Ebook Clinical diagnostic tests: Par 2
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Ebook Clinical diagnostic tests: Par 2
CHAPTER 4Clinical ChemistryJAMES H. NICHOLSCAROL A. RAUCHSPECIMEN RECEIVING AND PROCESSINGThe specimen receiving and processing area of the laboratory Ebook Clinical diagnostic tests: Par 2y is the entry point for specimens into the laboratory. As the initial contact point, processing staff may examine a specimen and detect common preanalytical errors before the specimen is analyzed. Mislabeling, wrong tube types, transportation delays, and other mistakes can affect patient results. B Ebook Clinical diagnostic tests: Par 2y detecting and correcting problems before the specimen is placed on an analyzer, staff can prevent clinical mismanagement based on erroneous results.Ebook Clinical diagnostic tests: Par 2
Receiving a quality specimen is the first step toward ensuring a quality result.PREANALYTICAL ERRORSLabeling Errors^nnciiìtPỉi IHÌY-Íins lĩinìỉnrrnr CHAPTER 4Clinical ChemistryJAMES H. NICHOLSCAROL A. RAUCHSPECIMEN RECEIVING AND PROCESSINGThe specimen receiving and processing area of the laboratory Ebook Clinical diagnostic tests: Par 2icians may envision their patient as the only one being analyzed by the laboratory, but in today's highly automated clinical laboratory, specimens are lined up and analyzed solely based on the label/barcode on the side of the tube. Often, an operator must retrieve individual specimens if they are ne Ebook Clinical diagnostic tests: Par 2eded for reanalysis or additional testing. Searching for a specific specimen among racks of similar specimens can be labor intensive, so automated proEbook Clinical diagnostic tests: Par 2
cesses that archive and manage specimen storage and retrieval can improve the laboratory's efficiency. These additional processes are also based on inCHAPTER 4Clinical ChemistryJAMES H. NICHOLSCAROL A. RAUCHSPECIMEN RECEIVING AND PROCESSINGThe specimen receiving and processing area of the laboratory Ebook Clinical diagnostic tests: Par 2tely labeled before sending them to the laboratory.Labeling errors can encompass a variety of mistakes beyond unlabeled specimens. Samples can be mislabeled with another patient's name or contain incorrect information, such as name misspelling or wrong demographics such as age or sex. Partially labe Ebook Clinical diagnostic tests: Par 2led specimens contain two appropriate identifiers, but may be missing important information, such as specimen source or date/time of collection. IllegEbook Clinical diagnostic tests: Par 2
ible labels that have been smudged or partially destroyed are also commonly encountered. Institutions should have a specimen labeling policy to determCHAPTER 4Clinical ChemistryJAMES H. NICHOLSCAROL A. RAUCHSPECIMEN RECEIVING AND PROCESSINGThe specimen receiving and processing area of the laboratory Ebook Clinical diagnostic tests: Par 2beling policy.Specimen labeling errors may not be immediately apparent. Errors with one specimen may implicate4: CLINICAL CHEMISTRY 145Collection in the Incorrect Tube AdditiveFailure to follow the recommended collection and processing instructions can compromise the quality of test results. Specime Ebook Clinical diagnostic tests: Par 2n collection tubes are color coded to indicate different additives. Some additives prevent clotting and allow the analysis of plasma, while other addiEbook Clinical diagnostic tests: Par 2
tives inhibit glycolysis and metabolism. Color-coded tubes may also contain a gel barrier that facilitates sample processing. These different collectiCHAPTER 4Clinical ChemistryJAMES H. NICHOLSCAROL A. RAUCHSPECIMEN RECEIVING AND PROCESSINGThe specimen receiving and processing area of the laboratory Ebook Clinical diagnostic tests: Par 2ing, or transport prior to analysis.Errors in specimen TransportationDelays in transportation or exposure of specimens to extreme temperatures during transit to a laboratory can affect test results. Laboratories need to provide recommendations for limiting the exposure of specimens to extreme temper Ebook Clinical diagnostic tests: Par 2atures prior to processing and analysis. Couriers should monitor environmental conditions to ensure that specimens are maintained within specified conEbook Clinical diagnostic tests: Par 2
