PPM Question

I've heard the rationale of, if it involves a bodily fluid that can be removed from the patient, it is a lab test.  If it is something that cannot be removed/contained, it is considered part of the patient procedure.  But that line can be muddied.

I guess it could be considered a qualitative semen analysis - even though all the other traditional evaluations (volume, liquefaction, morphology) are not being done.  Sounds like maybe it's a call for your state's Bureau of Labs??

Thanks James!

Does anyone do Fern Testing?

Our hospital does.

Yup. What's up?

We are having difficulty with documentation of results. We have a log sheet that RNs are to record results but that is not getting done. We do not have access to the area in the patient's chart that the RNs record result so it is hard to audit. How do your RNs record Fern test results?

Also, IQCP is not needed for Fern testing since fern testing does not have quality control, am I correct?

Thanks! Sherri

We also stopped Fern testing a few years ago because of failed PTs. We went to Amnisure that is tested in the main laboratory. We found out that doctors were taking slides to their offices since we had removed microscopes from the departments doing Fern testing.

For some reason, the doctors do not trust Amnisure so we were forced (under duress) to bring back Ferning. For Theresa and I (POCCs) it has been a big headache and a total nighmare.

Our hospital has the provider order the test in our LIS and enter the results, then the Point of Care Coordinator verifies it was entered by the performing provider (and not a nurse) and then pushes the result into the patients chart. Up until last month we were using a paper log to record patient information and test results, while the doctors were also required to log the test and results in their doctor notes and then scan it into the patient charts. Providers often lacked to document the test and/or results into the patients chart so we took this away. 

I left the doctors with step by step instructions on how to order the test and now have a print off if needed stating when the test was performed and by whom.  

When clinics performing PPM was my responsibility, we had an electronic form in the Cerner PowerChart that had dedicated spaces we designed for PPM.  After entering the results, the data would flow automatically to the Lab Data/All Data page.  An audit report (basically an Excel spreadsheet) could generate the following day to a POCC or other designate to check for acceptable entries.  It was quite slick.

 Naturally, though, we still had issues with physician compliance.  And there was no way to know if a patient had had a test done and the physician simply didn't document it.  I recall a TJC inspection once where the inspector stopped a physician and asked to be shown some completed documentation for PPM.  The physicians were basically giggling at the idea of having to try and recall the last patient who had PPM.  Fortunately we (lab)were not cited, as we were making the necessary tools available.

  The clinics were moved under a different administrative division which fortunately were no longer my responsibility, so I no longer have to worry about it, which I am grateful for.  It is needless to say a quite awkward position to be in to require compliance from physicians from a laboratory perspective.  It so often is a losing battle.

  Sherri - I am not sure of the EHR format you're speaking of, but is it possible that they can give you 'nurse' status in your EHR?  In the Cerner product anyway, that's what they had to do with me, as my "lab" status allowed me to see very little.  No one questioned the need to change my status.

We ran into the same thing with semen quality checks.  We called it a qualitative test and were able to use a survey through WSLH for post vasectomy as a PT test.