensic
examination of the physical, chemical, and microscopic properties of urine
what is the routine urinalysis for testing?
color, transparency, specific gravity, pH, protein, glucose, ketones, blood, bilirubin, nitrite, urobilinogen, and leukocyte esterase
what are the reasons to have an urinalysis?
detect renal and metabolic disease, kidneys or urinary tract, and monitor patients with diabetes
study of disease caused by disorders of the immune system
what are the test based on in the immunology department?
the reactions of antibodies, proteins formed in the body in the response to foreign substances as bacteria and virus
a foreign substances are proteins
parts of the immune system fail to provide an adequate response
condition in which the immune system attacks its own host's body
the study of blood typing and compatibility testing for transfusion or the dept of blood bank
a complex glycoprotein produced by B lymphocytes in response to an antigen
What does the immunohematology dept detect for when testing comes in?
antigen or antibody reactions that can harm a patient receiving a tranfusion
what is the common testing in an immunohematology laboratory?
crossmatching for compatibility of blood for blood transfusion in patients and for detection and identification of antibodies
immunohematology also provide testing to detect hemolytic disease to who?
identifies the microorganisms that cause disease
what are the studies in microbiology?
bacteriology, virology, mycology, parasitology
study of fungi and yeasts
infectious agent is a biological agent that causes disease or illness to its host
the primary subspecialty of anatomic pathology. is the study of tissues removed from living patients during surgery to help diagnose a disease and determine a treatment plan
study of the microscopic structure of tissue
study of the microscopic structure of cells
is a type of cytology used to test the genetic structure of the cells obtained from fluids: amniotic fluid
types of histology specimens
biopsy and surgical frozen sections
what is the most common test for cytology testing?
Papanicolaou (Pap) test
laboratory tests organized into standard groups to effectively evaluate disease processes or organ systems
centers of medicare and medicaid services (CMS)
government department that mandates that use of panels defined by (AMA) for national standardization of nomenclature and testing
what is the best source of information for safe and accurate testing?
a package set containing test devices, instructions, reagents, and supplies needed to perform a test and generate results
handbook that contains test methods and other information needed to perform testing,
(POC tests or POCT) a technology allows small, handheld devices to be carried to the patient's bedside, the pharmacy, the physician's office, the patient's home, and to other nonlaboratory sities
what are the common devices that are used in most small laboratories?
automated cell counter, microscope, chemistry analyzer, centrifuge, incubator, refrigerator or freezer
an automated analyzer used to count and size blood cells: counts only RBCs and WBCs and performs hemoglobin and hematocrit testing
perform from a single to a few tests and require manual operation to complex analyzers that perform 30 or more
a device that separates the WB, RB, and securm in a tub
grow microorganisms under controlled conditions.
refrigerators and freezers
is used for specimen to stored in cold area
is the pale yellow liquid component of blood that normally holds the blood cells in whole blood
what is the center white stuff is called after centrifuge?
what is a special type of centrifuge called and used for?
microhematocrit centrifuge and is used for hematocrit testing
how long should we stored a specimen for?
24 hours to grow
what should be stored in a refrigerators and freezers?
reagents, kits, and specimens
what should be the temp. for the refrigerators?
4c to 8c
Clinical Laboratory Improvement Amendments Act of 1988: a federal regulatory program that sets standards for the quality of laboratory testing
Commission on Office Laboratory Accrediatation: an organizations CLIA approves to do laboratory inspections and works to support the health care industry by providing knowledge and resources for maintaining quality laboratory operations
What CLIA goals?
to standardize laboratory testing and enforce quality protocols anywhere test are performed on patients
what are the levels CLIA regulates?
Waived test, moderate-complexity tests, and high-complexity tests
simple and one-steps tests, performing incorrectly can cause errors and endanger patient health
what do we require to get a waived test done?
the government requires a Certification of Waiver (CW)
who controls the waived tests?
