Curriculum to Accompany

Medical Assisting:

Administrative and Clinical Competencies,

6th Edition

Course:

Specimen Collection and Laboratory Procedures


Curriculum to Accompany Medical Assisting: Administrative and Clinical Competencies, 6th Edition

Course: Specimen Collection and Laboratory Procedures

Contents

Part A: The Microscope

Part B: Capillary Blood Collection

Part C: Venous Blood Collection

Part D: Common Physician’s Office Lab Diagnostic Tests

Part E: Bacterial Specimen Collection, Cultures, and Diagnostic Tests

Part F: Other Frequently Ordered Laboratory Tests and Normal Values


Curriculum to Accompany Medical Assisting: Administrative and Clinical Competencies, 6th Edition

Course: Specimen Collection and Laboratory Procedures

Course Overview

This unit covers basic elements of blood collection techniques, CLIA waived lab diagnostic tests, and bacterial/microbiological testing. In the physician’s office it is not uncommon for the medical assistant to collect capillary and/or venous blood samples and perform simple testing on the samples to aid in diagnoses and maintenance of good health. Understanding the importance of proper sample collection as well as analysis of the specimens is extremely important for quality patient care. Although microbiological responsibilities may be limited in many offices, one will find that frequently pediatricians, family practice physicians, and general practice providers may order throat cultures and/or rapid strep screens. This means that the medical assistant needs a general familiarity with these procedures for success in the externship and beyond. Many providers request lab studies to be completed by an outside source (hospital lab or reference lab) so you need to know what the most commonly ordered tests are, what they check for, and what their normal values are. By recognizing normal and panic values, you will play an important role in helping to screen and follow up test results.

Resource List

Textbook: Medical Assisting: Administrative and Clinical Competencies, Sixth Edition, by Lucille Keir, Barbara Wise, Connie Krebs, and Cathy Kelley-Arney. © 2007, Delmar Cengage Learning, ISBN 1-4180-6633-8. Chapter 15.

Student CD-ROM: CD-ROM that accompanies Medical Assisting: Administrative and Clinical Competencies, Sixth Edition. This CD-ROM contains StudyWARE, The Critical Thinking Challenge, and an Audio Library.

Workbook: Workbook to accompany Medical Assisting: Administrative and Clinical Competencies, Sixth Edition, by Lucille Keir, Barbara Wise, Connie Krebs, and Cathy Kelley-Arney. © 2007, Delmar Cengage Learning, ISBN 1-4180-3267-0. Chapter 15.

Instructor’s Materials: Instructor’s Resource Manual to accompany Medical Assisting: Administrative and Clinical Competencies, Sixth Edition, by Lucille Keir, Barbara Wise, Connie Krebs, and Cathy Kelley-Arney. © 2007, Delmar Cengage Learning, ISBN 1-4180-3268-9.

Instructor’s CD-ROM: Electronic Classroom Manager to accompany Medical Assisting: Administrative and Clinical Competencies, Sixth Edition, by Lucille Keir, Barbara Wise, Connie Krebs, and Cathy Kelley-Arney. © 2007, Delmar Cengage Learning, ISBN 1-4180-3269-2.

The Internet: It is strongly recommended that faculty and learners alike have a working knowledge of the Internet.

Equipment List

  1. Multimedia projector
  2. Computer with Internet access
  3. Multimedia equipment
  4. AAMA credentialing information
  5. AMT credentialing information
  6. DVD player

CAAHEP content

III.C.1.g.(3) Diagnostic testing

III.C.1.g.(2) Specimen collection and processing

III.C.1.g.(4) Patient care and instruction

III.C.1.g.(6) Medical emergencies

ABHES content

VI.B.1.b.10.a.5 Care of the microscope

VI.B.1.b.10.c.1. Personal protective equipment

VI.B.1.b.10.c.2.b. Finger puncture

VI.B.1.b.10.c.2.a. Venipuncture

VI.B.1.b.10.b. Urinalysis

VI.B.1.b.10.c. Hematology

VI.B.1.b.10.d. Basic blood chemistries

VI.B.1.b.10.g. OSHA compliance rules and regulations

CAAHEP competencies

III.C.3.c.(2)(f) Demonstrate knowledge of federal and state health care legislation and regulations

