Each step in the process should be recorded as it is being observed. Two examples of how to record the information are shown below. Example 1 is the table that was presented previously. The first column in the table lists all the required steps in the process. The second column can be used to document any deviations that are observed in the process. Example 2 is a simple listing of the steps as they are observed. This list will be compared later to the list of required steps.
Example 1
Process Step
| Comments
|
Ammonia test is ordered by provider
|
|
Test's priority is determined
| This is determined by the provider
|
EMR transmits the order to the phlebotomist
|
|
Phlebotomist prepares supplies for collection, including cup of ice
|
|
Phlebotomist identifies patient
| Phlebotomist checked ID band but did not ask patient to state name
|
Phlebotomist applies tourniquet to locate vein
|
|
Phlebotomist releases tourniquet before collecting sample
| Phlebotomist performed venipuncture with tourniquet in place
|
Phlebotomist collects and labels sample
|
|
Phlebotomist places labeled sample into zip closure bag and places bag on ice immediately
| Phlebotomist checks venipuncture site and applies bandage before placing sample on ice. (5 minutes elapsed from time of collection)
|
Phlebotomist transports sample to lab immediately
|
|
Lab assistant documents receipt in LIS
| Lab assistant removes sample from ice before documenting receipt in LIS.
|
Lab assistant centrifuges sample, separating plasma from cells within 15 minutes of collection
| Time lapse before centrifugation is 8 minutes
|
Lab assistant delivers sample to chemistry for testing
| Chemistry testing personnel notice STATSpin lid is closed and investigate (4 minutes elapse)
|
Example 2Ammonia Testing Process
- Ammonia test is ordered by Provider
- The test's priority is determined
- EMR transmits the order to the phlebotomist
- Phlebotomist reviews the order
- Phlebotomist prepares supplies for collection
- Phlebotomist travels to patient room and performs patient identification
- Phlebotomist applies tourniquet to locate vein
- Phlebotomist performs venipuncture with tourniquet in place
- Phlebotomist completes venipuncture and sets blood sample on bed
- Phlebotomist labels blood sample
- Phlebotomist checks venipuncture site and applies bandage
- Phlebotomist places sample in reclosable biohazard bag
- Phlebotomist places bag containing sample into bag of ice (5 minutes elapses between steps 9 and 13)
- Phlebotomist transports sample to laboratory
- Lab assistant receives sample on ice
- Lab assistant removes sample from ice
- Lab assistant documents sample receipt in LIS
- Lab assistant walks sample to STATSpin centrifuge
- Lab assistant spins sample for 5 minutes (8 minutes elapse between steps 15 and 19)
- Chemistry testing person notices STATSpin lid is closed and investigates (4 minutes elapse)
