Presentation on theme: "Chapter 45 Laboratory and Equipment Safety Medical Assisting"— Presentation transcript:
1Chapter 45 Laboratory and Equipment Safety Medical Assisting PowerPoint® presentation to accompany:Medical AssistingThird EditionBooth, Whicker, Wyman, Pugh, Thompson
2Learning Outcomes45.1 Describe the purpose of the physician’s office laboratory.45.2 List the medical assistant’s duties in the physician’s office laboratory.45.3 Identify important pieces of laboratory equipment.45.4 Operate a microscope.
3Learning Outcomes (cont.) 45.5 Identify the regulatory controls governing procedures completed in the physician’s office laboratory.45.6 Identify measures to prevent accidents.45.7 Describe the goal of a quality assurance program in a physician’s office laboratory.
4Learning Outcomes (cont.) Identify the medical assistant’s record-keeping responsibilities.Describe correct waste disposal procedures.45.10 Describe the need for quality assurance and quality control programs.
5Learning Outcomes (cont.) 45.11 Maintain accurate documentation, including all logs related to quality control.45.12 List common reference materials to consult for information on procedures performed in the physician’s office laboratory.45.13 Communicate with patients regarding test preparation and follow-up.
6Introduction Laboratory testing – integral part of patient care Medical assistant must knowCommon laboratory equipmentSafety in the laboratorySteps to prevent accidentsCLIA ’88 – impact on laboratory settingQuality assuranceQuality control proceduresRequired record-keeping
7Role of Laboratory Testing in Patient Care Analysis of blood, urine, and other body fluidsRegular monitoring to identify diseases or other problemsConfirm initial diagnosisDetermine and monitor dosage of a medication
8Role of Laboratory Testing (cont.) Kinds of laboratoriesReference laboratoryOwned and operated by an organization outside the practiceHave technological resources beyond the POLPOLQuicker turnaroundEliminates need for patient travel to other test locationSome managed care companies require their subscribers to use a specific reference laboratory.
9Role of Laboratory Testing (cont.) Purpose of POLAccurate and timely processing of routine testsReporting test results to physicianTestsChemical analysisHematologic testsMicrobiologic testsUrinalysis
10Super! Apply Your Knowledge Compare a reference laboratory and the POL.ANSWER: A reference laboratory is lab facility usually run by an organization separate from the practice. It has technologies beyond the POL. Patients have to travel to this facility. A POL provides quicker turnaround on results but is limited in the testing that can be performed. Patients are able to have testing done during an appointment without leaving the office.Super!
11Medical Assistant’s Role Processing tests done in POLPreparing the patientCollecting the sampleCompleting the testReporting the resultsCommunicating information about the test
12Medical Assistant’s Role (cont.) Additional responsibilitiesUnderstand regulationsAccident preventionWaste disposalHousekeeping and maintenanceQuality assurance and controlRecord-keepingInventory and order equipment and suppliesUse reference materialsScreen and follow-up results
13Apply Your Knowledge Very Good! What are the duties of a medical assistant related to testing done in the POL?ANSWER: The medical assistant duties may include preparing the patient, collecting the sample, running the test, reporting the results, and, once the physician has reviewed the results, communicating the results to the patient.Very Good!