III.C.3.c.(4)(b) Perform routine maintenance of (administrative and) clinical equipment

III.C.3.b.(2)(b) Perform capillary puncture

III.C.3.b.(2)(a) Perform venipuncture

III.C.3.b.(3)(c)(i) Perform urinalysis

III.C.3.b.(3)(c)(ii) Perform hematology testing

III.C.3.b.(3)(c)(iii) Perform chemistry testing

III.C.3.b.(3)(c)(iv) Perform immunology testing

III.C.3.b.(4)(i) Screen and follow up test results

III.C.3.c.(4)(d) Use methods of quality control

III.C.3.b.(3)(c)(v) Perform microbiology testing

III.C.3.b.(4)(i) Screen and follow up test results

ABHES competencies

VI.B.1.a.5.(g) Monitor legislation related to current healthcare issues and practices

VI.B.1.a.6.(b) Operate and maintain facilities and perform routine maintenance of (administrative and) clinical equipment safely

VI.B.1.a.4.(t) Perform capillary puncture

VI.B.1.a.4.(s) Perform venipuncture

VI.B.1.a.4.(i) Use quality control

VI.B.1.a.4.(l) Screen and follow up test results

VI.B.1.a.4.(y) Perform urinalysis

VI.B.1.a.4.(z) Perform hematology

VI.B.1.a.4.(aa) Perform chemistry testing

VI.B.1.a.4.(bb) Perform immunology testing

VI.B.1.a.4.(l) Screen and follow up test results

Learning Activities

(HW) Terminology Notebook. Assign chapter for reading and have students define key terms and retain in a key term notebook for future reference.

(ICA) MSDS Activity. Print or copy several MSDS sheets for students to review and identify key components.

(ICA) Biohazardous Waste Manifests. Provide completed biohazardous waste manifests from your institution for reference; discuss state requirements for regulation of biohazardous waste.

(ICA) OSHA Review. Discuss laboratory OSHA regulations for engineering controls, work practice controls, and personal protective equipment.

(ICA) Guest Speaker. Invite the local fire department to demonstrate the proper use of the fire extinguisher and discuss fire safety in the workplace.

(ICA) Microscope Labeling. Ask the students to review Figure 15-2; following this, have them to identify the various components of the microscope.

(ICA) Competency evaluation, Procedure 15-1. Demonstrate the proper use of the microscope and require the students to return the demonstration for evaluation of their competency for Procedure 15-1.

(HW) Chapter 15, Unit 1 Workbook Assignment Sheet

(ICA) Capillary Puncture Determination. Have students to observe their fingers to determine fingerprints for correct capillary puncture technique.

(ICA) Competency evaluation, Procedure 15-2. Allow students to practice proper capillary puncture technique on each other followed by evaluation of competency for Procedure 15-2

(HW) Chapter 15, Unit 2 Workbook Assignment Sheet

(ICA) Applying tourniquets. Demonstrate the proper application of the tourniquet and have the students practice application of such on each other. Assist them in palpating veins in the antecubital fossae.

(ICA) Equipment assembly. Assemble various types of venipuncture collection devices; after showing the class how to assemble, allow each student to do so.

(ICA) Phlebotomy practice, Part I. After demonstrating correct methods of venipuncture, provide the students time to practice and perfect their techniques on a mannequin arm.

(ICA) Phlebotomy practice, Part II. As students gain confidence and competence in phlebotomy skills, progress them to practicing on each other or volunteers (unless precluded by state law or institutional policy).

