2016 mec laboratory procedures manual

MEC Laboratory Procedures Manual
January 2016

i MEC Laboratory Procedures 2016
Table of Contents
Chapter Page
1 Overview and Laboratory Team Responsibilities .......................................... 1-1
1.1 Overview ................................................................................................ 1-1
1.2 The Laboratory Team........................................................................... 1-2
1.3 Tasks ....................................................................................................... 1-2
1.4 Organization of the Laboratory .......................................................... 1-3
1.5 Tasks—Phlebotomy Room ................................................................. 1-4
1.6 Tasks—Lab Workstation 1 .................................................................. 1-5
1.7 Tasks—Lab Workstation 2 .................................................................. 1-6
1.8 Tasks—Lab Workstation 3 .................................................................. 1-7
1.9 Cross-Training ....................................................................................... 1-8
2 Laboratory ISIS Functionality .......................................................................... 2-1
2.1 Laboratory-Specific Functionality ...................................................... 2-1
2.2 Laboratory Heads-Up Display ............................................................ 2-1
2.3 Laboratory Task Bar ............................................................................. 2-2
2.4 Menu Bar Options ................................................................................ 2-3
2.4.1 File Menu Options ............................................................... 2-4
2.4.2 Utilities Menu Options ........................................................ 2-5
2.4.3 Quality Control Menu .......................................................... 2-6
2.4.4 Report Menu Options .......................................................... 2-7
2.4.5 Modules .................................................................................. 2-8
2.4.6 Shipping ................................................................................. 2-9
2.5 Informed Consent (IC) Exclusions .................................................... 2-10
2.6 Set Session Utility .................................................................................. 2-11
2.7 Container Map ....................................................................................... 2-13
2.8 Content Container Verification .......................................................... 2-15
2.9 Subsample Preview ............................................................................... 2-20
2.10 Informed Consent Status ..................................................................... 2-22
2.11 Access a Processing Module ................................................................ 2-24
2.12 Warning and Error Messages .............................................................. 2-25
2.12.1 Not Filled Require a Comment .......................................... 2-25
2.12.2 Labels Must be Printed in Advance ................................... 2-26
2.13 Coulter and Urine Scale Icons............................................................. 2-26

ii MEC Laboratory Procedures 2016
Contents (continued)
Chapter Page
3 Venipuncture ....................................................................................................... 3-1
3.1 Introduction ........................................................................................... 3-1
3.2 Equipment and Supplies ...................................................................... 3-3
3.3 Overview ................................................................................................ 3-5
3.4 Gaining Cooperation ............................................................................ 3-7
3.4.1 Refusal Conversion .............................................................. 3-9
3.5 Performing the Venipuncture on SPs Who Do Not Speak
English .................................................................................................... 3-10
3.6 Open the Exam and Log the SP into the Exam .............................. 3-10
3.7 The Phlebotomy Interview .................................................................. 3-14
3.7.1 Pregnancy Shared Exclusion Question ............................. 3-15
3.7.2 Safety Exclusion Questions ................................................. 3-18
3.8 Administering the Fasting Questionnaire .......................................... 3-27
3.9 Venipuncture Procedures .................................................................... 3-37
3.9.1 Preparation of the Puncture Site ........................................ 3-38
3.9.2 Venipuncture Technique for the Nipro (19- and
21-Gauge) .............................................................................. 3-40
3.9.3 Venipuncture Technique for the BD Safety-
Lok™ Blood Collection Set (23-Gauge) ........................... 3-41
3.9.4 Concluding the Venipuncture ............................................. 3-43
3.10 Pediatric Venipuncture ......................................................................... 3-44
3.10.1 Age Specific Care And Phlebotomy .................................. 3-45
3.11 Hand Venipuncture .............................................................................. 3-53
3.12 Veinlite EMS .......................................................................................... 3-53
3.13 Recording the Results of the Venipuncture Procedure ................... 3-55
3.14 Venipuncture Status .............................................................................. 3-62
3.15 Repeat Blood Draw .............................................................................. 3-66
3.16 Phlebotomy Quality Control ............................................................... 3-68
3.16.1 Daily Quality Control ........................................................... 3-69
3.16.2 Supply Use Control Log ...................................................... 3-72

