Hemoccult Fecal Occult Blood - Point of Care Testing

PATIENT CARE POLICY / PROCEDURE STATEMENTPROCEDURE NAME:EFFECTIVE DATE:REVIEW/REVISIONHISTORY:DEFINITIONS:EQUIPMENT:Hemoccult Fecal Occult Blood Screen01/02/9201/25/95, 02/04/98, 10/01/03 (Reviewed 02/06)Outlines the procedure for using the Hemoccult screening test for fecal occult blood.Responsible staff for this testing are RNs and LPNs.Hemoccult SlideHemoccult DeveloperApplicatorNOTE: Hemoccult reagents must be stored at room temperature.DO NOT REFRIGERATE. Protect from heat and light. Failure to storeproperly may cause erroneous results.PPE: GlovesPROCEDURE:STEPSI. Collect a small fecal sample on one end of theapplicator.OCCULT BLOOD TESTKEYPOINTSMaintain universal precautions. Hemoccult is forfecal samples only; DO NOT use with gastricsamples.2. Apply a thin smear of sample in “Box A”.3. Reuse the applicator to obtain a second samplefrom a different part of the stool.4. Apply a thin smear in “Box B”.5. Close the slide cover.6. WAIT 5 MINUTES before testing. Allow adequate time for samples to penetrate testpaper before developing.7. Open the flap in the back of the slide. Apply 2drops of hemoccult developer to the guaiac paperdirectly over each smear.If developer comes in contact with eyes or skin, rinsepromptly with water.8. Read results within 60 seconds. Any trace of blue on or at the edge of the smear ispositive for occult blood.PERFORMANCE MONITOR / TEST VALIDATION1. Apply one drop only of developer between thepositive and negative Performance Monitor areaswhich are located directly below sample windows.Always develop and interpret the patient resultsbefore developing the Performance areas. The bluefrom the positive area may interfere.2. Read results within 10 seconds. Positive monitor area will appear blue. Negativemonitor area will not turn blue.ERRONEOUS RESULTS1. If the performance control areas do not react asexpected, the test results are invalid.a. Check the expiration date.Complete unusual occurrence if test results areinvalid and forward report to Nurse Manager / ChargeNurse.

. Repeat test and performance controls.c. If the results are still invalid, repeat usinga new lot number.2. False positives can result from:a. Intake of red meat, liver, turnips, radishes,melons and Vitamin C rich foods within 48hours.b. Intake of aspirin within 7 days.c. Testing during menses.d Testing if hematuria or rectal bleeding ispresent.DOCUMENTATION:Record patient results in Physician Progress Notes andNursing Flow Record.________________________________Fred G. Odere, M.D.Medical Director / Laboratory__________________Date________________________________Rosemary Brown, CNO__________________DateCROSS REFERENCE:APPLICABLE STANDARDS:RCH LaboratoryDEVELOPED BY:Nursing Administration and LabPOLICY PRIMARY:CNO and Medical Director, LaboratorySCHEDULED REVIEW DATE: 01/09FILE NAME:G:\DOCS\POLICIES - PT. CARE\2006 F-Y REVISIONS\HEMOCCULT FECAL OCCULT BLOOD SCREEN REVIEWED 1-06..DOC(Reviewed - P. Davis, CNS 01/06)2