MEC Laboratory Procedures Manual January 2017 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 .................................................................. 1-5 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 ............................................................................. 2-3 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 .............................................................. 2-24 2.12.1 Not Filled Require a Comment .......................................... 2-5 2.12.2 Labels Must be Printed in Advance ................................... 2-25 2.13 Coulter and Urine Scale Icons............................................................. 2-26 iii MEC Laboratory Procedures 2017 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 .................................................................... 3-36 3.9.1 Preparation of the Puncture Site ........................................ 3-37 3.9.2 Venipuncture Technique for the Nipro (19-, 21-, and 23-Gauge) ....................................................................... 3-39 3.9.3 Concluding the Venipuncture ............................................. 3-40 3.10 Pediatric Venipuncture ......................................................................... 3-41 3.10.1 Age Specific Care And Phlebotomy .................................. 3-43 3.11 Hand Venipuncture .............................................................................. 3-50 3.12 Veinlite EMS .......................................................................................... 3-50 3.13 Recording the Results of the Venipuncture Procedure ................... 3-52 3.14 Venipuncture Status .............................................................................. 3-58 3.15 Repeat Blood Draw .............................................................................. 3-62 3.16 Phlebotomy Quality Control ............................................................... 3-63 3.16.1 Daily Quality Control ........................................................... 3-65 3.17 Red Cross Procedures for Handling Fainting (Syncope) ................ 3-67 3.18 How to Deal With System Failure ...................................................... 3-68 iv MEC Laboratory Procedures 2017 Contents (continued) Chapter Page 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 ......................................... 4-22 4.6.1 Manually Document Urine Collection With Barcode Scanning ................................................................. 4-22 4.6.2 Manually Document Urine Collection Without Barcode Scanning ................................................................. 4-24 4.6.3 Manually Entering Adults Who Collect in CC2 ............... 4-27 4.7 Urine Specimen Assays ........................................................................ 4-27 4.8 Urine Specimen Protocols ................................................................... 4-28 4.9 Labeling Urine Processing Vessels ..................................................... 4-29 4.10 Urine Specimen Processing ................................................................. 4-29 4.11 Record the Results of Urine Specimen Processing .......................... 4-31 4.12 Second and Third Urine Samples ....................................................... 4-35 4.13 Specimen Storage .................................................................................. 4-36 4.14 How to Deal With System Failure ...................................................... 4-37 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 .......................................... 5-4 v MEC Laboratory Procedures 2017 Contents (continued) Chapter Page 5.6 Reagents and Supplies .......................................................................... 5-4 5.6.1 Reagents ................................................................................. 5-4 5.6.2 Supplies .................................................................................. 5-6 5.7 Calibration .............................................................................................. 5-6 5.8 Assay Procedure .................................................................................... 5-6 5.9 Reportable Range of Results ............................................................... 5-7 5.10 Quality Control (QC) ........................................................................... 5-7 5.11 Interpretation