FECAL OCCULT BLOOD TESTING USING SERACULT SLIDES

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FECAL OCCULT BLOOD TESTING USING SERACULT SLIDES
WellOne Primary Medical and Dental Care
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• For Medical Clinical Staff

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WARNING

• Conducting this test exposes the operator to
  potentially infectious material. Standard
  precautions, including glove use are required for
  this procedure.
• .

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Fecal Occult Blood Testing General Overview of
Testing

• As with any fecal occult blood test, results are
  not to be considered conclusive evidence for the
  presence or absence of any gastrointestinal
  pathology. The test is not a substitute for
  other diagnostic procedures such as endoscopy or
  colonoscopy, barium enema or other studies.
• The fecal occult blood test will be considered a
  screening test at WellOne. Positive results must
  be followed with diagnostic procedures to confirm
  and when indicated, negative results should be
  followed with recommended testing.
• Since bleeding from gastrointestinal lesions may
  be intermittent, fecal samples for testing
  should be collected from three consecutive bowel
  movements or three bowel movements closely spaced
  in time.
• To further increase the probability of detecting
  occult blood, separate samples should be taken
  from two different sections of each fecal
  specimen.
• Foods which contain peroxides may leave residues
  in the feces that may interfere with the test.
• The expected/normal result is a sample that is
  negative for fecal occult blood.

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A positive fecal occult blood test
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• Should be repeated for validation
• Requires follow up testing such as colonoscopy
  and CBC
• Can be ignored if the patient has not followed
  dietary restrictions
• Is almost always related to hemorrhoids

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The correct answer is

• Requires follow up testing such as colonoscopy
  and CBC
• Since bleeding from the intestinal tract
• may be intermittent (come and go), even
• one slightly positive test should not be
• ignored

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Fecal Occult Blood Testing Storage and Stability

• Test slides
• Store slides at room temperature (15-30ºC),
  protected from light, heat, and UV radiation
• Slides are stable until expiration date unless
  general integrity is interrupted.
• Developer Solution
• Store developer at room temperature (15-30ºC)
• If properly stored, developer will remain stable
  until expiration date on bottle.

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Fecal Occult Blood Testing Storage and Stability

• Prior to testing a slide, be sure to check that
  the slide and developer solution have not expired

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Each stool card is imprinted with an expiration
date on the back of the card that can be
difficult to see without close inspection-
marking over the area with ink will help you to
see the date
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Fecal Occult Blood Testing Procedural Steps

• Open the front flap of the slide and apply a very
  thin layer of stool smear to one window and apply
  a very thin smear of stool to the other window
  then close front flap of slide.

BACK
FRONT
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For accurate fecal occult blood testing, the
fecal smear should be
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• thinly spread on window
• applied thickly on window
• applied to both sides of the card
• applied with a cotton swab

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The correct answer is
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• thinly spread on window
• applied thickly on window (this will interfere
  with reading results)
• applied to both sides of the card (the front flap
  is for the test specimen and the back flap is for
  test and control interpretation)
• applied with a cotton swab (the specimen should
  be applied with a gloved finger or wooden
  spatula)

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Fecal Occult Blood Testing Procedural Steps

• Open perforated cover on back of slide.
• Apply 2 drops of developer solution to each smear
  in specimen test area and read at 30-60 seconds.
• A positive result is indicated by the appearance
  of any blue color in the testing window. A lack
  of blue color indicates a negative result.

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When performing fecal occult blood testing, ____
drops of solution are to be applied to each of
the test areas on the back of the card
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• One
• Two
• Three

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The correct answer is
2 drops for testing
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The fecal occult blood test result should be read
at __________
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• 2 minutes
• 5 minutes
• 5-10 seconds
• 30-60 seconds

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The correct answer is
30-60 seconds for test interpretation
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A positive test result is indicated by the
appearance of
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• any black color
• any yellow color
• any blue color
• any white color

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The correct answer is any blue color
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Fecal Occult Blood Testing Procedural Steps

• Develop the performance control for each slide
  (only after specimen tests have been completed
  and interpreted) by applying 1 drop of developer
  solution to the performance Control line.
• A blue color should appear within 30 seconds
  (indicating a valid test slide).
• Remove and dispose of gloves in regular trash
  perform hand hygiene.
• Document results in the patient record (verbally
  alert provider of any positive results) and mark
  on the encounter form.

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Fecal Occult Blood Testing More On Control
Testing

• The internal control must be performed with each
  test done by applying 1 drop of developer
  solution to the performance control line only
  after the interpretation of the actual test
  results. A blue color should appear within 30
  seconds. A positive control test lets us know
  that both the slide and solution are likely to
  give accurate results. A negative control tells
  us that there is a problem with either the test
  slide or solution and the test results are not
  valid.
• If the control is negative, disregard the testing
  results and perform control testing on another
  slide from the same lot. If the control is
  positive, repeat testing using another slide and
  interpret test and control results accordingly.
• If the control remains negative, immediately
  notify the COO or designee. Action to taken
  includes the determination of the source of the
  problem (ie. developer verses test slides). Use
  a different developer solution from same lot if
  possible on same lot of test slides-if control is
  now positive, discard the original developer
  solution bottle. If control remains negative,
  test the same lot of test slides using a
  developer solution from a different lot. If
  control is now positive, segregate and return all
  developer solution bottles of this lot number.
  If control remains negative, run the control on a
  test slide from a different lot of stool cards.
  If control is now positive, segregate and return
  to manufacturer all test slides of the affected
  lot number.

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Internal control testing must be performed
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• with the opening of each new box
• with the opening of a new solution
• with each test performed
• never there is no control

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The correct answer is..

• With each test performed.

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Control testing must be performed
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• Prior to interpreting the test results
• Only after interpreting the test results

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The correct answer is..

• Only after interpreting the test results

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To perform control testing, use ______ drop/s of
solution a blue color must appear in _______ to
be counted as a valid test
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• One, 30-60 seconds
• Two, 30-60 seconds
• One, 30 seconds

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The correct answer is..

• One (drop of solution) with a blue coloring
  appearing within 30 seconds

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If the control on the fecal occult blood card is
negative
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• the test is positive
• the test is negative
• the test is not valid
• the test is sensitive

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The correct answer is..

• The test is NOT VALID- The results MUST NOT BE
  INTERPRETED

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You have reached the end of this program..

• Once you are confident that you are comfortable
  with all the materials presented, proceed to the
  Fecal Occult Blood Testing post-test at
  http//www.classmarker.com/professional/
• Your username is the first initial of your first
  name followed by your full last name. Your
  password is nwhealth

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