14Use of Laboratory Equipment You may routinely use the following:AutoclaveCentrifugeMicroscopeElectronic equipmentEquipment used for measurement
15Use of Laboratory Equipment (cont.) Autoclave - sterilizes surfaces of instruments and equipmentCentrifuge – spins and separates specimen into its component parts
16Use of Laboratory Equipment (cont.) Optical microscopeUses light, concentrated through a condenser and focused through the object, to project an imageCompound microscope – two lenses magnify the image created by condensed light
17Use of Laboratory Equipment: Microscope OcularsEyepiecesMonocularBinocularContain a magnifying lens – magnify image 10 times (10X lens)ObjectivesContain another magnifying lensMoved under ocular when neededThree objectivesTwo dryOne oil-immersionMicroscope
18Use of Laboratory Equipment: Microscope (cont.) Arm and focus controlsArm – attaches oculars and objectives to bodyFocus controls – used to focus the objectLight sourceUnder stage and substageAdjustable intensityStage and substageStage – platform for slideSubstage – condenserSpecimen slides / coverslipMicroscope
19Parts of the Microscope 5.Eyepieces6.Nosepiece7.Objectives1.Arm8.Slide Clips9.Stage10.Condenser11.Iris2.Fine Adjustment3.Coarse Adjustment12.Light Source4.BaseBack
20Use of Laboratory Equipment (cont.) Using an optical microscopeOperate correctlyCare and maintenanceClean after each useStore under plastic coverMove by holding arm and supporting the base
21Use of Laboratory Equipment (cont.) Electronic equipment and softwareUsed to create and maintain clinical dataMore accurate, safer, and more efficient than manual methodsPhotometer – measures light intensityEquipment used for measurementPipettesFlasks or beakersHemocytometerThermometers
22Nice Job! Apply Your Knowledge Matching: ___ Measures light intensity A. Focus controls___ Platform for slide B. Hemocytometer___ Contains magnifying lens C. Stage___ One is an oil-immersion D. Photometer___ Condenser to concentrate light E. Ocular___ Move body tube up and down F. Substage___ Calibrated to count cells G. ObjectiveANSWER:DCEGNice Job!FAB
23Safety in the Laboratory Primary concernOSHAProtection of employees in the workplaceSpecific guidelinesGeneral duty clauseIf no specific guidelinesWorkplace free from recognized hazardsEnforces guidelines from CDC
24Safety in the Laboratory (cont.) OSHA guidelinesStandard PrecautionsHazard communication standardsOSHA Bloodborne Pathogens StandardHazardous Waste Operations and Emergency Response Final RuleNeedlestick Safety and Prevention Act
25Safety in the Laboratory (cont.) Standard PrecautionsAssume that all blood, blood products, human tissue, and body fluids are contaminatedPPE guidelinesGlovesEye protectionUse equipment appropriatelyProper biohazard disposal
26Safety in the Laboratory (cont.) Hazard communicationBiohazard labelsMaterial Safety Data Sheets (MSDS)Hazard labelsName of materialHazardous effects
27Safety in the Laboratory (cont.) OSHA Blood-borne Pathogens StandardWritten OSHA Exposure Control PlanTrainingBloodborne pathogensPPEUniversal PrecautionsPrevention of exposureHepatitis B vaccination
28Safety in the Laboratory (cont.) Hazardous wasteDispose in proper containersSharpsOther biohazardous wasteLocation of containersReduce spillageNeedlestick Safety and Prevention ActRevision of Bloodborne Pathogen StandardUse of devices to reduce risk
29Safety in the Laboratory (cont.) Accident prevention guidelinesPhysical safetyCommon sensePPEManufacturers’ guidelinesFire and electrical safetyFire drillsFire extinguishersReduce electrical hazards
30Safety in the Laboratory (cont.) Chemical safetyMSDSPPEBiologic safetyStandard PrecautionsDisinfectionWaste disposalAccident reportingOffice proceduresEnsure safety / first aidClean up
31Safety in the Laboratory (cont.) HousekeepingReduce risk of disease transmissionGuidelinesWritten policies and proceduresClean up spills / splashes immediatelyClean equipment after useDispose of waste correctly
32Apply Your Knowledge What information must be included on the MSDS? E XCLNT!ANSWER: MSDS must include:Name of the productChemical and common name of ingredientsChemical characteristics of the productsPhysical hazardsHealth hazardsGuidelines for safe handlingEmergency and first-aid procedures for exposure
