Clinic Assistant Training: Level 2 February 2017

Specialty Visits Diabetic Patient Work-Ups Asthmatic Patient Work-Ups

Diabetic Patients What is Type II Diabetes? What are the risk factors? It is the most common form of diabetes, and occurs when the body does not produce enough insulin or when the body is unable to use the insulin produced. What are the risk factors? Smoking High Blood Pressure Poor Physical Activity High Blood Glucose

Diabetic Patients How can patients prevent Type II Diabetes? Eating well by consuming low-fat foods and whole, raw foods such as fruits and vegetables. Maintaining a healthy weight by not eating more calories than those recommended. Consuming an additional 500 calories per week results in gaining 1 pound! Staying physically active by exercising 30 minutes a day, 5 days a week.

Diabetic Patient Work-Up Clinic Assistants can assist our Diabetic Patients by… Asking patients for the time of their last meal Performing Blood Glucose Screenings (Level 2 CAs, as requested by Medical Provider) Asking patient to remove shoes in the exam room for Diabetic Foot Exams

Vitals: Blood Glucose Screening Step 1: Gather Supplies Step 2: Test Blood Glucose Gloves - put on BEFORE starting Alcohol pad Cotton balls Small Band-Aid Blood Glucose monitors: Found in the Lab. You have to sign out for the machine. Blood Glucose monitor strips: Also found in the Lab. Make sure the strip code matches the monitor code. Clean finger w/ alcohol pad and dry using a cotton ball Activate NEW lancet and turn machine on. Instructions will read: Insert strip (you should insert the test strip) Wait Apply sample. Collect blood sample: To remove lancet cover, twist and pull. Then apply slight pressure to the finger until some blood appears. Wipe away the first drop of blood. Apply slight pressure again, until enough blood for a sample appears. Record results: Wait until the glucometer beeps, for total blood sugar results. Dispose of used materials & Return monitor - Remove used lancet and discard in Sharps container. Dispose of other materials (alcohol pad, cotton, etc.) in regular trash. Return monitor to its place in the work-up room Remove gloves, and wash hands.

Diabetic Patient Work-Up (Next-Gen) Blood Glucose Screening in Next-Gen Click link on NextGen that says “Standing Orders” On list, click “Blood Sugar” Under Details type the results. Be sure to note when the patient last ate Check “Submit to Superbill” and click “Place Order” **If pt has TYPE I DM and has blood sugar over 400, flag for staff ASAP!**

Diabetic Patient Work-Up Testing patients’ blood glucose monitors… If a patient is in to visit a Diabetes Specialist: Ask if they brought their machine Administer their blood test on the VFC machine as well as the individual’s machine, using the same stick/sample Note both results in “Office Diagnostics”

Vitals: Peak Flow & Pulse Ox Measure Peak Flow & Pulse Ox When a patient… Is asthmatic Has a common cold Complains of coughing Has a fever (Pulse Ox) Is experiencing difficulty breathing

Vitals: Peak Flow & Pulse Ox Measures patient’s ability to push air out of the lungs. Peak Flow is an indicator of lung efficiency. How to test Peak Flow: Use paper towel to insert tube into peak flow machine. Ask the patient to stand up straight and take a deep breath, and exhale through mouthpiece. Repeat 3 times, and record the highest reading.

Vitals: Peak Flow & Pulse Ox Pulse Oximetry Measures O2 saturation, which indicates the percentage of air in the lungs. How to test Pulse Oximetry: Locate the machine. Turn on machine Ask patient to stay still and quiet. Clamp machine on patients finger. Wait until reading stabilizes. Record patient’s O2 Saturation reading. Notify staff if Pulse Ox is less than or equal to 92% on room air

Acutely Ill Patients Eye Problems Urinary Complaints Cough Fever If a patient complains of…. Take the following actions… Eye Problems Urinary Complaints Cough Fever Ask MA to perform Visual Acuity Exam Ask MA to perform Urinalysis Give Patient a mask Check 02 Saturation

Spanish for Clinic Assistants 101 Things to Know: Numbers, Dates, Body Parts, and Basic Phrases! ¡Que qué! Months of the Year Enero January Febrero February Marzo March Abril April Mayo May Junio June Julio July Agosto August Septiembre September Octubre October Noviembre November Diciembre December ¿Habla usted inglés? (Do you speak English?) ¿Cómo se llama? (What is your name?) Por favor tome un asiento en la sala espera. (Please have a seat in the waiting room.)

