Question

Chapter 2: Quality Assurance and Legal issues in Case Studies Case Study 2-1: Quality Assurance in a Cow Laboratory Cow Laboratory in a large internal medicine group QUESTIONS actice performed over 50 waived tests a day. The medical assistants and the phlebotomists who performed 1. What are CLIA and CLIACI he waved testing were all trained it was obvious 2. Why is CLA visiting their site from the inconsistent results recorded on the cumulative eart that everyone's technique differed somewhat 3. What are the GLP's and what makes them valuable W e notification came from CLIA that they would be in standardizing the waived testing process visiting the site within the next month, the lead physician 4. What are other examples of OC components that decided that a OA process had to be put into place. He could be put in place in this laboratory setting! directed the laboratory staff to the CLIA Web site for Instructions on waved testing standardization in the form of GLP issued by CLIAC Case Study 2-2: Blood Draw Fails Delta Check It was a very busy day in the hospital laboratory since the patient Later that morning the delich two phlebotomists were out for medical reasons. An The second specimen was recollected and the results order came from the fourth floor for a timed draw. showed the specimen that Joe had drawn to be in error Joe, a phlebotomist from a temporary agency, was still there, even though he was supposed to have gotten QUESTIONS off 2 hours earlier. No one was there to collect the specimen except Joe. Knowing how important it was 1. What is a delta check? he decided to go ahead and collect it. When he arrived in the room, the patient was seated in a chair between 2. What do you see that could have caused this the beds. Joe asked the patient his name and in which discrepancy? bed he belonged. When the seated patient answered 3. What should Joe have done differently? with the right last name and pointed to the correct bed, Joe proceeded to collect the specimen from him while 4. What were Joe's obligations to the laboratory after he sat in the chair. Joe labeled the specimen tubes at his regular shift? the nursing station while noting the draw on the desk 5. Who is ultimately responsible for Joe's actions clipboard. When a second specimen was drawn from while he is at work? in the area of the draw. The phlebotomist quickly wraps a pressure bandage around the arm and tells her she is free to go. The patient is later diagnosed with permanent nerve injury and sues the clinic. Case Study 2-3: Nerve Injury A phlebotomist prepares to draw three tubes of blood from an outpatient. The only vein that is visible is the basilic vein on the right arm. He was taught that the basilic vein is the last choice for venipuncture because it is hard to anchor and a major nerve lies close to it, but it is so large he decides that he can draw it without a problem. When he inserts the needle, sure enough, the vein rolls and the needle slips beside the vein. The patient cries out in pain, and jerks her arm. The needle goes even deeper, but blood begins to flow into the tube, so he continues the draw. The patient tells him it is hurting and to pull the needle out, but the tubes are filling quickly, so he continues to fill all three before ending the draw. The woman is still in pain and her arm begins to swell QUESTIONS 1. Can the phlebotomist be held liable for the woman's injury? 2. What tort might be involved in this casel 3. Do you think the standard of care was breached? Why or why not?

Answer 1

2.1 :-

1. CLIA is clinical laboratory improvement amendments and CLIAC is the advisory committee of CLIA that monitors the quality assurance .

2. CLIA is visiting this site because of the inconsistent results .

3. GLP's is good laboratory practices and it assures the quality of the test which makes them valuable in standardizing the waived testing process .

4. The examples of components of quality control are :-

Human resources

Leadership

Relevant ethical requirements, acceptance and continuance of clients relationships

Monitoring

Engagement performance