Ph Paper
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Does anyone use Ph paper in their ED? Our ED has been using it without our knowledge to test Eye Ph after eye washes. I would be interested in any information you can provide on how your ED reports the levels and what kind of QC you do?
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Yes our ER uses Ph paper
I called CAP last week. It is not a lab test because they are not recording any results
to the patient's chart.
Only used to verify that the eye has been flushed completely and nothing left over.
to harm the eye.
So the lab has no responsibility since no results are being recorded.
One less thing to worry about.
We do QC upon opening and once a month until the roll is finished. Buffer 5 and 7 solutions
If the patient/insurance company is being charged for the procedure, then it is a big matter. They are in a healthcare setting, they used the "results" even though there was no documentation (which is another whole legal matter). Think of it this way ... if the pH paper were kept in the main laboratory and the clinical laboratorian performed the testing, would there be a record of the results? A bill to the patient? A CPT code associated with the testing? Just because someone dipped the pH paper into the fluid and threw it away without recording the result, even in a provider note, legally that "result" was used for clinical application ... Did the fluid of the eye return to a normal pH. A lawyer would say that the test was used to make a medical decision, even if flushing was the only action provided. Did that healthcare provider "properly" read the pH within the time designated by the manufacturer, or did they dip and then stop to look for the color reference to match the paper to the reference? How were they trained? Where do they keep the pH paper? Is that storage according to the manufacture's policy? These are all legal questions that a lawyer would use for malpractice if something were to occur to the patient due to incompetence of the proper testing procedure.
Think again before thinking that a CAP inspector would not be all over this. It may be "out of the lab" but if you have a POCT department, you may find a POCT Coordinator who is a CAP inspector with a totally different viewpoint.
It is not a lab test but it is a procedure. Our nurses report it in nurses notes.
I taught them to do QC each day they have to do an eye pH. WE document their competency.
If they are used to treat a patient it can become legal especially if there was adverse result.
The patient could be blind because someone threw chemicals at their face, etc.
Sam and all reading thread,
Interesting points. I agree with Sam the pH paper use shouldn't be overlooked. I'm not saying it's the 'lab's responsibility'.
If it's considered 'a procedure' (in a way causing an 'end to treatment' - in a ballpark kind of way - sort of made me think of pulse ox use) then whomever role-wise is responsible for the procedures in ED would seem to be on the hot seat if it's use is ignored. Stepping back, if pH paper is used to stop flushing, and it's not as if one is going to get a 3 digit read on pH paper, one figures the flushing goes well past any type of harm to the patient if the flushing stops (and I can't imagine one reading is taken and off the patient trots).
Let's say CAP is the accreditor coming in to inspect the lab but pH paper use in the ED is out of the hands of 'the lab, it's a procedure in ED'. OK so then is the use of the pH paper ignored? (Again guessing) I doubt it because it's written in a protocol or procedure for eye flushing which must be a written document that is up for grabs when the ED is surveyed by TJC/accreditation for the hospital/ED.
Think transcutaneous bilirubin which is in the hands of nursing - not a lab test either but impact of making an error can be huge.