Fingerstick Proficiency Training Overview Fingerstick waiver form Background
Fingerstick Proficiency Training
Overview § § § Fingerstick waiver form Background presentation Universal Precautions Demo Participants do 5 sticks - 2 on an object (oranges, tennis balls, etc. ) - 3 on fingers § No actual tests will be run
Requirements § Passed counselor training § Complete fingerstick proficiency training § Observed doing two finger sticks with no errors
California State Law § State law allows certified HIV test counselors to conduct finger sticks for the purpose of collecting blood samples for HIV and hepatitis C testing § This law does not allow you to do venipuncture
Universal Precautions The universal practice of avoiding contact with patients' body fluids (blood), by means of the wearing of nonporous articles such as medical gloves
Gloves • Wear them when handling blood or blood products, and…. • TODAY – when you perform fingersticks and collect blood samples!!!! • How often do you change them? • How do you remove them?
Sharps Handling & Disposal § Medical instruments that are used to puncture the skin (syringes, lancets, needles) § Dispose of sharps immediately in a hard red plastic bio bin! § Do NOT dispose of sharps in a red bio hazard bag
Biohazard Bags Handling & Disposal § Bandages, used cotton and gauze, and gloves with body fluids on them are bio hazardous waste § Wear gloves when handling biohazard bags § Check where your organization wants you to dispose of filled biohazard bags
For Today’s Training § Place loops and lancets in the sharps container § Place gloves and all other trash in the brown paper bag
Universal Precautions All of the Universal Precautions that we talked about during the testing proficiency part of the training apply here, including: § Use of gloves § Handling and disposal of loops and lancets § Use of biohazard bags
Materials § § § § § Competency Assessment Test form (CAT) Absorbent workspace cover (chux) “Spill kit” for clean-up in the event of a spill Gloves Alcohol wipes Gauze pads Bandages Lancets Collection loops Sharps container and bio hazard bag
The Workspace § Well lit § Sturdy chair § Sturdy testing surface § Away from traffic, opening doors, and other hazards and distractions
Technician Attributes § § § § Good organizational skills Projects competence Manages unexpected situations Follows Universal Precautions Good interpersonal skills Good eyesight A steady hand
Trigger release Lancets § Retractable needles or blades § Trigger release or contact activated § Low, medium, and high flow Contact activated
Choosing a Finger Best Choices Do NOT stick Possibility of bone injury
Fingerprints § Notice the direction of fingerprints § Stick should be perpendicular to fingerprints
Where to Stick § Non-dominant hand § Inside the circles § Black lines show lancet position Do NOT stick § On the sides § On the tip § In the center
Cleaning the Finger § One firm swipe with alcohol wipe - Do not rub the alcohol wipe over the same area over and over again § Let alcohol air dry – don’t blow or fan - If alcohol is wet, the stick might sting - The sample should not be contaminated with alcohol
Feeling the Stick § Lancet type can affect pain level § Location of stick can determine pain level § Stick lasts for a fraction of a second
Roots of Anxiety § It’s normal § It happens before the stick § It’s not pleasant
Working with Anxious Clients § Reassure the client Check in with them: – How are they feeling? – Any questions? – Address the anxiety honestly
Positioning the Client § Feet firmly on the floor, or laying down (never standing) § Sitting back in the seat, supported by the seatback
Positioning the Client § Arms are not crossed § Sharps container within easy reach
Positioning the Client § Who is comfortable here?
Framing the Process Informs the client what will be happening § “I’m going to collect a drop of blood by doing a fingerstick. ” § “Which is your dominant hand? ” The Proces s § Ask, “Do you have any history of fainting or passing out when getting blood drawn? ”
Performing the Stick Contact-Activated Lancets § Remove protective cap (twist to break the seal or pull off) § Position firmly against puncture site § Press firmly against puncture site until you hear a “click” § Discard into a sharps container
Performing the Stick Trigger-Activated Lancets § Remove protective cap (twist to break the seal or pull cap off) § Position firmly against puncture site § Press trigger § Discard into sharps container
What’s Wrong Here? See if you can name 2 things wrong
Collecting the Blood Sample § Hold finger until sample has been taken § Wipe away first drop with sterile gauze pad § “Milk” the finger to get a second drop of blood § Touch loop to drop of blood § Dispense sample into testing device
Collecting the Blood Sample Touching the loop to the drop of blood
Dispensing Sample onto Absorbent Material § Touch open end of loop to center of absorbent material in sample well § If sample remains inside loop, gently twist loop against absorbent material allowing the sample to flow out.
Dispensing Sample into Buffer Solution Vial § Dispense sample into vial § Do not touch sides of vial § Stir loop into buffer solution § Dispose of loop
Model Fingerstick § Participant reads checklist § Trainer follows, pointing out combined steps where necessary § Participants watch
Debrief § Allow alcohol to air dry § The stick and the disposal are like one step § Importance of wiping away first drop (tissue juice) § Discuss specimen collection and dispensing into test device § Answer questions
Practice on Object § Follow checklist § Treat object like a person
Debrief § What was the experience like? § What was easy? § What was difficult? So. . . § Did you feel the lancet release and hear a click?
First Participant Fingerstick § Follow the checklist § Stick and dispose § Do not hold filled loop above your head § When you finish, switch roles and do again
Debrief § How did that go? Wad daya thin k? § What were the easy parts? § What were the more challenging parts?
Participant Final Fingersticks § Continue to practice fingersticks with new partners. § Use the checklist every time. § Do at least three fingersticks. § Two fingersticks will be observed.
Debrief Better? § How did that go? § Did anything feel easier this time? § What were the more challenging parts?
End of the Training Congratulations! You have just completed: § HIV Counselor Training § Rapid Test Proficiency Training § Fingerstick Training
- Slides: 42