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Phlebotomy chpt. 2
Chapter 2 - Quality Assurance and Legal Issues
| Question | Answer |
|---|---|
| Exsangunation | Romoval of too much blood from the body - blood letting contributed to George Washinton's death |
| ASCP | American Societyl for Clinical Pathology |
| Homeostasis | Constant state of balance, healthly, temperature, electrolytes |
| Proxemics | Concept and use of space (personal) |
| Quantitative | Determines how much of a substances is actually present in the specimenualitative |
| Qualitative | Yes or No answer - pregnancy test results the strip will reveal the presence of an positive or negative result |
| Immunohematology | Aka: blood bank |
| CLIA88 | Cinical Laboratory Improvement Amendments Fed. regualtions establish quality atrds that apply to all facilities,clinices,physicians office labs that test human specimens for the purpose of providing infomation used to diagnose prevent/treat disease |
| CAP | College of American Pathologists - The highest cetification a laboratory can recieve - standards are very high |
| The Joint Commission | A voluntary nongovernmental agency charged with among other things establishing standards for the operation of hopitals and other health related facilities and services, tracking complaints from the patients, makes facilities take accoutibility |
| CLSI | Clinical and Laboratory Standards Institute - This is a global, nonprofit, standards developing organization with representatives from the profrssion, industry and government |
| NAACLS | National Accrediting Agency for Clinical Laboratory Sciences-Recognized by the US dept of Edu./auth./edu. qal an is commited to serving the international healthcare community thur the involvement of volunteer exp dedicated to maint. qal. strds in edu. |
| QA Indicators | Must be measurable well defined ojective specific and clearly related to an important aspect of care. Indicators can measure quality,adequeacy,accuracy,timeless effectivesness of patient care, customer satisfaction |
| What to check on blood tubes | The expiration date |
| What to check for on needles | Burrs |
| What to make sure is done with blood tubes when the blood draw is complete | Make sure the labeling is completed with patients name, date of birth and date/time |
| Delta Check | Compares current results of a lab test with previous results for the same test on the same patient |
| Specimen Collection Manual | Nursing Service manual - the manual details how to prepare the patient and collect a high quality sample |
| Infection Control Procedure Manual | Outlines hand washing and decontamination procedure precaution to take when dealing w/patients handling specimens |
| Occurance Report | Explain in detail - just state the facts on how the event happened |
| Civil Law/Tort Law | A tort is a wrongful act other than breach of contract committed agains someone's person, property, reputation, or other legally protected right, for which the individual is entitled to damages awarded by the court |
| Assault | Act or threat causing another to be fear of immediated battery |
| Battery | Intentional harmful or offensive touching of or use fo force on a person without consent |
| Fraud | Billing for sevices that have not been provided |
| Invasion of Privacy | Right to be left alone - and their records kept safe (HIPPA) |
| Breach of Confidentiality | Failure to keep privileged medical information private-unautorized release of patient information such as laboratory results |
| Malpractice | A type of negligence committed by a professional |
| Negligence | Failure to exercise DUE CARE - the level of care that a person of ordinary intelligence and good sense |
| Respondent Superior | Let the master respond - your employer is liable for the actions of an employee |
| Vicarious liability | The employer has liabilitly for neglience by an independent contractor or consultant who was hired |
| Bilirubin specimen is | Ictertic |
| Legal actions in which the alleged injured party sues for monetary damages are: | Civil actions |
| Significant gaps in the quality of testing practices in physicians' offices resulted in the recent development of: | good laboratory practices |
| The level of care that a person of ordinary intelligence and good sense would exercise under the given circumstances is the definition of: | due care |
| Deceitful practice or false portrayal of facts either by words or conduct is the definition of: | fraud |
| Continuous quality improvement involves | identifying situations that pose risks to employees |
| Quality system essentials (QSEs) are: | accompanied by quality indicators that monitor workflow |
| One of the responsibilites of the Center for Medicare and Medcaid Services (CMS) is to: | provide healthcare worker insurance |
| A process in which one party questions another under oath while a court reporter records every word is a: | deposition |
| Which one of the following is found in a procedure manual | The purpose of the procedure The requied equipment Revision dates |
| An internal process focused on identifying and minimizing situations that pose danger to patients and employees is: | facility wide risk management |
| CLIA categorizes certificates for laboratories according to: | the complexity of testing |
| CLIA laboratories that perform high complexity testing | are subjected to routine inspections |
| The Joint Commission's Sentinel Event QI program's purpose is to: | demonatrate flexibility in setting QC measures |
| If a sentinel event occurs, the healthcare organization is required to: | monitor improvements to see if they are effective |
| A clinical laboratory "path of workflow" is: | made up of preanalytical, analytical, and post-analytical processes |
| Guides used to monitor all aspects of patient care are called | QA indicators |
| What is the abbreviation for an agency that has an approval process for phlebotomy programs | NAACLS - National Accrediting Agency for Clinical Laboratory Sciences |
| A very busy phlebotomist misidentifies the patient when collecting a specimen for transfusion preparation. The possible misdiagnosis of blood type could cause the patient's death. If the phlebotomist's action results in injury, this wrongful act is called | negligence |
