Fern Testing
Does anyone have physicians performing fern testing in a hospital setting? Does the hospital have a PPM waiver or are you testing under moderate or high complexity? Do you have the providers performing any QC or proficiency testing? I have some doctors that have hospital rights that would like to perform fern testing within the hospital. They have the PPM for their own private practice and I know that they can not perform testing at our facility under the private practice CLIA but I am not sure what the best route to take would be. I am wondering how other facilities have handled this situation. Any information that you would be willing to share would be greatly appreciated.
Thank You,
Kelly VanWagner MLS(ASCP)CM SHCM
Point of Care Administrator
Covenant HealthCare Laboratory
Saginaw, MI
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Please change your subject line in the email when you have changed the subject of discussion.
It is quite confusing when we have hundreds of emails to sort through.
We train the RN in our OB/ED. They receive competency and blind samples. We switched to ROM+ about three years ago and found that although we have a few false
positives (especially towards the end of pregnancy) we are happier than false negatives we had with Amnisure. We also explain the rule of three to our doctors and RN. No lab test should be a stand-alone, always use at least two methods that agree when determining
rupture.
Diana Meyer MT(ASCP)
Poc Specialist
The Womens Hospital
4199 Gateway BLVD
Newburgh, IN 47630
812-842-2514
Diana.meyer@deaconess.com
Susan,
That is a very specific definition. I would cut that way down in order to gain compliance.
Also, you could remove the critically ill definition all together, since you have the Nova glucometer, and only state the one limitation that meter has.
What method(s) are you using for the ROM?
Amnisure, ROM+, Fern, pH, Pooling or a combination?
If you discontinued Fern Testing, how did you convince the doctors? We are having issues with our doctors being willing to discontinue this testing. Any suggestions would be greatly appreciated.
Thank You,
Kelly
We did NOT give them an option. Our OBs refused to participate in competency assessment and we were cited by CAP. We removed the microscope and switched to
AmniSure. We are currently looking at moving to ROM Plus.
Jeremy Williford, PBT (ASCP)
Point of Care Support Specialist, Clinical Laboratory Services
South Georgia Medical Center | 2501 N Patterson St. | Valdosta, GA 31602
229.259.4804 (office) |
229.249-5461 (fax)
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From: Kelly VanWagner via POCT Listserv (Groupsite) [mailto:users+1176677@poct.groupsite.com]
Sent: Wednesday, March 08, 2017 9:20 AM
To: Williford, Samuel 'Jeremy' <jeremy.williford@SGMC.ORG>
Subject: [POCT Listserv] Re: Fern Testing
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We use Nitrazine test first and then if negative Amnisure. This was the procedure already in practice when I took over the POC position. The coordinator before me said she talked to the OB physician that was over L/D at the time and explained the benefits of making this change. I would think that physician compliance with competency should be a good point to use.
Tessa
Jeremy, your story should be a cautionary tale for all laboratories struggling with physician compliance when it comes to POCT!
Amen!
J We locked that microscope up! My POCC thought she was going to lose her job.
Jeremy Williford, PBT (ASCP)
Point of Care Support Specialist, Clinical Laboratory Services
South Georgia Medical Center | 2501 N Patterson St. | Valdosta, GA 31602
229.259.4804 (office) |
229.249-5461 (fax)
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From: James Beck via POCT Listserv (Groupsite) [mailto:users+1173212@poct.groupsite.com]
Sent: Wednesday, March 08, 2017 12:37 PM
To: Williford, Samuel 'Jeremy' <jeremy.williford@SGMC.ORG>
Subject: [POCT Listserv] Re: Fern Testing
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DO NOT CLICK: Links or attachments unless you recognize the sender and know the content is safe.
And a POCC should never have to be in that (no-win) position! :)
Had the same thing happen at one of our clinics under JC about 10+ years ago. Two years prior to be cited, the physicians performing PPMP were warned by a JC inspector that they needed to have documented training and competency assessment prior to the next survey. Two years came and went, with nothing in place. Next survey, three clinics were cited. Major clean-up to achieve compliance, but unfortunately it took that to make it happen.
For those of you who perform either Amnisure or ROM Plus. Do you list the "rule of three" within your procedure, explaining that no laboratory test should not be used as a stand alone? Are your doctors following that recommendation or are they using the Amnisure/ROM Plus as their only evaluator? Also are you still performing Nitrazine testing for ROM evaluation?
We are looking to switch to Amnisure but I need to make sure that the doctors are aware that they need to use it as a tool along with other evaluators (ultrasound, contraction monitors, fetal heart rate, etc...). I'd like to eliminate Ferning and Nitrazine Testing but I need to figure out a way to make sure they do not rely solely on the Amnisure result.
If you would be willing to share how your institution is handling this, I would greatly appreciate it.
Thank You,
Kelly VanWagner MLS(ASCP)cm SH cm
Point of Care Administrator
Covenant HealthCare Laboratory
Saginaw, MI
Our providers perform Fern testing and Nitrizine under PPM. We are in the process of transferring our Amnisure testing out of the main laboratory and up to L&D under a moderate complexity CLIP. We get PPM PT surveys from API and Amnisure from CAP. It is clearly stated in all SOPs that any single test is not diagnostic in and of itself. This is re-iterated at all initial and annual trainings. Amnisure put out a bulletin not to long ago indicating that the ROM test alone is not diagnostic and should be used in conjunction with other testing. Perhaps the story of the lawsuit behind the memo would convince the providers?
Thank You Fiona!!
For those that are performing Ferning, as moderate complexity...Does anyone create "Control" slides or have you written an IQCP?
Any information would be much appreciated.
Thank You,
Kelly
Do mind sharing your competency for the Fern Testing? I am new to POCT testing and are not aware of all the regulations yet. I have a CAP inspection coming up soon and I need to get things in order.
Thanks
Asha Singh
POC Lead,
Chilton Medical Center
Pomton Plains, NJ