1. RAPID HIV TESTING OraQuick ADVANCE HIV 1/2
WellOne Primary Medical and Dental Care for Medical Clinical Staff
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2. OraQuick ADVANCE Rapid HIV Testing : AT WELLONE
Oraquick Rapid HIV Testing can be processed using a blood specimen or oral specimen-
At WellOne, we use only blood for specimen processing
The test is not approved for persons under age 13
Testing should be offered to all persons age 13 to 64 routinely
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3. TRUE or FALSE: OraQuick Advance Rapid HIV testing is not approved for persons under age 16
True False
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4. The correct answer is FALSE
The test is not approved or persons under age 13
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5. The OraQuick® ADVANCE Rapid HIV-1/2 Antibody Test kit consists of:
A divided pouch
containing a
test device
and a
developer solution vial
Reusable test stands
Collection loops
Subject information pamphlet
Package insert.
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6. Oraquick Rapid HIV Testing : Storage & Stability
Test Kits
At WellOne, kits are stored in the laboratory unrefrigerated
The laboratory room temperature must be monitored daily. If the temperature is out of acceptable storage range (35-80º F), notify your supervisor immediately
Controls
Controls are stored refrigerated at 2-80 C ( F)
Do not use controls past the expiration date printed on the outer carton.
Open control vials only when you are performing tests.
Recap and store the vials in their original container at 2-80 C after use.
Date the controls with the date opened and “do not use after” date.
Opened vials expire 8 weeks after opening.
The temperature of the biological fridge is checked daily. Action is to be taken if results are out of range.
Do not use controls if the reagent appears visually cloudy or discolored.
Practice standard precautions when handling controls.
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7. TRUE or FALSE: The OraQuick control solution is good for 8 weeks after receiving the solution
True False
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8. The correct answer is FALSE
The control solution is stable until the expiration date when stored in the refrigerator at appropriate temperatures.
After opening, the control solution expires in 8 weeks from the date first opened.
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9. The laboratory room temperature and refrigerator temperature must be checked and documented by the MA:
Weekly Monthly Daily
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10. DAILY The correct answer is…. Click here to go back
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11. HIV TESTING: EXTERNAL CONTROLS
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HIV TESTING: EXTERNAL CONTROLS
External Controls (three total) including and HIV 1 positive, HIV 2
positive, and HIV 1/2 negative control will be run and recorded on
QA form:
With each new lot of test packs received prior to placing them in service
If there is a change in the conditions of testing (e.g. new location, lighting, temperature, etc.)
If the temperature of the test storage area falls outside of 2-270C (35-800F)
If the temperature of the testing area falls outside of C (59-800F)
Monthly (May change depending on testing volume)
Whenever two consecutive invalid test results are obtained on a person being tested.
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12. The OraQuick ADVANCE® controls should be run in each of the following situations except:
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When a new lot of
OraQuick ADVANCE® kits are
received.
If there is a change in
conditions of the storage
area.
By each operator at the
start of a shift.
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13. The correct answer is……….
By each operator at the start of a shift.
External control testing must be performed when a new
lot of OraQuick ADVANCE® kits are received and if there is
a change in conditions of the storage area.
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14. WARNING
Conducting this test exposes the operator to potentially infectious material. Standard precautions, including glove use are required for this procedure.
HIV controls are potentially infectious and should be handled in the same manner as a patient specimen, using all appropriate precautions.
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Click here for MSDS

15. Testing Procedure
Identify patient using two patient identifiers (name and DOB)
Explain procedure to patient in culturally appropriate, age appropriate terms.
Be sure the patient has received an OraQuick Advance Subject Testing Information Pamphlet.
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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16. from the correct side, taking care never to touch the flat pad.
Open the divided pouch. Using the notched corners, tear the top of each end of the divided pouch containing the test device and developer solution vial. Remove the developer solution bottle. To prevent contamination, leave the Test Device in the divided pouch until needed.
Open the divided pouch
from the correct side, taking care
never to touch the flat pad.
Upon opening,
check to be sure that an Absorbent Packet is present .
If no Absorbent Packet is present,
discard the test device
and obtain a new divided pouch for testing.
Flat Pad: Do NOT Touch
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17. Remove the Developer Solution Vial from the Divided Pouch.
Place the Reusable Test Stand on a flat, level surface. Use only the stand provided.
Don gloves.
Remove the Developer Solution Vial from the Divided Pouch.
Firmly holding the Developer Solution Vial, carefully uncap the vial by gently rocking the cap back and forth. Slide the uncapped Developer Solution Vial into the top of the slot in the angled Reusable Test Stand.
Be sure the vial is completely seated in the stand. DO NOT Force the vial into the stand from the front of the slot, as splashing may occur.
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18. Testing Procedure Follow finger stick procedure
Use the Specimen Collection Loop and collect the blood on the rounded end of the loop, making sure the loop is completely filled with blood.
