Blood Pressure Basics
What position should the patient be in when taking a blood pressure?
Seated, feet flat on the floor, back supported, arm at heart level.
How often should the PHQ-9 be completed?
Every 90 days.
What does “STARS” stand for?
Medicare Star Ratings System (not an acronym, but refers to CMS quality ratings).
How often should Alpha-1 Antitrypsin Deficiency (A1AT) screening be done, and what is the main purpose of this test?
A1AT screening should be done for patients with a family history of lung disease or early onset emphysema. It helps identify Alpha-1 Antitrypsin deficiency, a genetic condition that increases the risk of lung and liver disease. The screening is often performed once as part of the initial health assessment.
When disposing of a needle after a blood draw, what is the correct procedure to ensure safety and compliance with biohazard waste protocols?
What is placing the needle immediately into a puncture-resistant sharps container without attempting to recap or manually dispose of it
What is the ideal range for controlled blood pressure in our population?
Less than 140/90 mmHg.
What score range on the PHQ-9 suggests mild depression?
5–9
Why are STARS measures important for our organization?
They impact quality scores, reimbursement, and patient care outcomes.
A patient has been prescribed a Zio Patch for 14 days. What key instructions should be provided to ensure proper use and avoid complications?
Patients should be instructed to wear the Zio Patch for the full 14-day period, ensuring it stays on the chest and is not disturbed by activities such as showering, swimming, or excessive sweating. Instruct them to avoid applying lotions or oils to the patch site and to keep the area dry. If the patch becomes loose or detached, they should contact the office for guidance. Upon completion of the wear period, the patient should return the patch promptly for data analysis.
In the context of lab testing, what is the purpose of running a control sample before processing patient specimens?
What is to verify that the equipment and reagents are functioning correctly, ensuring the accuracy and reliability of patient test results?
Why do we wait a few minutes before re-taking a high blood pressure reading?
To allow the body to rest and get a more accurate reading.
What screening do we use for alcohol use?
AUDIT-C.
Name one STARS measure the MA directly influences.
Blood pressure control, A1C screening, diabetic eye exam, COL, KED
What is the purpose of the BNP (B-type natriuretic peptide) test, and when is it typically ordered for patients?
The BNP test is used to assess heart failure by measuring levels of a hormone released by the heart in response to stress or fluid overload. It is typically ordered to screen pts for heart failure
Hgb A1C test cartridges can be stored at room temperature for how many days?
Test cartridges can be stored at room temperature for 90 days.
How do you properly measure a patients arm to make sure you're using the right bp cuff size?
Compare the arm circumference to the min/max range printed on the blood pressure cuff.
If the arm circumference falls within the min and max range: This indicates that the cuff is the correct size for the patient. Use this cuff to take the blood pressure reading.
If the arm circumference is below the minimum range: Choose a smaller cuff designed for smaller arms to ensure accurate readings.
If the arm circumference exceeds the maximum range: Choose a larger cuff to ensure the proper fit and accurate readings.
What should an MA do if a patient scores high on suicidal ideation (#9)?
Notify the provider immediately; do not leave the patient alone.
What tool do we use to identify STARS care gaps for our entire center?
Regional quality worklist or tableau dashboard
What is an abnormal BNP level? If the BNP level is abnormal, what screening/test will the patient need next?
1. greater than or equal to 30
2. echo
After obtaining blood sample from patient, labeling and printing requisition, it is required to document the process in the patient's chart.
Topics to be documented include:
Blood draw site
Patient tolerance to blood draw
Number of attempts made (max 2)
If the draw was missed, or certain tests not able to be performed
Name 3 things that can falsely elevate a blood pressure reading.
Talking, legs crossed, recent activity/caffeine/smoking, incorrect cuff size, unsupported arm.
Which five screenings are part of the “annual wellness” workflow?
PHQ-2, AUDIT-C, SDOH, VES-13, Cognitive Screener
A patient age 68 had a colonoscopy 8 years ago at another facility but doesn’t remember where. Their COL screening gap is still open in Canopy. The provider is behind and asks you to “just give them a FIT kit.” What should you consider, and what’s the best course of action to support both care quality and STARS performance?
A colonoscopy is valid for 10 years, so if it was truly 8 years ago, the patient is not overdue. Giving a FIT kit may cause confusion and duplicate screening. Instead, explain to the patient why it’s important to confirm prior screenings, and offer to help track it down. Document the attempt and notify the care team or center records lead to request the outside colonoscopy report. This ensures accurate data, avoids unnecessary testing, and properly closes the STARS gap once the record is received and logged in the EMR.
A patient has a CDQ score of 21 and completes spirometry in-center. The pre-bronchodilator FEV₁/FVC ratio is 0.68. The provider is unsure if this confirms COPD. Based on the workflow and clinical guidelines, what step should be taken next and why?
What is to suggest the patient for a post-bronchodilator spirometry test, as a pre-bronchodilator FEV₁/FVC <0.70 suggests possible obstruction, but post-bronchodilator testing is required to confirm COPD?
What is the correct order of draw when collecting multiple blood specimens to prevent cross-contamination between tubes?
All draws required to be sterile (i.e. blood cultures)
Citrate containing tubes (light blue top)
Plain non-additive tubes (SST red top, plain red top, plain royal blue)
Heparin containing tubes (green top)
EDTA containing tubes (lavender top, EDTA royal blue top)
Oxalate/fluoride containing tubes (gray top)