iii MEC Laboratory Procedures 2016
Contents (continued)
Chapter Page
3.17 Red Cross Procedures for Handling Fainting (Syncope) ................ 3-75
3.18 How to Deal With System Failure ...................................................... 3-76
4 Urine Specimen Collection and Processing .................................................... 4-1
4.1 Introduction ........................................................................................... 4-1
4.2 Supplies ................................................................................................... 4-2
4.3 Urine Flow Rate Background .............................................................. 4-3
4.4 Using the Scale for Urine Collection .................................................. 4-4
4.5 Document Urine Collection ................................................................ 4-6
4.5.1 Quantity Not Sufficient (QNS) Urines ............................. 4-11
4.6 Manually Documenting Urine Collection ......................................... 4-21
4.6.1 Manually Document Urine Collection With Bar
Code Scanning....................................................................... 4-21
4.6.2 Manually Document Urine Collection Without
Bar Code Scanning ............................................................... 4-23
4.7 Urine Specimen Assays ........................................................................ 4-26
4.8 Urine Specimen Protocols ................................................................... 4-27
4.9 Labeling Urine Processing Vessels ..................................................... 4-27
4.10 Urine Specimen Processing ................................................................. 4-28
4.11 Record the Results of Urine Specimen Processing .......................... 4-29
4.12 Second and Third Urine Samples ....................................................... 4-38
4.13 Specimen Storage .................................................................................. 4-39
4.14 How to Deal with System Failure ....................................................... 4-40
5 Urine Pregnancy Test ......................................................................................... 5-1
5.1 Purpose and Principle of the Test ...................................................... 5-1
5.2 Special Safety Precautions .................................................................... 5-2
5.3 Computerization: Integrated Survey Information System
(ISIS) ....................................................................................................... 5-3
5.4 Specimen Collection and Preparation ................................................ 5-3
5.5 Procedure for Microscopic Examination .......................................... 5-3
5.6 Reagents and Supplies .......................................................................... 5-3
5.6.1 Reagents ................................................................................. 5-3
5.6.2 Supplies .................................................................................. 5-5

iv MEC Laboratory Procedures 2016
Contents (continued)
Chapter Page
5.7 Calibration .............................................................................................. 5-5
5.8 Assay Procedure .................................................................................... 5-6
5.9 Reportable Range of Results ............................................................... 5-7
5.10 Quality Control (QC) ........................................................................... 5-7
5.11 Interpretation of Results and Remedial Action ................................ 5-23
5.12 Record Results ....................................................................................... 5-25
5.13 Limitations of Method: Specimen Rejection, Interfering
Substances, and Conditions ................................................................. 5-40
5.14 Reference Ranges .................................................................................. 5-44
5.15 Action Limits ......................................................................................... 5-44
5.16 Specimen Storage and Handling During Testing ............................. 5-44
5.17 Alternative Method for Performing Test or Storing
Specimens if Test System Fails ........................................................... 5-44
5.18 Test Results Reporting System Protocol for Reporting
Action Limits ......................................................................................... 5-45
5.19 Specimen Accountability and Tracking ............................................. 5-45
5.20 Quality Control Summary Statistics and Graphs ............................. 5-45
5.21 References .............................................................................................. 5-45
6 Complete Blood Count (CBC) ......................................................................... 6-1
6.1 Introduction ........................................................................................... 6-1
6.2 Purpose and Principle of Test ............................................................. 6-1
6.2.1 Coulter Method ..................................................................... 6-3
6.2.2 VCSn Technology ................................................................. 6-3
6.2.3 Dataplot Development ........................................................ 6-4
6.2.4 Parameter Measurement, Derivation, and
Calculation ............................................................................. 6-5
6.3 Components of DxH 800 .................................................................... 6-6
6.3.1 The Specimen Processing Module (SPM) ......................... 6-6
6.3.2 The System Manager ............................................................ 6-7
6.3.3 Pneumatic Supply Module (PSM) ...................................... 6-7
6.4 Special Safety Precautions .................................................................... 6-7
6.5 Computerization: Integrated Survey Information System
(ISIS) ....................................................................................................... 6-8