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MODESTO JUNIOR COLLEGE MEDICAL ASSISTING PROGRAM

Syllabus

Course Number: MDAST 325 Course Title: Medical Assisting Laboratory Procedures Course Description: Introduction to laboratory procedures necessary to aid the physician. Includes patient preparation for diagnostic studies, purposes, techniques, and recording of procedures commonly performed. Credit: 3 units Class Hours: 2 hours lecture/3 hours lab Instructor: Amy Duffy email: duffya@mjc.edu Office: Glacier Hall 124 phone: (209) 575-6380 Class location: Glacier Hall 207 Instructor office hours are after class or by appointment. Methods of Instruction: This course will be taught by lecture, collaborative learning

experience, guided discussion, audio-visual materials, case studies, computer assignments and demonstration of clinical procedures.

Texts: Proctor, Niedzwiecki, Pepper, Madero, Garrels & Mills (2017).

The Medical Assistant (13th ed.). St. Louis, Missouri: Elsevier

Proctor, Niedzwiecki, Pepper, Madero, Garrels & Mills (2017).

Student Study Guide for The Medical Assistant (13th ed.). St. Louis, Missouri: Elsevier

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Minimum Performance Standards: The student will receive one grade from this course. The

requirements for satisfactory completion and minimum performance in this course will be evaluated by the instructor based on the student's:

I. Tests, quizzes, class assignments, computer

assignments and written assignments. II. Successful completion of entry-level procedures for the

medical assistant.

Each procedure is initially completed as a Peer Evaluation. The student then has a maximum of three attempts to achieve a satisfactory rating by the instructor for each procedure. CAAHEP accreditation requires 100% of Medical Assisting graduates pass 100% of all competencies

Failure to clearly demonstrate any of the Minimum Performance Standards will result in failure of the course.

If the student’s performance falls below a “C”, the instructor will require a counseling session with the student and complete a Student Contact Sheet. If improvement does not take place, the instructor will initiate another meeting with the student and complete a Probation Notice. If the student’s performance remains unsatisfactory, the student will need to repeat the entire course. Any student required to repeat a medical assisting course will be required to withdraw from the program and reapply to repeat the course the following year.

Grading Scale: The grading policy requires a grade of “C” or better to

progress in the Medical Assisting Program. A = 100-90% B = 89-80% C = 79-70% D = 69-60% F = 59 and below

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A. COURSE GOAL

As a result of satisfactory completion of this course, the student should be prepared to:

Discuss the role of the clinical laboratory in patient care and the medical assistant’s role in coordinating laboratory tests and results. Also, compare and contrast the agencies that govern or influence practice in the clinical laboratory. Additionally, summarize techniques to minimize physical, chemical and biological risks in the clinical laboratory.

B. STUDENT LEARNING GOALS

Mastery of the following learning goals will enable the student to achieve the overall course goal.

Required Learning Goals Upon satisfactory completion of this course, the student will be able to:

a. Develop basic skills in operation and care of the microscope.

b. Schedule appointment for lab tests.

c. Instruct patient in preparation for diagnostic procedures.

d. Obtain, prepare, label and handle specimens to be sent for analysis.

e. Complete lab requisition forms.

f. Define and identify the normal range of laboratory tests.

g. Perform routine diagnostic tests under the direction of a physician.

h. File lab reports in patient’s medical record.

i. Maintain laboratory supplies and equipment.

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COURSE LEARNING OUTCOMES Upon satisfactory completion of this course. The student should be prepared to: 1. Perform blood chemistry procedures including capillary punctures. 2. Demonstrate the proper techniques for urine collection and urinalysis procedures.

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CHAPTER 42 Principles of Electrocardiography PREPARATION: Read Chapter 42 in The Medical Assistant Complete Chapter 42 in the Study Guide CONTENT: This chapter covers the electrical conduction activity of the heart and the procedure of the electrocardiogram.

LEARNING OBJECTIVES:

1. Define, spell, and pronounce the terms listed in the vocabulary. 1. Illustrate the electrical conduction system through the heart and discuss the

cardiac cycle. 2. Explain the concepts of cardiac polarization, depolarization, and

repolarization. 3. Identify the PQRST complex on an electrocardiographic tracing.

4. Summarize the properties of the electrocardiograph and discuss features of

electrocardiograph paper. 5. Describe the electrical views of the heat recorded by the 12-lead

electrocardiograph. 6. Discuss the process of recording an electrocardiogram and perform an

accurate recording of the electrical activity of the heart. 7. Compare and contrast electrocardiographic artifacts and the probable cause

of each. 8. Interpret a typical electrocardiographic tracing.

