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For Medical Clinical Staff

WellOne Primary Medical and Dental Care

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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.



A positive fecal occult blood test:

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



Fecal Occult Blood Testing: Storage and StabilityTest 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.Click here to move on


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



Each stool cardis 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



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.



For accurate fecal occult blood testing, the fecal smear should be:

thinly spread on window

applied thickly on window

applied to both sides of the card

applied with a cotton swab Click here to go back


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The correct answer is:

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) Click here

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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.



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

One

Two

Three





answer



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The fecal occult blood test result should be read at __________:

2 minutes

5 minutes

5-10 seconds

30-60 seconds Click here to go back





answer

A positive test result is indicated by the appearance of:

any black color

any yellow color

any blue color

any white colorClick here to

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The correct answer is any blue color



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.



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.



Internal control testing must be performed:

with the opening of each new box

with the opening of a new solution

with each test performed

never; there is no controlClick here to

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answer

The correct answer is…..

With each test performed.



Control testing must be performed:

Prior to interpreting the “test’ results”

Only after interpreting the “test” results



answer


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Only after interpreting the “test” results



To perform control testing, use ______ drop/s of solution; a blue color must appear in _______ to be counted as a valid test

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



If the control on the fecal occult blood card is negative:

the test is positive

the test is negative

the test is not valid

the test is sensitiveClick here to

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



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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Documents

fecal occult blood testing

answer slide

fecal samples

positive test

recommended testing

fecal specimen

screening test

stability test slides