| The abbreviation for the federal regulations that established quality standards for all laboratories that test human specimens is: | CLIA'88 - Clinical Laboratory Improvement Ammendments |
| The abbreviation for a national agency that sets standards for phlebotomy procedures is the: | CLSI - Clinical Laboratory Standards Institute |
| Which of the following is not an area of phlebotomy subject to quality control (QC) procedures | Patient IV adjustment |
| Lab tech asked a phlebotomist to recollect a spec on a pt.When the phlebotomist asked what was wrong with the spec, the tech replied,The specimen was OK,but the results were inconsistent.How would the lab tech have decide thatthe results were questionable | compare with previous results after a delta check |
| Which organization provides voluntary laboratory inspections and proficiency testing | CAP - College of American Pathologists |
| QC protocols prohibit use of outdated evacuated tubes because | stoppers may shrink, allowing specimen leakage if the tube is inverted |
| The Joint Commission: | accredits healthcare organization |
| An example of a QC measure in phlebotomy is: | checking the expiration dates of evacuated tubes |
| When the threshold value of a QA clinical indicator is exceeded and a problem is identified: | a corrective action plan is implemented |
| Which of the following is a phlebotomy QA procedure | Checking needles for blunt tips and small barbs |
| Which preanalytical factor that can affect validity of test results is not always under the phlebotmist's control | Patient preparation |
| Which of the following contains a chronologic record of a patient's care | Medical record |
| Failed venip. attempt & b4 deciding 2 switch 2 the other arm,the phlebotomist moves the needle several x w/out knowing the current needle proximity to the desired vein.the blood is obtainbed & quickly from the new site.The pt later complains of pn | Negligence can be claim |
| A specimen was mislabeled on the floor by the same phlebotomist for the second time. You, as the phlobomtomist's supervisor, are required to fill out a performance improvement plan. Which of the following is the only information that would not be include | Suggestion for new guidelines |
| An example of a QA indicator is: | the contamination rate for BCs will not exceed the national rate |
| What laboratory deocument describes in detail the steps to follow for specimen collection | Procedure manual |
| Drawing a patient's blood without his or her permission can result in a charge of: | assault and battery |
| The term tort means a: | wrongful act |
| One of the steps in the risk management process is: | educating of employees |
| Which of the following would not violate a patient's right to confidentiality | sharing information on a difficult draw with a coworker |
| Unauthorized release of confidential patient information is called | invasion of privacy |
| Civil actions involve: | legal proceedings between private parties |
| Malpractice is a claim of: | improper treatment |
| An example of negligence is when the phlebotomist: | fails to report significant changes in a patient's condition |
| A patient is told that she must remain still during blood collection or she will be restrained. Which tort is involved in this example | Assault |
| A patient agrees to undergo treatment after the method, risks, and consequences are explained to him. This is an example of: | informed consent |
| The period within which anb injured party may file a lawsuit is known as: | statute of limitations |
| The definition of a minor is anyone: | who is not the age of majority |
| Performing one's duties in the same manner as any other reasonable and prudent person with the same experience and training is referred to as: | the standard of care |
| Doing something that a reasonable and prudent person would not do or failing to do something that a reasonable and prudent person would do is: | negligence |
| A phlebotomist explains to an inpatient that he has come to collect a blood specimen. The patient extends his arm and pushes up his sleeve. This is an example of: | implied consent |
| A 12 yr old inpatient who refused to have his blood collectd was restrained by a healthcare worker while the phlebotomist collected the specimen. This is an example of: | assault and battery |
| The standard of care used in phlebotomy malpractice cases is often based on guidelines from this organization | Clinical Laboratory Standards institute |
| Which one of the following actions points to negligence | Causing harm as a result of a violation of duty |
| The process of gathering information by taking statements and interrogating parties involoved in a lawsuit is called: | discovery |
| The "standard of care" in the practice of phlebotomy is influenced by which of the following organizations | The Joint Commission |
| A lawsuit is filed against the phlebotomist after a patient claimed an injury occurred during a venipuncture. In litigation proceedings, the phlebotomist is the: | defendant |
| Which of the following tests must be collected after a discard tube is drawn | APTT - Activated Partial Thromboplatin Time |
| One of the Joint Commission's new screening criteria used to determine accreditiation of the clinical laboratory is the category Immedicate Threat to Health and Salfety. An example of not meeting this criteria would be | serious problems with specimen labeling and handling |
| One of NPSG's (National Patient Safety Goal) specified 2010 goals for the laboratory is to: | improve communication |
| CLIAC's (Clinical Laboratory Improvement Advisory Committee)role in assisting CMS (Center of Medicare/Medicaid Services)to administer CLIA (Clincial Laboratory Improvement Amendments)is to: | advise |
| The purpose of the Office of Quality Monitoring is to: | evaluate and track complaints related to care |
| Which test specimen has to be centrifuged and spearated and have the plasma frozen immediately | Antithrombin activity |
| Which test collection time is dependent on the time the patient's coagulation therapy was give: | APTT - Activated Partial Thromboplatin Time |
Created by:
mmfleischer