1. Quickvue In-Line rapid strep a testing
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WellOne Primary Medical and Dental Care
For Medical Clinical Staff

2. WARNING Conducting this test exposes the operator to potentially
infectious material. Standard precautions, including glove
use, are required for this procedure.
this test exposes the operator to potentially infectious material. Standard precautions, including glove use are required for this procedure.
Controls are potentially infectious and should be handled in the same manner as a patient specimen, using all appropriate precautions.
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3. Rapid Strep A Testing: Overview
Pharyngitis, can be caused by streptococci from serogroups other than Group A, as well as other pathogens. The rapid strep test will not detect these other groups and pathogens.
The Quick Vue ® Strep test will not differentiate asymptomatic carriers of Group A Streptococcus from those exhibiting streptococcal infection.
The test is designated as a screening test at WellOne since, if clinical signs and symptoms are not consistent with test results, follow-up laboratory performed culture procedure should be performed.
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4. Question (True or False): A negative Rapid Strep test is proof positive that the patient does not have strep throat.
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TRUE
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FALSE
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5. The correct answer is FALSE
The rapid strep test is 92% sensitive (meaning that 8 out of 100 persons with strep throat will have a negative rapid strep test)
If clinical signs and symptoms are not consistent with test results, follow-up laboratory performed culture procedure should be performed.
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Rapid Strep A Testing: Storage and Stability
Reagents should be stored at room temperature, in the laboratory 59 F -86F (15 C -30C) and out of direct sunlight. The laboratory room temperature must be checked daily and action taken for out of range temperatures.
Kit contents are stable until the expiration date printed on the outer box.
Swab specimens should be processed as soon as possible after collection and the test kit not opened until just prior to testing.
The Test Cassette must remain sealed in the protective foil pouch until just prior to use.
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Rapid Strep A Testing: Initial Control Testing
Each test kit comes with two control swabs (one positive and one negative) that must be checked prior to use of a new box of tests
Be sure that controls have been run and are acceptable for the test kit that you are using prior to patient testing
If results are not as expected (ie. Positive control is negative and/or negative control is positive) DO NOT USE BOX. Segregate box of tests and notify supervisor immediately.
Document the results of control testing on the strep testing log form
Use a new log form for each new box of tests opened
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8. Steps in Testing: General
Identify patient using two patient identifiers (name and DOB)
Explain procedure to patient in culturally appropriate, age appropriate terms.
Gather all necessary equipment and supplies prior to start of the procedure.
Inspect all equipment and supplies for damage, general integrity and expiration date- do not use any damaged or expired materials
Perform hand hygiene before and after patient contact; before and after donning gloves.
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9. Before conducting a strep test, the tester must:
Ensure that the lot number on the test kits begins with 1003
External controls have been run on the test kit and the control results were acceptable
The green lettering on the box has not faded
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The correct answer is:
External controls have been run on the test kit and the control results were acceptable. External controls must be run on each test kit prior to use and recorded on the strep testing log. B
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11. Steps in Testing: Collecting the Specimen
Collect the specimen: Use ONLY the swabs supplied with the test kit for Strep testing (these swabs have a green handle)
Avoid the uvula as stimulation may result in gagging
Stand off to the side of the patient to collect the specimen (helpful if the patient coughs or gags)
Take the sample from both sides of the throat at the tonsillar areas
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12. The specimen should be collected from:
The uvula
The posterior gyros
Both sides of the tonsillar areas
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13. The correct answer is both sides of the tonsillar areas
Avoid the uvula as stimulation may result in gagging
Take the sample from both sides of the throat at the tonsillar areas
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14. The proper test swabs to use for Rapid Strep A testing are:
Wooden with a cotton tip
Supplied with the kit and have a green handle
Supplied with the kit and have a wooden handle
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The correct answer is:
Supplied with the kit and have a green handle
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16. Strep Testing: Standing Orders for MA Staff
Collect and test specimen on all patients presenting with sore throat or patients stating that they have recently been exposed to strep and are ill.
