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What does CLIA stand for? Clinical Laboratory Improvement Act
What is CLIA'S role in the laboratory? CLIA establishes guidelines for certain tests that may be performed in both a patient's home and medical facilities, cald CLIA-waived tests.
What is a CLIA waived test? The require a minimum of judgement and interpretation and present less risk to patients because they involve small amounts of blood or other specimen, such a urine.
Examples of CLIA-waived tests Blood glucose by blood monitoring devices, fecal occult blood, spun micro hematocrit, urine chemical screening and visual color comparison urine tests for pregnancy
Commonly Monitored Therapeutic Drugs (TDM's) -Dilantin -Theophylline -Valproic Acid -Tobramycin -Digoxin -Vancomycin
Basal State the body's state after 8 to 12 hours of fasting and not exercising.
Most affected tests if not fasting Glucose and triglycerdes
Diurnal Variations the normal daily fluctuations in body chemistry related to hormonal cycles, sleep wake cycles and other regular patterns of change.
Factors that affect Blood Composition Age, Altitude, Body Position, Dehydration, Diet, Diurnal Variation, Drugs, Environment, Exercise, Gender, Pregnancy, Smoking, Stress
Blood Constituents that show marked Diurnal Variation Glucose, Hormones (ex. Cortisol, Estradiol, Progesterone, Testosterone) and White Blood Cells <WBC's>
TDM = Therapeutic Drug Monitoring measures rate of metabolizing a medication and it's toxic levels.
Half LIfe is the rate of metabolism or the time for HALF the drug to be metabolized.
Trough is the lowest serum level. occurs immediately before the next dose of medicine.
Peak is the highest serum level. occurs sometime AFTER the dose is given.
Fecal / Stool is ordered to detect Parasites Microorganisms that cause enteric disease Occult Blod/Colorectal Cancer
Urine volume should be 12-50 mL
Random Urine at any time
Clean-Catch Midstream cleanse area with soap and water and or wipes discard first stream, collect midstream Culture and Sensitivity (C&S) should use a STERILE CUP
Timed Urine Over a period of time such as 24 hours
First Morning Urine Is more concentrated. Examples of tests: pregnancy test, culture and microscopic examination.
Catheterization withdraws urine with tube through urethra to the bladder.
Suprapubic uses a sterile syringe into the bladder
Semen Transport < 2 hours to lab, Maintain at body temperature, spermicide free container
Urine Process within 1 hour of collection (at room temperature)
Preserved specimens May be kept up to 72 hours
Chain of Custody process that maintains control of and accountability from each specimen from the time of collection until time of disposal.
Required on the Chain of Custody forms name of patient, name of person receiving the sample, date, location, signature of person receiving which acknowledging specimen is correct and matches documentation, signature and date of every person has had possession of sample (even transporter)
Do you need patien consent for Blood Alcohol levels? -MUST have written consent -if patient doesn't consent, and phlebotomist attempts to get sample, may be accused of battery and assault.
Antiseptic for Blood Alcohol -antiseptic is non alcohol such as chlorhexidine (not iodine either)
Point-of-Care-Testing tests performed near patient (bedside, physician's office)
Critical values potentially life threatening values (highs or lows)
When informing critical values by phone collect the following: full name of receiving person, date, time
sputum samples require special handling because of a poisonous preservative
Continuity of Care Document (CCD) document with accepted format for electronically sharing patient information securely and easy to read format to share among provider locations.
Meaningful Use a federal incentive program sponsored my Medicaid Services. Encourages technology for communication of health records.
Created by: glamorousglenys