(ICA) Competency evaluation, Procedures 15-3 through 15-5. Evaluate each student on their competence for Procedures 15-3 through 15-5.

(ICA) Order of Draw documentation. Provide the students the order of draw posted on this text’s online companion site, http://www.delmarlearning.com/companions/content/1418032662/i_resource/updates/index.asp. (This is in the Instructor’s Resource section of the online companion; the user name is “keirolc” and the password is “enter”.)

(HW) Research project. Assign research project for students to outline what tests are drawn in what tubes.

(HW) Chapter 15, Unit 3 Workbook Assignment Sheet

(ICA) Competency evaluations, Procedures 15-6 and 15-7. Instruct the students on the correct operation of the facility’s hemoglobinometer and microhematocrit centrifuge. Put students in pairs to collect and measure hemoglobin and hematocrit on one another for evaluation of competency for Procedures 15-6 and 15-7 (attach the results as evidence of the work products).

(ICA) Competency evaluation, Procedure 15-8. Have each student collect an EDTA tube; cover the steps for ESR testing. Evaluate the students on their competency for Procedure 15-8 (attach the results as evidence of the work product).

(ICA) Competency evaluation, Procedure 15-9. Cover the operation of the facility’s glucometer(s); assign each student a partner on which to collect a capillary puncture and perform a blood glucose test. Evaluate the students on their competency of Procedure 15-9 (attach the results as evidence of the work product).

(ICA) Competency evaluation, Procedure 15-10. After explaining the operation of the Hemoglobin A1C instrument, have the students to perform analysis on each other. Evaluate their competency of Procedure 15-10 (attach results of the tests as evidence of the work product).

(ICA) Competency evaluation, Procedure 15-11. Explain how to perform cholesterol testing on the facility’s instrument or methodology; have each student to perform a capillary puncture and testing for evaluation of competency of Procedure 15-11 (attach the results as evidence of the work product).

(ICA) Competency evaluation, Procedure 15-12. Have the students remove Procedure 15-12 and the case studies from their workbooks to complete for evaluation of competency of the procedure.

(ICA) Competency evaluation, Procedure 15-13. Explain the manufacturer’s instructions for the infectious mononucleosis kit; have the students to collect and analyze screening results for evaluation of competency of Procedure 15-13 (attach the results as evidence of the work product).

(HW) Project. Assign the students to design and prepare a professional brochure for males and females for a clean-catch, midstream urine specimen.

(ICA) Competency evaluation, Procedure 15-14. Using the brochures the students created as a Project (see Homework Assignments), proceed to Procedure 15-14 and evaluate the students on their competency for patient instruction and collection of specimens (attach the brochure as evidence of the work product).

(ICA) Competency evaluation, Procedure 15-15. Demonstrate the manual use of the Multistix 10 SG or comparable chemical analysis strips; have the students to practice testing followed by evaluation of their competency of Procedure 15-15 (attach the results as evidence of the work product).

(ICA) Competency evaluation, Procedure 15-16. Following completion of Procedure 15-15, instruct the students to pour 10-12 mL of the specimen into a centrifuge tube to complete Procedure 15-16.

(ICA) Competency evaluation, Procedure 15-17. After explanation on the use of the facility’s pregnancy test, evaluate the students on their competency of Procedure 15-17 (attach the results as evidence of the work product).

(ICA) Competency evaluation, Procedure 15-18. Tell the students to remove Procedure 15-18 with the case studies from their workbooks for completion and evaluation of competency of the procedure.

(ICA) Competency evaluation, Procedure 15-19. Place the students in pairs and have each to explain the collection of a stool specimen; evaluate each on their competency of Procedure 15-19.

(ICA) Competency evaluation, Procedure 15-20. Prepare hemoccult slide with a simulated specimen; have the students to analyze, perform the QC, and record their results. Evaluate the students on their competency of Procedure 15-20 (attach the results as evidence of the work product).