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17. Steps in Testing: Testing the sample
Label with patients name (or initials) and date of birth
Open a test cassette and place on a clean, level surface.
 Insert the swab completely into the swab chamber.
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18. Steps in Testing: Testing the sample
Inspect the extraction solution bottle and do not use if the solution is not clear. DO NOT USE EXTRACTION SOLUTION IF IT IS GREEN PRIOR TO BREAKING AMPULE.
Squeeze carefully to crush the glass ampule inside the extraction solution bottle.
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19. Steps in Testing: Testing the sample
Vigorously shake the bottle 5 times to mix solution. Solution should turn green after the ampule is broken (do not use if green color is not present).
Solution must be used immediately.
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20. The extraction solution bottle should be crushed and __________ prior to use.
shaken vigorously 5 times
warmed
cooled
frozen
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21. The correct answer is shaken 5 times
SHAKE 5 TIMES
SHAKE 5 TIMES
SHAKE 5 TIMES
SHAKE 5 TIMES
SHAKE 5 TIMES
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22. The extraction solution before crushing should:
Be clear green
Be pink
Contain a green hue
Be Clear
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23. The correct answer is be clear…..
If the solution is GREEN before crushing, the ampule has already been crushed before you handled it.
Since the solution must be used immediately after mixing, the extraction bottle must be discarded.
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24. The extraction solution (after crushing) should:
Not be used if it is not clear green
Be pink
Contain a black hue
Be orange
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25. The correct answer is clear and green
Before crushing and mixing the ampule, the extraction solution should be After crushing and mixing the ampule, the extraction solution should be clear (not cloudy) and
CLEAR
GREEN
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26. Steps in Testing: Testing the sample
Remove the cap from the bottle and quickly fill the chamber to the rim.
Begin timing (5 minutes)
If liquid has not moved across the Result Window in 1 minute, completely remove the swab and re-insert. If liquid still does not move across, retest with a new specimen, Test Cassette and Extraction Solution Bottle.
The Test Cassette should not be moved until the assay is complete.
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27. Steps in Testing: Testing the sample
Read and record results at 5 minutes; verbally alert
provider of positive results
Discard test
Record information on Strep testing log
Check procedure on encounter form
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28. Steps in Testing: Interpreting Results
Positive Result:
The appearance of any pink - to purple line next to the letter “T” in the Result window, along with the blue control Line next to the letter “C” means that the test is positive for group A Streptococcus.
C for control Even a light line at the T is positive
T for Test
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29. Steps in Testing: Interpreting Results
The Control line is vivid blue- indicating an acceptable test
The Test line is light pink indicating a positive test
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30. Steps in Testing: Interpreting Results
Negative Result:
The appearance of only the blue control Line next to letter “C” in the Result Window means that the test is negative. A negative QuickVue ® result means that the swab is presumptive negative for group A Streptococcus. A line at the C= acceptable test
No line at the T= negative test
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31. Steps in Testing: Interpreting Results
No line at the C=
Test is not acceptable-
Discard and repeat
If second test does show a control line, place the box out of use and notify supervisor
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32. A blue control line next to the letter C means that:
The test is positive
This was a “good” (or reliable) test
The patient has strep throat
The results are not valid
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33. The correct answer is: This was a “good” (or reliable) test
For more on controls, place mouse here
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34. Any shade of a light pink to purple line at the “T” means:
The test is positive
This was a “good” (or reliable) test
The patient has mono
The results are not valid
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35. Click here to go back and review previous slide
The correct answer is:
The test is positive
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36. Steps in Testing: Interpreting Results
A negative background control is provided by the clearing of background color in the result window and indicates that there were no immunological interfering substances in the specimen. This area should be white to light pink within 5 minutes.
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37. Rapid strep results should be read at:
20 minutes minutes
8 minutes
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38. Steps in Testing: Testing the sample
Read and record results at 5 minutes
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39. You have reached the end of this program…..
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QuickVue Rapid A Strep Testing
Once you are confident that you are comfortable with all the materials presented, proceed to the QuickVue Rapid A Strep Testing post test at:
Start Over
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