The preexamination phase of our ammonia testing is shown below. Notice that the process is broken down into steps and space is provided next to each step, which will allow the personnel who are assessing the process to record deviations from the written procedural documents while they observe the performance of the tasks. They may also want to add other comments related to potential risks that could occur at that step in the process or may want to note that potential risks at that step have already been addressed, perhaps by the manufacturer of the test system. You can add as much detail as you deem necessary. You can simply list the steps, create a table, as we have done here, create a flow diagram, or use another method that you prefer. Whatever your approach, try to include all the steps that are needed to accomplish the process from start to finish.
Process Step
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An ammonia test is ordered by the provider.
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The test priority is determined.
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EMR transmits the order to the phlebotomist.
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The phlebotomist prepares supplies for collection, including a cup of ice.
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The phlebotomist identifies the patient.
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The phlebotomist applies tourniquet to locate vein.
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The phlebotomist releases the tourniquet before collecting the sample.
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The phlebotomist collects and labels sample.
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The phlebotomist places the labeled sample into the reclosable bag and places the bag on ice immediately.
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The phlebotomist transports the sample to the lab immediately.
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Lab assistant documents receipt in LIS.
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Lab assistant centrifuges sample, separating plasma from cells within 15 minutes of collection.
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Lab assistant delivers sample to chemistry for testing.
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