(ICA) Competency evaluation, Procedure 15-21. Following the guidelines for instructing patient on collection of a sputum specimen in the text, evaluate the students on their competency of Procedure 15-21.

(HW) Chapter 15, Unit 4 Workbook Assignment Sheet

(ICA) Competency evaluation, Procedure 15-22. Demonstrate the proper technique for performing a wound culture for microbiological testing and have each student return the demonstration for evaluation of competency of Procedure 15-22.

(ICA) Competency evaluation, Procedure 15-23. Demonstrate the technique for obtaining a throat culture and have each student return the demonstration for evaluation of competence for Procedure 15-23.

(ICA) Competency evaluation, Procedure 15-24. Using throat cultures from Procedure 15-23, explain the manufacturer’s instructions for Rapid Group A Strep screening. Evaluate the students on their competency of Procedure 15-24.

(HW) Chapter 15, Unit 5 Workbook Assignment Sheet

(ICA) What are Normal Values? Discuss the normal values in Table 15-4.

(HW) Chapter 15, Unit 6 Workbook Assignment Sheet

(HW) The Critical Thinking Challenge, page 830.

(HW) The StudyWare Challenge, Chapter 15. Have students take the Quiz in “Quiz Mode” and either email their scores to the instructor, or print the scores to turn in.

(ICA) Following review of the chapter and homework assignments, give a quiz on this chapter that includes the content and competencies listed for CAAHEP and ABHES.

Part A: The Microscope

Learning Objectives

Cognitive

  1. Spell and define all the Words to Know in the unit.
  2. Identify the parts of the microscope and the purpose of each.
  3. Describe the proper way to adjust and focus the objectives and state their magnification powers.
  4. Explain how to properly maintain the microscope.
  5. Explain the general purpose of the microscope in a medical office.

Psychomotor

  1. Properly use a microscope.

Initial Questions and Activities

å  Show the students simulated lab logbooks and QC logs for your institution

Key Concepts / References & Activities / Slides
Quality control / Page 759
(HW) Terminology Notebook
Efficient POL / Page 760
(ICA) MSDS Activity
(ICA) Biohazardous Waste Manifests
(ICA) OSHA Review
(ICA) Guest Speaker
Microscope components / Figure 15-2
Page 751
(ICA) Microscope Labeling
(ICA) Competency evaluation, Procedure 15-1 / 3-10
(HW) Chapter 15, Unit 1 Workbook Assignment Sheet

(ICA) In-Class Activities

  1. MSDS Activity. Print or copy several MSDS sheets for students to review and identify key components.
  2. Biohazardous Waste Manifests. Provide completed biohazardous waste manifests from your institution for reference; discuss state requirements for regulation of biohazardous waste.
  3. OSHA Review. Discuss laboratory OSHA regulations for engineering controls, work practice controls, and personal protective equipment.
  4. Guest Speaker. Invite the local fire department to demonstrate the proper use of the fire extinguisher and discuss fire safety in the workplace.
  5. Microscope Labeling. Ask the students to review Figure 15-2; following this, have them identify the various components of the microscope.
  6. Competency evaluation, Procedure 15-1. Demonstrate the proper use of the microscope and require the students to return the demonstration for evaluation of their competency for Procedure 15-1.

(ICD) In-Class Discussion

  1. What is quality control and how does it impact the POL?

Quality control is defined as a process that validates the final test results and determines any variations. All laboratories are required to have a carefully performed, documented, and on-going QC program to ensure that test results are accurate and errors and trends are discovered and addressed.

  1. Name as many parts of the microscope as you can.

Oculars, objectives, stage, arm, observation tube, illuminator, diaphragm, coarse and fine adjustment knobs, slide clips, neck

(HW) Homework Assignments

  1. Terminology Notebook. Assign the unit for reading and have students define key terms and retain in a key term notebook for future reference.
  2. Chapter 15, Unit 1 Workbook Assignment Sheet.

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