Department of Health and Human Services (HHS)
department of health and human services
HSS: is the US government's agency for protecting the health of all Americans and providing essential human services
Centers for disease control and prevention
(CDC): is the US federal agency under HHS that works to protect public health and safety
Centers for disease control and prevention's job is to focus the nation's attention on what?
disease prevention, environmental health, occupational safety and health, prevention and education activities to improve the health of the people of the US
list waived tests are
urine dipstick or reagent tablets, fecal occult blood packets, urine pregnancy testing kits using color comparison charts, centrifuged microhematocrits, point-of-care blood glucose determination testing
what must a POL do for a waived testing?
follow all manufacturers' recommendations
Food and Drug Administration
(FDA) is an agency of the HSS, responsible for protecting and promoting public health through the regulations and supervision of laboratory and blood transfusions products
an additional, more specific test performed to rule out or confirm a preliminary test result to provide a final result
the standardization of any measuring instrument or testing procedure
has one or more of the characteristic: only highly trained scientists can do the test procedure with detailed QA and QC
(PPM or PPMP)
direct microscopic examination
examination of a patient specimen using a microscope; a type of nonwaived testing
complex tests that do not meet the Clia' criteria for waiver and require training and specific quality measures to ensure the accuracy and reliability of test results
provider-performed microscopy: can only performed by a physician, nurse, midwife, NP or PA under the direct supervision of a physician
what does the PPM tests included?
all direct wet-mount preparations
"" potassium hydroxide preparations
urine sediment examinations
is rarely performed in medical offices
What does high-complexity test includes?
Advanced cell studies (cytogentics)
Cytology (Pap tests)
Manual cell counts
which tests can a medical assistant perform?
every laboratory is require to be certified in order to perform any lab work.
is the evaluation of a person's ability to perform a test and to use a testing device
what plan CLIA requires?
a QA (quality assurance) plan
what is QA policy?
to prevent problems before they occur, have a training and continuing education plan for laboratory personnel
provides evaluation of the laboratory. The programs provide unknown samples to test as if they were patient specimen
what does the policy and procedure manuals will instruct the medical assistant in the laboratory to do?
prepare the patient, handle the specimen, perform test, and know what to do if the test results are questionable
CLIA standards for Laboratory
Clia require each laboratory to have a procedure for every test in the laboratory as following the manufacturer's testing instructions
is a device or solution used to monitor the test to correct test results
is a substance that produces a reaction with a patient specimen so the analyte can be detected or measured
manufacturer's product inserts
contain most of the needed information to write a procedure and POL must add the instructions to make the test results available within that office
also known as alert values or critical limits: life threatening test results
where do we find the interval reference for a test?
the manufacturer's package insert
a form used to collect important data regarding a patient's condition
is the test result range the physician wants for the patient
finding out a testing problem is called....
what are the two types of controls in waived testing?
internal control and external control
built into the testing device
monitors the test from applying the specimen to result interpretation
how should the records and documentation be retained for?
at least 2 years
Clinical and Laboratory Standards Institute
(CLSI): establishes rules to ensure the safety, standards, and integrity of all testing performed on human specimens
adding water to bring a material back to its liquid state
has positive or negative resuts
measured and reported in a numeric value
Levey-Jennings QC chart
a tool for manually recording quantitative quality control
a situation in which quality control results make an obvious change in performance levels
when control results progressively increase or decrease over time
are chemicals used to perform a test
what are the four skills for safe laboratory practice?
common sense, safety-focused attitude, good personal behavior, and good housekeeping
Occupational safety and health administration
(OSHA): a federal agency in the US department of labor that monitors and protects the health and safety of workers
what are the OSHA two standards ?
bloodborne pathogens and hazardous communication (HazCom)
personal protective equipment
PPE: protection material wear from hazardous exposure
what are the three types of latex reaction?
irritant dermatitis, delayed cutaneous hypersensitivity, immediate reaction
suspended particles in gas or air
Material safety data sheet
(MSDS): a detailed record of all characteristics and protection required from a hazardous substance
Chemical Hygiene Plan
(CHP): a part of the Occupational Safety and Health Administration's HazCom standard
usual steps to prevent injury or disease
controlling infection by treating all human blood and certain human body fluids as known contaminated
which type of gloves fails more than latex and nitrile?
what is color code blue?
identification of health hazard
what is color code red?
identification of flammability
what is color code yellow?
identification of reactivity/release of energy (stability)
for patients who come to the office infected with pathogens
what are the three transmission-based precaution?
1. contact precautions
2. droplet precautions
3. airborne precautions
are used to prevent transmission of disease spread through close respiratory or mucous membrane contact with respiratory secretions