The preanalytical phase of our ammonia testing is shown below. Notice that the process is broken down into steps and space is provided next to each step, which will allow the personnel who are assessing the process to record deviations from the written procedural documents while they observe performance of the tasks. They may also want to add other comments related to potential risks that could occur at that step in the process or may want to note that potential risks at that step have already been addressed, perhaps by the manufacturer of the test system. You can add as much detail as you deem necessary. You can simply list the steps, create a table, as we have done here, create a flow diagram, or use another method that you prefer. Whatever your approach, try to include all the steps that are needed to accomplish the process from start to finish.
Process Step
| Comments
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Ammonia test is ordered by provider
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Test's priority is determined
| This is determined by the provider
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EMR transmits the order to the phlebotomist
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Phlebotomist prepares supplies for collection, including cup of ice
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Phlebotomist identifies patient
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Phlebotomist applies tourniquet to locate vein
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Phlebotomist releases tourniquet before collecting sample
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Phlebotomist collects and labels sample
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Phlebotomist places labeled sample into reclosable bag and places bag on ice immediately
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Phlebotomist transports sample to lab immediately
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Lab assistant documents receipt in LIS
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Lab assistant centrifuges sample, separating plasma from cells within 15 minutes of collection
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Lab assistant delivers sample to chemistry for testing
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