1. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Chapter 44 The Physician’s Office Laboratory

2. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Lab Classifications The POL falls under numerous regulatory bodies: – CLIA – CMS – OSHA The complexity of lab tests performed determines the classification

3. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Categories of Testing Waived Moderately complex – Provider-performed microscopy procedures is a subcategory Highly complex

4. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Quality Assurance Refers to evaluated services and the results, compared to accepted standards All labs are required to follow QA programs Patient identificationInstrumental and technical performance Patient preparation and specimen collection Safety Specimen processing and transportationIn-service training and education of all health care personnel

5. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Quality Control A process of assessing test procedures, reagents, and technique of individuals Use of test kit controls – Value range of control – Reagent strip test

6. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Safety in the POL Use standard precautions Use PPE and protective barriers Dress appropriately – Long hair should be up and away from face – Jewelry items can harbor organisms Maintain personal immunizations – HBV series necessary if in contact with patients

7. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. The Microscope Used to examine minute objects that cannot be seen by the naked eye

8. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. The Microscope Must be handled with care – Carry microscope with one hand under base, and other hand on arm – Follow appropriate maintenance

9. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Parts of the Microscope Arm – Supports eyepiece Eyepieces – Contains lens to magnify item being examined – Binocular: two eyepieces – Monocular: one eyepiece

10. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Parts of the Microscope Body tube – Leads to revolving nosepiece, which has 3-4 small lenses (objectives) – Low-power field (lpf) objective: magnifies x10 – High-power field (hpf) objective: magnifies x40 – Oil-immersion lens: magnifies x100

11. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Parts of the Microscope Stage – Has two clips to hold the specimen – Substage (below stage) Location of condenser, directs light on specimen Can be raised or lowered – Shutter (diaphragm) controls the light desired