Filing Laboratory Forms After healthcare providers have reviewed laboratory test reports, they will initial the form. Initialing the form indicates the healthcare provider has reviewed the test results. After the healthcare provider releases the laboratory report, it should be filed in the patient’s inpatient or outpatient health record, as appropriate. If a standard form is used to record test results, it should be attached chronologically to the SF-545, Laboratory Report Display, inside the patient’s health record. The SF-545 functions as a display form for multiple laboratory reports. See figure 7-2. Use the preglued areas provided on the lab forms. However, since the glue is notorious for losing its grip after a while, you may use tape or staples to attach the form to the SF-545. Each SF-545 can accommodate a limited number of laboratory reports, so do not overcrowd the display form. When the SF-545 is full, add a new SF-545 to the health record and place it in front of the old SF-545. In this way, the most current lab reports will remain in chronological order. Automated or computer-generated laboratory test reports, depending on the form’s size, may be either mounted on the SF-545 or placed adjacent to the SF-545 in the health record. Keep in mind that these automated or computer-generated forms should also be filed chronologically. ETHICS AND GOOD PRACTICES IN THE LABORATORY The nature of laboratory tests and their results must be treated as a confidential matter between the patient, the healthcare provider, and the performing technician. Chapter 16 of the MANMED outlines the Navy’s ethics policy with regard to disclosure of the contents of a patient’s medical record, including lab reports. It is good practice to prevent unauthorized access to these reports, to leave interpretation of the test results to the attending provider, and to refrain from discussing the results with the patient. BLOOD COLLECTION LEARNING OBJECTIVE: Identify the correct steps to perform blood collection by t h e f i n g e r p u n c t u re m e t h o d a n d venipuncture method, and recall Standard Precautions and other safety precautions that apply to blood collection. There are two principal methods of obtaining blood specimens: the finger puncture method and the venipuncture method. For most clinical laboratory tests requiring a blood specimen, venous blood obtained by venipuncture is preferred. Blood collected by venipuncture is less likely to become contaminated, and the volume of blood collected is greater. Infection control practices, equipment requirements, and step-by-step instructions on performing both of these blood collection methods will be discussed in the following sections. STANDARD PRECAUTIONS Under the concept of “Standard Precautions” outlined by the Centers For Disease Control and Prevention (CDC), blood and other bodily fluids should be considered as potentially infectious. To protect medical personnel from direct contact with blood during phlebotomy (blood collection), gloves are required to be worn. Gloves should be disposed of after each patient. Needles and sharps used in the blood collection process should be handled with extreme caution and disposed of in biohazard sharps containers. Sharps containers should be conveniently located near phlebotomy work sites. Absorbent materials, such as cotton 2 x 2’s used to cover blood extraction sites, normally contain only a small amount of blood and can be disposed of as general waste. However, if a large amount of blood is absorbed, the absorbent material should be placed in a biohazard waste container and treated as infectious waste. Clean phlebotomy work site equipment and furniture daily with a disinfectant. FINGER PUNCTURE The finger puncture method is used when a patient is burned severely or is bandaged so that the veins are either covered or inaccessible. Finger puncture is also used when only a small amount of blood is needed. Materials Required for Finger Puncture Procedure To perform a finger puncture, the following materials are required:  Sterile gauze pads (2" x 2") 7-3