Medical Assisting PowerPoint to accompany

PowerPoint® to accompany
Medical Assisting
Chapter 45
Second Edition
Ramutkowski  Booth  Pugh  Thompson  Whicker
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
1
Laboratory Equipment and
Safety
Objectives:
45-1 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.
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 correct waste disposal procedures.
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Laboratory Equipment and
Safety
Objectives (cont.)
45-8 Describe the need for quality assurance and quality
control programs.
45-9 Maintain accurate documentation, including all logs
related to quality control.
45-10 List common reference materials to consult for
information on procedures performed in the physician’s
office laboratory.
45-11 Communicate with patients regarding test preparation
and follow-up.
45-12 Identify the medical assistant’s record-keeping
responsibilities.
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Introduction
 Laboratory
testing is an
integral component
of patient care.
 You will learn
safety in the
laboratory
mandated by
OSHA and steps to
aid in preventing
accidents.
You must understand quality assurance, quality control
procedures and required record keeping.
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Role of Laboratory Testing in
Patient Care
Analysis of blood, urine, or other
body fluids and substances provides
three kinds of information
 Regular monitor for
normal results
 Specific tests for
diagnosis
 To determine and
monitor medications
5
Kinds of Laboratories
Reference Laboratory
 Owned and operated by an
organization outside the
practice
 Have technological
resources beyond the
(POL)
Physician’s Office
Laboratory (POL)
 Laboratory that is operated
from the physician’s office
 Processing tests in the POL
produces quicker
turnaround
 No need for patient to travel
to other test sites.
Some managed care companies have contracts with
laboratory companies requiring their subscriber to use
a specific reference laboratory.
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Medical Assistant’s Role
You may be responsible for
processing tests done in the POL:
 Preparing the patient for the test
 Collecting the sample
 Completing the tests
 Reporting the results
 Telling the results to the patient
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Use of Laboratory Equipment
Learn by on the job or formal training.
You may routinely use the following:
 Autoclave
 Centrifuge
 Microscope
 Electronic equipment
 Equipment used for measurement
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Name the parts of this
Parts of the
MICROSCOPE.
Microscope
5. Eyepieces
6. Nosepiece
7. Objectives
1. Arm
2. Fine Adjustment
3. Coarse Adjustment
8. Slide Clips
9. Stage
10. Condenser
11. Iris
12. Light Source
4. Base
Click the Page Down button to see answers.
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Safety in the Laboratory
 You must always be aware of and observe
guidelines for laboratory safety.
 OSHA guidelines
 Universal precautions
 Hazard communication standards
 OSHA Bloodborne pathogens standard
 Hazardous Waste Operations and Emergency
Response Final Rule
10
Universal Precautions
Follow these guidelines;
 Wear gloves when handling
body fluids, secretions and
excretions
 Change gloves every time
you move from patient to
patient
 Wash hands after removing
gloves
11
Hazard Communication
Standard
 Biohazard labels
 Material Safety Data Sheets (MSDS)
 Hazard labels
12
OSHA Blood-borne Pathogens
Standards
 Written OSHA Exposure Control Plan
must be created and updated annually
 Training must be provided to all
employees as mandated by the
standard that includes use of PPE.
 Employees must take hepatitis B
vaccine or decline in writing.
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Hazardous Waste Operation &
Emergency Response Final Rule
Hazardous waste products include:









Blood and blood products
Body fluids and tissue
Cultures
Vaccines
Sharps
Gloves
Specula
Inoculating loops
Paper product contaminated with body fluids
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Accident Prevention
Guidelines
 Physical safety
 Fire and electrical
 Chemical safety
 Biologic safety
safety
15
Apply Your Knowledge
How are each of the following pieces of
equipment used in the POL?
1.Autoclave
2.Microscope
3.Centrifuge
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Apply Your Knowledge –Answer
How are each of the following pieces of
equipment used in the POL?
1. Autoclave – sterilize or eradicate all
microorganisms
2. Microscope – examination of blood smears and
identification of microorganisms
3. Centrifuge – spinning a specimen to separate its
component parts
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Responding to an Accident
 You should be able to deal with most
emergencies
 There should be a written procedure
to follow in the event of an accident.
 Ensure safety for you, your
colleagues and patients.
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Responding to an Accident
(cont.)
 Administer first aid
 Take steps to get help
 Use appropriate cleaning
products for spilled
chemicals
 Do not touch broken glass,
use tongs or broom and
dustpan
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Housekeeping
 Designed to reduce the
risk of disease
transmission
 Guidelines for good
operation procedures
and reduce the risk of
infections
 Written policies and
procedures
 Immediately clean up
skills or splashes or
contaminated materials
20
Quality Assurance Programs
 Design to monitor the
quality of the patient
care a medical lab
provides
 Clinical laboratory
improvement
amendments (CLIA)
 Labs under Health
Care Financing
Administration
(HCFA) and CDC
regulations
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Certificate of Waiver Tests
 Tests pose insignificant risk to the patient if
they are performed or interpreted incorrectly
 Procedures involved are simple and accurate
to such a degree that risk of obtaining
incorrect results is minimal
 Tests have been approved by the Food and
Drug Administration for use by patients at
home.
22
Quality Assurance Program
Must include :




Quality control
Instrument and equipment maintenance
Proficiency testing
Training and continuing
education
 Standard operating
procedures documentation
23
Quality Control
Focus is to ensure accuracy in test results by carefully
monitoring test procedures.
Must follow these procedures:
 Calibration regularly of all equipment
 Control samples serves as a check on the
accuracy of the test
 Reagent Control formulated to react in specific
ways when exposed to special conditions
24
Quality Maintenance



Testing instruments and equipments must be
properly maintained and procedures
documented
Documentation includes:
Careful adherence to procedures to identify
problems
Careful documentation of all procedures.
25
Proficiency Testing
Measures accuracy of test results and
adherence to standard operating procedures
 A passing mark indicates that your
laboratory can continue to perform that
particular test
 Failing mark means that your laboratory
must stop the test and possibly other tests as
well.
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Training, Continuing
Education & Documentation
Must provide training, written reference materials
and procedures conducted in the POL.
 MSDS
 Standard operating procedures
 Safety manuals
 Equipment manufacturers’ user or reference guides
 Clinical Lab Technical Procedure Manuals
 OSHA standards
 Maintenance and housekeeping schedules
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Communicating With the Patient



Before the patient
submits samples for
lab tests
During the specimen
collection procedures
After the interpreted
lab results have been
given to the patient
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Record Keeping
Accurate and complete record keeping can be
summed up: “If it is not written down, it was
not done”
Keep Records on:
 Inventory control
 Patient records
 Specimen identification
29
Apply Your Knowledge
Congress placed all laboratory facilities
under what federal agencies?
30
Apply Your Knowledge -Answer
Congress placed all laboratory facilities
under what federal agencies?
Health Care Financing Administration
(HCFA) and CDC regulations
31
Apply Your Knowledge #2
When you arrive at work one morning
you notice a fellow medical assistant
putting on some lip balm in the POL .
What should you do?
32
Apply Your Knowledge #2 -Answer
When you arrive at work one morning
you notice a fellow medical assistant
putting on some lip balm in the POL .
What should you do?
Lip balm should not be put on in the POL. You
may want to remind your fellow employee
that it is for her safety not to put on make-up
in the laboratory.
33
Summary
Medical Assistant
The physician’s office lab offers many opportunities
for interesting and satisfying work in your role as a
medical assistant.
Keeping a level head and applying common sense
will go a long way toward making your work in the
lab efficient and accurate.
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End of Chapter
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