33Quality Assurance Programs Monitor the quality of patient careEnsure safety of workersAssess the quality of tests performedCLIARegulation of laboratoriesTest categoriesCertificate of WaiverModerate complexityHigh complexity
34QA Programs: Certificate of Waiver Tests Pose insignificant risk to the patient if they are performed or interpreted incorrectlySimple and accurate, so the risk of obtaining incorrect results is minimalApproved by the FDA for home useOffice must apply for a Certificate of WaiverExempt from CLIA ’88 standardsMay be randomly inspected
35QA Programs (cont.) Moderate-complexity tests High-complexity tests 75% of testsQualified laboratory personnelRandom inspectionsHigh-complexity testsTests for specialties and subspecialtiesQualified laboratory personnelRandom inspections
36QA Programs (cont.) Components Quality control program Adherence to proceduresCareful documentationInstrument and equipment maintenanceProficiency testingTraining and continuing educationStandard operating procedures documentation
37QA Programs: Quality Control and Maintenance Ensure accuracy in test results by carefully monitoring test proceduresProceduresEquipment calibrationUse control samplesPerform reagent controlsMaintain equipmentDocumentation of above procedures
38QA Programs: Quality Control and Maintenance (cont.) Equipment maintenanceManufacturer’s guidelinesTroubleshooting a problem – investigating the cause using a systematic approachDocumentationQuality control logReagent control logEquipment maintenance logReference laboratory logDaily workload log
39QA Programs: Proficiency Testing Proficiency testing programAccuracy of test resultsAdherence to standard operating proceduresControl sample, documentation sent to proficiency testing organizationPass – continue performing testFail – discontinue performing tests
40QA Programs (cont.) Training, continuing education, and documentation Employer responsibilityReference materialMSDS / safety manuals / SOPsManufacturers’ user or reference guidesClinical Lab Technical Procedure ManualsRegulatory documentation (OSHA, CLIA ’88)Maintenance and housekeeping schedules
41QA Programs (cont.) Requisition forms Medical assistant’s responsibilityComplete informationInclude with specimen or send with patient to laboratory
42Apply Your KnowledgeWhat is the purpose of a quality assurance program for a laboratory?ANSWER: The purpose of a QA program for a lab is to monitor the quality of patient care, ensure safety of workers, and assess the quality of tests performed.Quality Answer!
43Communicating with the Patient Before testingPatient preparationVerification of patient preparationDuring specimen collectionProper patient identificationVerbal and nonverbalAfter specimen collectionPost-procedure instructionsSchedule for further testing, if needed
44Communicating with the Patient (cont.) Test resultsReport to physician for interpretationReport to patient, if instructed to by the physicianPatient questionsAnswer if within your scopeRefer to physician
45Record-Keeping Quality control and equipment maintenance Inventory controlRecord test results in patient recordsTracking of specimens
46Record-Keeping (cont.) Patient recordsIdentify unusual findingsFollow office proceduresSpecimen identificationPatient informationPerson who collected specimenPhysicianPatient: Jason JonesDOB: 10/22/0000Date / time: 9:00 AMCollected by: shfPhysician: M. Welby
47Apply Your Knowledge Bravo! Mr. Jones called for his laboratory results but the physician has not reviewed the results. What should the medical assistant do?ANSWER: The medical assistant should tell Mr. Jones that the physician has to review the results before releasing them to the patient. She should also tell Mr. Jones that she or the physician will call with the results once they are reviewed.When she reviews Mr. Jones’ laboratory results, she notes that his glucose is elevated. What should the medical assistant do?ANSWER: She should identify the test result that is out-of-range by circling or underlining it based on office policy.
48In Summary Medical assistant and the POL Maintain and improve technical skillsKeep up on technological, legislative, and regulatory developmentsPrevent transmission of disease and occurrence of accidentsSeek ways to improve quality of patient carePerform tests efficiently and accuratelyMaintain equipment properly
49End of Chapter 45 Quality is not an act, it is a habit. ~ Aristotle