Labs
According to ARFP policy, what is the first step in communicating lab results with the patient, regardless of WNL, abnormal, or critical?
Call and make contact with the patient.
Where do you find the correct NDC to document into the patient chart?
Off the vial or syringe.
What visit types should be prepped at least one day prior to the patient’s appointment?
ALL. Nurse, lab, and provider visits.
If you are working with a provider other than your assigned provider what steps need to be taken?
Transfer to the other provider in Proliant and document it on your pink sheet.
What is absolutely required to be documented to qualify for a Nurse Visit to be billed?
Chief complaint, at least 2 vitals, diagnosis, and order/skill performed.
How soon should a patient with a critical result be contacted?
As soon as the result is received. No longer than 2 days.
True/False: A single dose vial that is only half used can be placed back on the shelf for later use.
FALSE. It must be wasted/discarded after the amount of medication needed is drawn up.
True/False: PHQ2/9 orders for neuropsych testing should be marked as “documentation only” and closed out once completed.
TRUE. These orders should not be sent out to other providers or us.
How many absences can you put on a blue sheet?
All the dates that fall within that pay period.
How often should you check the no show list for lab/nurse visits?
Daily.
True/False: When calling on lab results, after making contact with the patient, you should document "pt vu" and close out.
FALSE. You should document what was discussed with the patient and that they understand the instructions/recommendations given.
When opening a multidose vial for the first time, what must be documented so that the vial isn’t wasted prematurely?
open date, expiration date, and initials
What are the components that must be documented with each injection/medication/vaccine that is administered?
NDC number, lot number, manufacturer, expiration date, site administered.
True/False: Pimple patches and hoop nose rings are permitted during working hours.
FALSE
Your provider orders a Tdap on a Medicare (or MA) patient. What should you do?
Remind your provider that Tdap is not covered and ask for clarification. If they insist have the patient sign an ABN.
When can lab results be pushed through to the portal?
When the patient has been active in the last 30 days and all results are normal with no recommendations or changes from the provider.
What document do you reference for the “rules” when evaluating a medication that has been requested as a refill?
The Prescription Protocol
True/False: When a patient completes their PHQ2/9 screening questions online there is no need to enter the results.
FALSE. The results still have to be reviewed and added during intake.
True/False: You are required to text/call 1 supervisor in the event that you will not be able to report to work.
FALSE
While rooming the patient for ankle injury/sprain (etc..), they mention this occurred at work. What should you do?
Excuse yourself from the exam room and notify your provider and then a manager (Kelly) immediately.
When a provider send lab results with recommendations to start a new medication, What should you do?
Call the patient and inform them of the recommendation and educate them on the new medication. Verify the pharmacy on file and send in the new medication per the providers orders. If the patient refuses the medication, document accordingly.
What is the standard use for each size needle? 18g? 22g? 25g? 30g?
18g - Draw up only
22g - IM administration/draw up thin liquids
25g - IM administration only
30g - SQ/Intradermal (TB) administration only
During an annual visit which elements should be marked as reviewed?
Allergies, medications, Family hx, Social hx, surgical hx, ob/gyn hx, past medical hx
Where are the Maintenance Forms and I.T. Forms located?
Bulletin board across from Dawn's office.
Name one of the top 8 reasons patients often sue family practice doctors that YOU may contribute to.
2. Failure to follow up on test results (LABS!)
3. Medication errors (Medications that could be sent in incorrectly or delayed).
4. Failure to refer / Following up on referrals
5. Telephone triage errors
6. Poor or no documentation (can make a provider look negligent)
7. Communication failures (not only with the patient, but between provider/staff)
8. Failure to recognize emergency conditions