Transcript Finger Stick Training
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
T he 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 seat back
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 Process 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?
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?
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