? Number Spanish cero 17 diecisiete 1 uno 18 dieciocho 2 dos 30 cero 17 diecisiete 1 uno 18 dieciocho 2 dos 30 treinta 3 tres 40 cuarenta 4 cuatro 50 cincuenta 5 cinco 60 seisenta 6 seis 70 setenta 7 siete 80 ochenta 8 ocho 90 noventa 9 nueve 100 cien 10 diez 200 dos cientos 11 once 500 quinientos 12 doce 1000 un mil 13 trece 14 catorce 15 quince 451 ? 16 dieciséis 2009 Number 451: cuatrocientos cincuenta y uno Number 2009: dosmil nueve

Spanish Work-Up: Date of Birth Clinic Assistant: ¿Cuál es su fecha de nacimiento? Patient: Mi fecha de nacimiento es... _________. Date of Birth (Spanish) Date of Birth (English) el 20 de Junio 1972 el 04 de Noviembre 1993 June 20, 1972 November 4, 1993

Spanish Work-Up: Common Phrases Common Complaints Dolor en mi espalda Calambres Back Pain Cramps

Spanish Work-Up: Common Phrases Useful Phrases Would you like the flu shot? Usted quiere la vacuna contra gripe? What brings you to the doctor today? Qué le trae al doctor hoy?

Spanish Work-Up Guide Clinic Assistant Work-Up in Spanish English Work-Up: Step-by-Step English Spanish Hello, I am name , a clinic assistant. Nice to meet you! Hola, soy name un(a) asistente de clínica, mucho gusto. What is your date of birth? ¿Cuál es su fecha de nacimiento? I am here to check your vital signs. Vengo a tomarle los signos vitales – la temperatura, la presión arterial, y el pulso. Please stand on the scale. Por favor, párese en la balanza. Take off your shoes. We will measure your height. Quítese Los zapatos. Mediremos su estatura. I am going to take the temperature. Put this under your tongue, please. Voy a tomar la temperatura. Póngase esto abajo su lengua, por favor. I am going to take your blood pressure. Voy a tomar su presión. Clinic Assistant Work-Up in Spanish Work-Up: Step-by-Step English Spanish When was your last menstrual period? ¿Cuándo fue su última menstruación? (aka "regla" or "período“) Do you have any allergies to medication? ¿Tiene alergia a algún medicamentos? Do you drink alcohol? Do you smoke cigarettes? ¿Bebes alcohol? ¿Fuma cigarros? Do you take medication for diabetes, hypertension, or heart disease? ¿Toma medicamentos para la diabetes, alta presión, o enfermedades del corazón? Do you need a medication refill? ¿Necesita una dosis adicional de sus medicamento? What brings you here today? What is going on with you? ¿Qué es a lo que viene hoy? ¿Qué es lo que tiene? I’m sorry, but I don’t understand. I am going to find a translator. Lo siento, pero no entiendo. Voy a pedir un traductor. Introduce Yourself: State your name and your role. Ask patient for – Last Menstrual Period (LMP). Ask patient for – Allergies. Ask patient for – Date of Birth. Ask patient for – Alcohol & Cigarette Use. Communicate what you are going to do – Patient Vitals. Ask patient for – History of Diabetes & Hypertension. Measure patient’s – Weight. Measure patient’s – Height. Ask patient about Medication. Ask patient for – Reason for Visit. Measure patient’s – Temperature. Exit with courtesy – if necessary. Measure patient’s – Blood Pressure.