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Page 1 of 4 Title: Manual Urine Pregnancy Screen Testing Manual: Point of Care Testing Section: General Document Number: Issuing Authority: Medical Director, Laboratory Services POCT.GEN.3010 Date Issued: March 2001 Purpose This is a Point of Care Test (POC) and falls under the Ministry of Health and Long-Term Care Testing Policy for Hospitals and Other Facilities. This policy states, “Under current legislation, only physicians can authorize point of care testing. In these circumstances, the ordering physician must take responsibility for the tests performance and the test results produced.” Physicians can either perform the test themselves or have a properly trained Registered Nurse perform the test in accordance with the following procedure. Quality Assurance A quality assurance program will be maintained for this test according to the guidelines set forth in the Quality Assurance; Point of Care Testing Policy. Principle Solid phase, sandwich format immunochromatographic assay. HCG in sample binds to a monoclonal anti-hCG dye conjugate. hCG-anti-hCG dye conjugate is captured using an immobilized polyclonal anti-hCG. Excess anti-hCG dye conjugate is captured using an immobilized antibody to the anti-hCG dye conjugate. Specimen PATIENT PREPARATION: No special patient preparation is necessary. TYPE: Random urine, first morning is best Urines with low specific gravity may yield false negative results. HANDLING CONDITIONS: Store urine specimens at room temperature up to 8 hours, or at 2 -8C up to 72 hours. Bring samples to room temperature before testing. DISCLAIMER: This is a CONTROLLED document. The most current version is in electronic format on the BCHS intranet site. Any documents appearing in paper form are NOT controlled Page 2 of 4 Title: Manual Urine Pregnancy Screen Testing Manual: Point of Care Testing Section: General Document Number: Issuing Authority: Medical Director, Laboratory Services POCT.GEN.3010 Date Issued: March 2001 Material: hCG urine/serum test devices – Nova Century Scientific Catalog Number: FHC-202 (Box of 40 devices) pipette (included with each test kit) timer sample collection containers Testing devices are to be ordered directly from the Brantford General Laboratory, 751-5544 ext. 2448. The laboratory will Quality Control the box prior to sending to Day Surgery PREPARATION: Test device must be at room temperature before using. Use test device as soon as possible after opening, no longer than 1 hour. STORAGE REQUIREMENTS: Test devices are stored at room temperature, out of direct sunlight. Test devices can also be stored at 4 - 8C, but brought to room temperature before use. Test devices are stable to the expiry date printed on the foil pouches. Do not freeze. Calibration None required Quality Control Material INTERNAL The labeled antibody conjugate is captured in both the test and control bands. The presence of the control band in the results window is an internal positive quality control which validates the proper function of the test system, the environment and the operator. The appearance of the control band assures proper function of the detection component and adequate capillary migration of the sample. The appearance of the control band assures proper storage and handling of the test device. The appearance of the control band assures an adequate amount of fluid was added to the test device. The clearing background acts as a negative control as it should appear white to light grey and not interfere with the reading of results The Internal Quality Control Band (IQC) must be documented with every test result on the patient’s chart. DISCLAIMER: This is a CONTROLLED document. The most current version is in electronic format on the BCHS intranet site. Any documents appearing in paper form are NOT controlled Page 3 of 4 Title: Manual Urine Pregnancy Screen Testing Manual: Point of Care Testing Section: General Document Number: Issuing Authority: Medical Director, Laboratory Services POCT.GEN.3010 Date Issued: March 2001 ADDITIONAL QUALITY CONTROL: Additional QC (Positive and Negative) is to be run on each new lot number and/or shipment and Documented in Meditech by BCHS lab Procedure 1. Test must be ordered by a physician and performed by a properly trained physician or registered nurse. 2. Remove test device and transfer pipette from foil pouch and place on a flat surface. 3. Verify the patients name to be tested and that the urine is properly labeled. Record the name on the testing device. 4. Using transfer pipette, squeeze bulb and aspirate specimen. 5. Dispense three full drops (~100ul) into the sample well of the test device. 6. Set a timer and read the results in 3 minutes for urine. Do not interpret results after 10 minutes. Positive - Two red bands; one at T (test) and one at C (control) Negative - one band only at the C (control) Inconclusive - two red bands with the T (test) being very faint – Send serum to Lab for STAT quantitative Serum Pregnancy test Test is invalid and must be repeated if no red band is seen in the Control Position. Do not report results if test is invalid. Contact the BGH Laboratory if problems with invalid tests are encountered. Urine should be stored at 2-8ºC for 24 hours before discarding to allow for confirmation testing if required. DISCLAIMER: This is a CONTROLLED document. The most current version is in electronic format on the BCHS intranet site. Any documents appearing in paper form are NOT controlled Page 4 of 4 Title: Manual Urine Pregnancy Screen Testing Manual: Point of Care Testing Section: General Document Number: Issuing Authority: Medical Director, Laboratory Services POCT.GEN.3010 Date Issued: March 2001 Reporting Results REPORTING FORMAT: If the test meets the QC criteria the results are reported as Positive or Negative. If the band in the test area is very faint result as Inconclusive Do not report invalid tests. The Internal QC must be checked and documented with the test result.. Results will be reported and transmitted to the patient’s electronic medical record via glucose meter 1. Power on the meter 2. Scan your Id barcode 3. From the Main Menu screen touch Patient Test. 4. From the Patient Test Menu touch Other Test. 5. Touch Pregnancy. 6. Select the desired test from the display list. 7. Scan the Patient ID 8. Touch √ to enter the current date and proceed to the next screen. 9. Touch √ to enter the current time and proceed to the next screen 10. Select the result of the Internal Control as acceptable or not acceptable by touching the appropriate button. 11. Select the patient test result as positive or negative or inconclusive by touching the appropriate button. 12. Touch √ to validate results 13. Results will post in the EMR Limitations of the Procedure Dilute urines (low specific gravity) may not have representative levels of hCG. False negative results may occur if levels of hCG are below the sensitivity of the test (25 mIU/ml). References n.c.s hCG Method Insert; Catalog Number; FHC-202 NCCLS; GP2-A2; Clinical Laboratory Technical Procedure Manuals-2nd Edition DISCLAIMER: This is a CONTROLLED document. The most current version is in electronic format on the BCHS intranet site. Any documents appearing in paper form are NOT controlled