Friday, July 2, 2010

MATERIALS and SAFETY for performing venipuncture

ROUTINE VENIPUNCTURE PROCEDURE

MATERIALS

1.    Safety Needles, 22g or less
2.    Butterfly needles. 21g or less
3.    Syringes
4.    Blood Collection Tubes.  The vacuum tubes are designed to draw a predetermined volume of blood. 
       Tubes with different additives are used for collecting blood specimens for specific types of tests. 
       The color of the rubber stopper is used to identify these additives. 
       See Selecting the Appropriate Collection Tube  and Specimen Container Types.
5.    Tourniquets.  Latex-free tourniquets are available
6.    Antiseptic.  Individually packaged 70% isopropyl alcohol wipes.
7.    2x2 Gauze or cotton balls. 
8.    Sharps Disposal Container.  An OSHA acceptable, puncture proof container marked "Biohazardous".
9.    Bandages or tape


SAFETY

1.    Observe universal (standard) safety precautions.  Observe all applicable isolation procedures.
2.    PPE's will be worn at all time.
3.    Wash hands in warm, running water with the chlorhexidine gluconate hand washing product (approved
       by the Infection Control Committee), or if not visibly contaminated with a commercial foaming
       hand wash product before and after each patient collection.
4.    Gloves are to be worn during all phlebotomies, and changed between patient collections. 
       Palpation of phlebotomy site may be performed without gloves providing the skin is not broken.
5.    A lab coat or gown must be worn during blood collection procedures.
6.    Needles and hubs are single use and are disposed of in an appropriate 'sharps' container as one unit.
       Needles are never recapped, removed, broken, or bent after phlebotomy procedure.
7.    Gloves are to be discarded in the appropriate container immediately after the phlebotomy procedure.
       All other items used for the procedure must be disposed of according to proper biohazardous
       waste disposal policy.
8.    Contaminated surfaces must be cleaned with freshly prepared 10% bleach solution.  All surfaces
       are cleaned daily with bleach.
9.    In the case of an accidental needlestick, immediately wash the area with an antibacterial soap, express blood
       from the wound, and contact your supervisor.
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Medicare physician fee schedule - Quick overview

Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:

* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.


Medicare Physician Fee Schedule Payment Rates

Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)


Medicare Physician Fee Schedule Payment Rates Formula


The Medicare PFS payment rates formula is shown below:

[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF

Medicare fee schedule download