30 Questions
What is the primary purpose of CLIA regulations?
To establish quality standards for lab testing performed on humans for disease diagnosis
Which of the following tests is considered CLIA-waived?
A plasma glucose test
What is the primary reason for choosing a test site off-center on the tip of the ring or middle finger?
To minimize pain
What should you do with the lancet after using it to prick the finger?
Dispose of it in a sharps container
Why should you massage the fingertip before pricking it with a lancet?
To encourage blood flow
What is the purpose of washing and drying your hands before performing a plasma glucose test?
To prevent infection and ensure a clean environment
What is the correct way to clean the test site with an alcohol wipe?
Wipe the site once and let it dry
What is required for facilities that perform non-waived laboratory testing?
A CLIA certification, inspection, and meeting all other CLIA quality standards
What is the sequence of steps to perform a glucose test?
Massage the finger upward toward the test site, touch the drop of blood onto the test strip, apply a bandage to the test site
What is the interpretation of a casual plasma glucose level of 180 mg/dL?
Diagnostic of diabetes mellitus
What is the glucose level that indicates an emergency?
Below 54 mg/dL
What is the follow-up action for abnormal results?
Recheck another day and perform an A1c test
What is the glucose level that indicates pre-diabetes?
FPG 100-125 mg/dL
What is the normal blood sugar range?
70-99 mg/dL
What should you do before putting on gloves?
Perform hand hygiene
When removing gloves, what should you assume about the outside surfaces of the gloves?
They are contaminated
How should you dispose of a used glove?
Throw it away in a regular trash can
What should you do if you notice blood on a test strip?
Place it in a RED biohazard waste bag
Where should you locate an FDA-approved sharps container?
Near the area where you are using the sharps
How should you hold a sharp when disposing of it?
With the sharp end pointing away from you
What should you do if you accidentally cut or stick yourself with a sharp?
Notify a preceptor immediately
What should you never do with a lancet, needle, or syringe?
Re-cap it
What is the main indication for performing an HbA1c test on a patient?
When a patient shows signs or symptoms of diabetes and has not had a recent HbA1c test
What is the purpose of the alcohol wipe in the HbA1c test procedure?
To disinfect the test site and minimize pain
What should be done with the lancet after use?
Dispose of it in a sharps container
What should be done to the blood collector after it is filled with blood?
Insert it into the shaker body and twist to seal
How long does the test cartridge need to be used after it is opened?
Within 2 minutes
What should be done to the shaker after it is sealed?
Shake it 6-8 times and place it upright
What will the analyzer screen display when it is checking quality controls?
WAIT
What should be done when the analyzer screen displays 'SMPL'?
Remove the base from the shaker and put the shaker onto the cartridge
Study Notes
Point of Care (In-Office) Testing
- Perform hand hygiene before putting on gloves and after removing them.
- When putting on gloves, take two from the box without touching other surfaces.
- When removing gloves, assume all outside surfaces are contaminated and use gloved hand to hold outside of other glove and remove it.
- Use ungloved finger to peel off the second glove from the inside surface.
- Discard gloves and perform hand hygiene.
Disposal of Gloves, Test Strips, Gauze, and Bandages
- Consider an item "soiled" if blood is visible.
- Place soiled items in a RED biohazard waste bag.
- Dispose of non-soiled gloves, wipes, gauze, bandages, drapes, and paper towels in a regular trash can.
Disposal of Sharps (Lancets and Needles)
- Use an FDA-approved sharps container.
- Dispose of sharps immediately after use.
- Hold the sharp with the sharp end pointing away from you and others.
- Place the sharp into the container with the sharp end down.
- Drop the sharp into the container from just above the opening.
- Perform hand hygiene after disposal.
- Do not touch a sharps container with ungloved hands or re-cap lancets, needles, or syringes.
CLIA Regulations
- CLIA (Clinical Laboratory Improvement Amendments) establishes quality standards for lab testing on human specimens.
- CLIA-waived tests are considered simple with insignificant risk of erroneous results.
- Facilities performing only CLIA-waived tests need a CLIA certificate and follow manufacturers' instructions.
- Facilities performing non-waived tests need a CLIA certification, be inspected, and meet all other CLIA quality standards.
Plasma Glucose Test
- Indications for test: signs or symptoms of diabetes, acute hyperglycemia or hypoglycemia.
- Procedure: gather supplies, perform hand hygiene, put on gloves, use glucometer, and follow instructions.
- Interpretation of results:
- Casual (not fasting) plasma glucose ≥ 200 mg/dL on two separate visits, or FPG (fasting plasma glucose) ≥ 126 mg/dL, is diagnostic of diabetes mellitus.
- FPG 100-125 mg/dL is considered pre-diabetes with increased risk of diabetes and cardiovascular disease.
- Hypoglycemia: below 70 mg/dL is harmful, and below 54 mg/dL is an emergency.
Hemoglobin A1c (HbA1c) Test
- Indications for test: signs or symptoms of diabetes in a patient who has not had a recent HbA1c test.
- Procedure: gather supplies, perform hand hygiene, put on gloves, use A1C Now kit, and follow instructions.
Learn the proper procedures for wearing and removing gloves in a point of care in-office testing setting, including hand hygiene and contamination prevention.
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