Nha module 7 point of care testing and laboratory procedures

The National Healthcareer Association (NHA) Module 7 covers Point of Care Testing (POCT). It also addresses Laboratory Procedures for clinical medical assistants and other healthcare professionals.

Here is the key concepts and topics commonly covered in Nha module 7.

• Overview of Point of Care Testing
• Laboratory Procedures
• Quality Control in POCT
• Regulatory Standards
• Safety in Laboratory Procedures

Overview of Point of Care Testing (POCT)

1. Point of Care Testing refers to medical diagnostic testing performed at or near the point of patient care (e.g., bedside or in a physician’s office).
2. It Provides immediate test results to assist in clinical decision-making.
3. Examples of Point of Care Testing:
   • Blood glucose monitoring
   • Urinalysis
   • Pregnancy testing (hCG)
   • Hemoglobin and hematocrit testing
   • Rapid strep tests
   • Cholesterol and lipid panels
   • INR (International Normalized Ratio) testing for blood clotting
   • Electrolyte and blood gas analysis

Laboratory Procedures

1. CLIA-Waived Tests:
   • Defined as simple laboratory tests with a low risk of incorrect results.
   • Examples include urine dipstick tests, blood glucose testing, and fecal occult blood tests.
2. Specimen Collection and Handling:
   • Proper techniques for collecting and labeling specimens (e.g., blood, urine, throat swabs).
   • Following chain-of-custody protocols for tests like drug screenings.
   • Ensuring specimen integrity by following proper transport and storage guidelines (e.g., refrigeration, avoiding contamination).
3. Common Testing Procedures:
   • Venipuncture: Blood collection using a needle and vacuum tube.
   • Capillary Puncture: Using a lancet for small blood samples (e.g., for glucose or hematocrit testing).
   • Urine Testing: Dipstick analysis for pH, glucose, protein, ketones, and infection indicators.
   • Microscopy: Basic identification of microorganisms or abnormalities in samples.

Quality Control in Point of Care Testing

1. Importance of Quality Control (QC):
   • Ensures accuracy and reliability of test results.
   • Includes routine calibration of equipment, monitoring control samples, and documenting QC activities.
2. Common Errors in Point of Care Testing:
   • Improper specimen collection or handling.
   • Use of expired reagents or test strips.
   • Failure to follow manufacturer instructions.
3. Role of Documentation:
   • Recording test results in the patient’s medical record.
   • Noting any deviations or errors in testing procedures.

Regulatory Standards

1. Clinical Laboratory Improvement Amendments (CLIA):
   • Regulations for all laboratory testing to ensure accuracy, reliability, and timeliness of patient test results.
   • POCT devices often fall under the CLIA-waived category, simplifying compliance requirements.
2. OSHA (Occupational Safety and Health Administration):
   • Mandates proper use of Personal Protective Equipment (PPE) and adherence to bloodborne pathogen protocols.
3. HIPAA Compliance:
   • Maintaining confidentiality of test results and patient records.

Safety in Laboratory Procedures

1. PPE (Personal Protective Equipment): Gloves, gowns, goggles, and masks as needed.
2. Hand Hygiene: Proper washing or sanitizing before and after procedures.
3. Sharps Disposal: Use of designated sharps containers for needles and lancets.
4. Biohazard Waste Disposal: Proper disposal of contaminated materials.

Important Points to Remember

1. Accuracy: Always follow manufacturer instructions for POCT devices.
2. Patient Identification: Verify patient identity before testing.
3. Documentation: Record test results and any observations promptly and accurately.
4. Communication: Explain testing procedures to patients to ensure understanding and cooperation.
5. QC Logs: Maintain records of quality control checks and calibrations for audit purposes.

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Common Test Scenarios

1. Blood Glucose Monitoring
   • Collect a capillary sample via fingerstick.
   • Use a glucometer to measure blood glucose levels.
   • Document and report abnormal results immediately.
2. Urinalysis
   • Instruct the patient on how to collect a clean-catch midstream urine sample.
   • Perform a dipstick test to analyze for pH, protein, glucose, ketones, and other markers.
3. Rapid Strep Test
   • Use a throat swab to collect a sample.
   • Add the sample to the reagent solution and follow the device-specific protocol.
4. Pregnancy Testing (hCG):
   • Test urine for the presence of human chorionic gonadotropin (hCG) using a dipstick method.

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Review Questions

1. What is the primary purpose of POCT in a clinical setting?
   Answer: To provide rapid test results at the point of care to support immediate clinical decision-making.
2. What are CLIA-waived tests? Provide two examples.
   Answer: Simple laboratory tests with a low risk of incorrect results, such as blood glucose testing and urinalysis.
3. What is the role of QC in POCT?
   Answer: To ensure the accuracy and reliability of test results by monitoring and documenting control samples and calibrating equipment.
4. List three safety measures that must be followed during laboratory procedures.
   Answer:
   • Use appropriate PPE (e.g., gloves, goggles).
   • Dispose of sharps in designated containers.
   • Adhere to proper hand hygiene protocols.