9. Describe common electrocardiographic arrhythmias.

10. Summarize cardiac diagnostic tests and fit a patient with a Holter monitor.

11. Discuss patient education and the legal and ethical issues involved when

performing ECGs.

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COMPETENCIES: Psychomotor Skills:

I.P2. Perform: a. electrocardiography

I.P8. Instruct and prepare a patient for a procedure or a treatment Affective Behavior:

I.A2. Incorporate critical thinking skills when performing patient care I.A3. Show awareness of a patient’s concerns related to the procedure

being performed PROCEDURES: 42-1 Obtain a 12-Lead ECG 42-2 Fit a Patient with a Holter Monitor

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CHAPTER 43 Assisting with Diagnostic Imaging PREPARATION: Read Chapter 43 in The Medical Assistant Complete Chapter 43 in the Study Guide CONTENT: This chapter covers body planes and positioning, patient instruction, the X-ray and other diagnostic imaging procedures used to assess injuries and conditions related the human body. LEARNING OBJECTIVES:

1. Define, spell, and pronounce the terms listed in the vocabulary.

2. Discuss basic principles of radiography and the types of x-rays. 3. Identify the principle components of radiographic equipment. 4. Discuss the four prime factors of x-ray exposure. 5. Do the following related to radiographic positioning:

• Distinguish among the three body planes and use these terms

correctly when discussing radiographic positions. • Differentiate between anteroposterior (AP) and posteroanterior

(PA), projections and describe the lateral and oblique, and radiographic positions.

6. Discuss fluoroscopy and contrast media. 7. Discuss cardiovascular and interventional radiography, computed

tomography, magnetic resonance imaging, sonography, and nuclear medicine.

8. Do the following related to basic radiographic procedures:

• Explain the patient preparation guidelines for typical diagnostic

imaging examinations. • Outline the general procedure for scheduling and sequencing

diagnostic imaging procedures. • Apply patient education principles when providing instructions for

preparing for diagnostic procedures.

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9. Describe the health risks associated with low doses of x-ray exposure,

such as those used in radiography. 10. Describe precautions for ensuring the safety of equipment operators and

staff members during x-ray procedures. 11. Summarize the steps for ensuring that patients receive the least possible

exposure during x-ray procedures. 12. Explain the legal responsibilities associated with x-ray procedures and the

administrative management of diagnostic images.

COMPETENCIES: Cognitive Knowledge:

I.C3. Describe: a. body planes b. directional terms

PROCEDURES: None

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CHAPTER 44 Assisting in the Clinical Laboratory PREPARATION: Read Chapter 44 in The Medical Assistant Complete Chapter 44 in the Study Guide CONTENT: This chapter discusses the regulations and procedures related to the clinical laboratory. Also, the proper collection and handling of specimens in preparation for testing is addressed. LEARNING OBJECTIVES:

1. Define, spell, and pronounce the terms listed in the vocabulary.

2. Discuss the role of the clinical laboratory personnel in patient care and the medical assistant’s role in coordinating laboratory tests and results.

3. Describe the divisions of the clinical laboratory and give example of a test

performed in each division. 4. Explain the three regulatory categories established by the Clinical Laboratory

Improvement Amendments (CLIA) and identify CLIA-waived tests associated with common diseases..

5. Identify quality assurance practices in healthcare, document the results on a

laboratory flow sheet, and discuss quality control guidelines.

6. Do the following related to laboratory safety:

• Compare and contrast the agencies that govern or influence practice in the clinical laboratory.

• Discuss the purpose of a Safety Data Sheet. • Summarize safety techniques to minimize physical, chemical, and

biologic hazards in the clinical laboratory.

7. Describe the essential elements of a laboratory requisition. 8. Discuss specimen collection, including the importance of sensitivity to patient’s rights and feelings when collecting specimen. Also, discuss the 8 steps in collecting specimens and informing patients of their results.

9. Explain chain of custody and why it is important.

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10. Describe the differences between Greenwich time and military time.

11. Identify the Fahrenheit temperature and the Celsius temperature of common laboratory equipment.

12. Name the metric units used for measuring liquid volume, distance, and mass. 13. Do the following related to laboratory equipment:

• Name the parts of a microscope, and describe their function. • Summarize selected microscopy tests that can be performed in the

ambulatory care setting. • Demonstrate proper use and maintenance of the microscope. • Describe the safe use of a centrifuge. • Discuss the use of an incubator.

