Policy Manual sample

MDT Home Health Care Agency, Inc. • Glucose • Ketone • Nitrite • Protein • Urobilinogen • Hemoglobin • Leukocytes • PH • Specific gravity b. Fecal occult blood c. Ovulation test (visual color comparison) d. Urine pregnancy (HCG) test (visual color comparison) e. Erythrocyte sedimentation rate (non-automated) f. Hemoglobin - copper sulfate (non-automated) g. BLOOD GLUCOSE BY GLUCOSE MONITORING DEVICES CLEARED BY FDA SPECIFICALLY FOR HOME USE h. Hemoglobin (automated) by single analyze instruments with self contained or component features: Hem Cue Hemoglobin System i. Cholesterol (ChemTrack AccuMeter/ Johnson & Johnson Advance Care for total cholesterol) j. Nitrazine (pH) paper for body fluid pH k. Gastroccult Test (SmithKline) 5. Manufacturers * instructions must be followed in performing the test. 6. All staff will receive training and orientation prior to performing the test. 7. The training and orientation will be specific to the laboratory tests the staff member will perform. The orientation may be obtained through reviewing the manufacturers * written material, viewing videotapes, or through arrangement with a certified laboratory. 8. Records must be made available and reports submitted as required by the Department of Health and Human Services. 9. All laboratory tests performed on waiver list will be per physician orders. 10. Only qualified staff that is properly trained, oriented to procedures, and evaluated for competence will perform testing. 11. A record is maintained of all equipment used by agency personnel, including serial numbers and a record of preventive maintenance. 12. Staff competence will be assured through random observation of qualified staff performing specific lab tests. 13. As applicable to tests agency staff perform, the agency will maintain written procedures regarding: a. Specimen collection b. Specimen preservation c. Instrument calibration per manufacturer guidelines, at least weakly. d. Quality control checks per manufacturers guidelines and remedial actions taken as necessary e. Equipment performance evaluation (on equipment owned/leased by a agency) f. Test performance 14. Quality control documentation will be kept on a log that tracks equipment by serial number of owned equipment. Home Health Agency Policies A-158