ditions. The quality of test results can be affected by preanalytical conditions.Specimen Processing ErrorsThe technique and manner of specimen procesCHAPTER 4Clinical ChemistryJAMES H. NICHOLSCAROL A. RAUCHSPECIMEN RECEIVING AND PROCESSINGThe specimen receiving and processing area of the laboratory Ebook Clinical diagnostic tests: Par 2abolism that leads to decreased glucose values. Exposure of specimens to air, or transport of specimens with bubbles through a146 CLINICAL DIAGNOSTIC TESTSSTANDARDS OF CAREThe clinical need for a test cannot overlook the issue of correct specimen identity.The integrity of the specimen from identific Ebook Clinical diagnostic tests: Par 2ation through collection, analysis, and reporting of results must be maintained.If a sample with a labeling error is analyzed, the test results shouldEbook Clinical diagnostic tests: Par 2
be associated with a comment to warn those interpreting the results of the potential for a specimen mix-up.Institutions must have a specimen labelingCHAPTER 4Clinical ChemistryJAMES H. NICHOLSCAROL A. RAUCHSPECIMEN RECEIVING AND PROCESSINGThe specimen receiving and processing area of the laboratory Ebook Clinical diagnostic tests: Par 2 never move the test from one patient's medical record to another patient's medical record.Specimens should be labeled in the presence of a patient immediately after collection to ensure that the specimen label matches the positive patient identification.The laboratory should be directly involved in Ebook Clinical diagnostic tests: Par 2 phlebotomy education to ensure that staff understand test requirements and preanalytical variation that can occur during specimen collection.A laboraEbook Clinical diagnostic tests: Par 2
tory should provide recommendations for limiting the exposure of specimens to extreme environmental conditions and to delays during transportation priCHAPTER 4Clinical ChemistryJAMES H. NICHOLSCAROL A. RAUCHSPECIMEN RECEIVING AND PROCESSINGThe specimen receiving and processing area of the laboratory Ebook Clinical diagnostic tests: Par 2the entire analysis without human intervention. This automation greatly reduces the possibility of previously common analytical errors such as mixing up aliquots, ordering incorrect tests within the laboratory, making dilution errors, and reporting results to the wrong patient. Even for low-volume l Ebook Clinical diagnostic tests: Par 2aboratories, automation in the latest models of instrumentation detects interferences from hemolysis, bilirubin, and lipemia that can affect certain rEbook Clinical diagnostic tests: Par 2
esults on individual specimens. These analyzers flag results to be held by the instrument management system pending review by the technologist prior tCHAPTER 4Clinical ChemistryJAMES H. NICHOLSCAROL A. RAUCHSPECIMEN RECEIVING AND PROCESSINGThe specimen receiving and processing area of the laboratory Ebook Clinical diagnostic tests: Par 2and failed delta checks and critical value limits) and warn the technologist of potential errors. Thus, automation of laboratory analyzers is an essential tool that enables the technologist to identify those specimens with unusual characteristics and specimens that need repeat testing or separate ha Ebook Clinical diagnostic tests: Par 2ndling. This improves the overall quality of testing.However, automated analyzers are not foolproof, and good-quality test results require quality speEbook Clinical diagnostic tests: Par 2
cimens. Mislabeled and mishandled specimens, inappropriate collection and transport, miscommunication, and misunderstanding of protocols and procedureCHAPTER 4Clinical ChemistryJAMES H. NICHOLSCAROL A. RAUCHSPECIMEN RECEIVING AND PROCESSINGThe specimen receiving and processing area of the laboratory Ebook Clinical diagnostic tests: Par 2h within the laboratory as well as outside of the laboratory. Preanalytical errors in test148CLINICAL DIAGNOSTIC TESTSCHAPTER 4Clinical ChemistryJAMES H. NICHOLSCAROL A. RAUCHSPECIMEN RECEIVING AND PROCESSINGThe specimen receiving and processing area of the laboratoryGọi ngay
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