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
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An ammonia test is ordered by the provider.
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The test priority is determined.
| This is determined by the provider.
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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.
| The phlebotomist checked the ID band but did not ask the patient to state their name.
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The phlebotomist applies tourniquet to locate vein.
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The phlebotomist releases the tourniquet before collecting the sample.
| Phlebotomist performed venipuncture with tourniquet in place.
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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.
| The phlebotomist checks the venipuncture site and applies the bandage before placing the sample on ice. (5 minutes elapsed from the time of collection)
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The phlebotomist transports the sample to the lab immediately.
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Lab assistant documents receipt in LIS.
| The lab assistant removes the sample from the ice before documenting receipt in LIS.
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Lab assistant centrifuges sample, separating plasma from cells within 15 minutes of collection.
| The time-lapse before centrifugation is 8 minutes.
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Lab assistant delivers sample to chemistry for testing.
| Medical laboratory scientist notices the STATSpin lid is closed and investigate. (4 minutes elapse)
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Example 2Ammonia Testing Process
- An ammonia test is ordered by the Provider
- The test's priority is determined
- EMR transmits the order to the phlebotomist
- The phlebotomist reviews the order
- The phlebotomist prepares supplies for collection
- The phlebotomist travels to the patient's room and performs patient identification
- Phlebotomist applies tourniquet to locate vein
- Phlebotomist performs venipuncture with tourniquet in place
- The phlebotomist completes venipuncture and sets the blood sample on the bed
- Phlebotomist labels blood sample
- The phlebotomist checks the venipuncture site and applies a bandage
- The phlebotomist places the sample in a reclosable biohazard bag
- The phlebotomist places the bag containing the sample into a bag of ice (5 minutes elapses between steps 9 and 13)
- The phlebotomist transports sample to the laboratory
- Lab assistant receives sample on ice
- The lab assistant removes the sample from the ice
- Lab assistant documents sample receipt in LIS
- The lab assistant walks the sample to the STATSpin centrifuge
- The lab assistant spins the sample for 5 minutes (8 minutes elapse between steps 15 and 19)
- The medical laboratory scientist notices the STATSpin lid is closed and investigates (4 minutes elapse)