Immediately immerse the blood-filled Specimen Collection Loop in the developer solution inside the Developer Solution Vial. Use the Specimen Collection Loop to stir the specimen in the developer solution. Remove the Specimen Collection Loop from the Developer Solution Vial and discard the used loop in a biohazard waste container.
Examine the solution in the Developer Solution Vial to ensure that it appears pink, indicating that the blood specimen was properly introduced. If the developer solution is not pink after adding the specimen, discard the Developer Solution Vial as infectious waste, open a new Divided Pouch, and collect a new specimen.
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19. Testing Procedure
Remove the Test Device from the Divided Pouch without touching the flat pad.
Insert the Test Device, flat pad first, into the Developer Solution Vial containing the specimen. Be sure that the result window faces forward and the flat pad touches the bottom of the Developer Solution Vial.
Label the specimen with the patient’s initials and DOB
DO NOT cover the two holes in the back of the Test Device after placing it into the developer solution. Doing so may cause an invalid result
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20. Begin Timing and Documenting
Document on the HIV testing log:
Date of testing
Patient name
DOB
Time Test was Started
Temperature of room where testing is being done
SET THE TIMER FOR 20 MINUTES
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21. Read and Document Results
CORRECT TIMING OF INTERPRETATION IS CRITICAL
RESULTS MUST BE INTERPRETED NO EARLIER THAN 20 MINUTES and NO LATER THAN 40 MINUTES after introducing the specimen into the developer solution.
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22. OraQuick ADVANCE® results must be interpreted at no less than _______minutes and no more than _______minutes
after introducing the specimen into the developer solution.
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10; 20
20; 60
20; 40
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23. 10; 20 20; 60 20; 40 The Correct Answer Is……………..
RESULTS MUST BE INTERPRETED NO EARLIER THAN 20 MINUTES and NO LATER THAN 40 MINUTES after introducing the specimen into the developer solution.
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10; 20
20; 60
20; 40
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24. Read and Document Results
After recording results, dispose of the test vial and test device in the biohazard waste container.
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25. Rapid HIV Testing: Internal Control Result
A line appears at the “C” (control) , indicating a valid test This is read as “control is positive”
An internal control is built into the test unit.
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26. Rapid HIV Testing: Internal Control Result
If the control line does not appear, the test is not valid and must be repeated
The lack of a control line may mean that an insufficient amount of blood has been added to the test device or the test device is not working
An internal control is built into the test unit.
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27. Rapid HIV Testing: Negative (Nonreactive) Test Result
This is a negative test with no line appearing at the “T” on the testing unit and a positive control line appearing at the “C”
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28. Rapid HIV Testing: Negative Test Result
A Non-Reactive result does not preclude the possibility of exposure to HIV or infection with HIV.
An antibody response to recent exposure may take several months to reach detectable levels.
Rule out a history of exposure to HIV within 3 months. Recommend a retest for clients with a recent exposure.
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29. Rapid HIV Testing: Positive (Reactive) Test Result
The intensity of the test line does not correlate with disease activity/severity.
All OraQuick reactive (preliminary positive) results must be followed up with either a Western Blot (WB) for confirmation.
Whenever the OraQuick® test result is reactive, the Health Care Provider must explain the results to the patient and provide the patient with a confirmatory testing lab slip to be performed at the lab. A follow up appointment must be scheduled to review the results with the patient.
The health care provider must indicate on the specimen requisition form that the specimen is from an individual who had a reactive OraQuick rapid test result. VV
Positive Control =
Valid test
Positive
TEST
RESULT
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30. TRUE or FALSE - The intensity of the color of the line next to the “T” zone that appears during a test signifies the amount of HIV antibodies in the specimen.
True False
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31. The correct answer is FALSE
The intensity of the test line does not correlate with disease activity/severity.
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32. TRUE or FALSE: A Western Blot must be ordered for preliminary positive results
True False
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33. The correct answer is TRUE
A Western Blot (not an ELISA) must be ordered as confirmatory testing.
Be sure to indicate on the specimen requisition form that the specimen is from an individual who had a reactive OraQuick rapid test result.
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34. Rapid HIV Testing: Invalid Test Results
No line is present in the area adjacent to either the “C” or “T” triangle (figure 1)
A line appears opposite the “T” triangle but not the “C” triangle (figure 2)
A red background in the result window makes it difficult to read the results after 20 minutes (figure 3)
A line appears, but not opposite the “C” (or “T”) triangle – misalignment
(figure 4)
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35. Which of the following is an example of an invalid test result using an OraQuick ADVANCE® test kit?
No line is present in the area
next to either the “C” or “T”
triangle.
A line appears opposite the “T” triangle but
not the “C” triangle.
The pinkish red background in the result
window does not disappear and makes it
difficult to read the result after 20 minutes.
All of the above.
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36. The Correct Answer is……
All of the above
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37. You have reached the end of this program…..
Once you are confident that you are comfortable with all the materials presented, proceed to the Rapid HIV Testing Using OraQuick ADVANCE post test at
Start Over
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