14. Identify legal and ethical issues in the clinical laboratory setting. COMPETENCIES: Cognitive Knowledge:

I.C10. Identify CLIA waived tests associated with common diseases I.C12. Identify quality assurance practices in healthcare VI.C9. Explain the purpose of routine maintenance of administrative and

clinical equipment XII.C2. Identify safety techniques that can be used in responding to

accidental exposure to: d. chemicals

XII.C5. Describe the purpose of Safety Data Sheets (SDS) in a healthcare setting

Psychomotor Skills:

I.P10. Perform a quality control measure II.P3. Maintain lab test results using flow sheets

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PROCEDURES: 44-1 Perform a Quality Control Measure on a Glucometer and Record the Results on

a Flow Sheet. 44-2 Use the Microscope and Perform Routine Maintenance on Clinical Equipment

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CHAPTER 45 Assisting in the Analysis of Urine PREPARATION: Read Chapter 45 in The Medical Assistant Complete Chapter 45 in the Study Guide CONTENT: This chapter will prepare the medical assistant for performance of routine urinalysis. The student will obtain knowledge of the physiology of urine production as well as tests related to urinalysis. LEARNING OBJECTIVES:

1. Define, spell, and pronounce the terms list in the vocabulary.

2. Describe the history of the analysis of urine. 3. Describe the anatomy and physiology of the urinary tract, and discuss the

formation and elimination of urine by describing the process of filtration, reabsorption, secretion, and elimination.

4. Do the following related to collecting a urine specimen:

• Show sensitivity to patients’ rights and feelings when collecting

specimens. • Discuss collection containers. • Instruct a patient in the collection of a 24-hour urine specimen. • Instruct a patient in the collection of a clean-catch midstream urine

specimen. 5. Examine and report the physical aspects of urine. 6. Perform quality control measures and reassure a patient of the accuracy of

the test results based on the steps taken for quality assurance and quality control when performing the chemical urinalysis.

7. Test and record the chemical aspects of urine using CLIA-waived methods. 8. Prepare a urine specimen for microscopic evaluation, and understand the

significance of casts, cells, crystals, and miscellaneous findings in the microscopic report.

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9. Explain or perform the following CLIA-waived urine tests:

• Glucose testing using the Clinitest method. • Urine pregnancy test. • Fertility and menopause tests.

10. Perform quality control measures to determine the reliability of chemical

reagent strips. 11. List the means by which urine could be adulterated before drug testing. 12. Discuss patient education and legal and ethical issues related to urinalysis. 13. Discuss the legal and ethical responsibilities of the medical assistant who is

assisting with urinalysis.

COMPETENCIES: Psychomotor Skills:

I.P11. Obtain specimens and perform: c. CLIA waived urinalysis

II.P2. Differentiate between normal and abnormal test results PROCEDURES: 45-1 Instruct Patient in Collection of a 24-hour Urine Specimen 45-2 Instruct Patient in Collection of a Clean-Catch Midstream Urine Specimen 45-3 Assess Urine Specimen for Color and Turbidity-the Physical Test 45-4 Differentiate Between Normal and Abnormal Test Results while Determining the

Reliability of Chemical Reagent Strips 45-5 Test Urine with Chemical Reagent Strips 45-6 Prepare Urine for Microscopic Examination 45-7 Test Urine for Glucose Using the Clinitest Method 45-8 Perform a Urine Pregnancy Test 45-9 Perform a Multidrug Screening Test on Urine 45-10 Assess a Urine Specimen for Adulteration Before Drug Testing

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CHAPTER 46 Assisting in Blood Collection PREPARATION: Read Chapter 46 in The Medical Assistant Complete Chapter 46 in the Study Guide CONTENT: This chapter instructs the medical assisting student in the various methods of blood collection by venipuncture as well as safety precautions and procedures regarding phlebotomy. LEARNING OBJECTIVES:

1. Define, spell, and pronounce the terms listed in the vocabulary.

2. List the equipment needed for venipuncture. 3. Explain the purpose of a tourniquet, how to apply it, and the consequences of

improper tourniquet application. 4. Explain why the stopper colors on evacuated tubes differ and state the correct

order of drawing samples for various types of tests. 5. Describe the types of safety needles used in phlebotomy. 6. Explain why a syringe rather than an evacuated tube would be chosen for

blood collection. 7. Discuss the use of safety-engineered needles and collection devices required

for injury protection. 8. Summarize postexposure management of accidental needlesticks. 9. Do the following related to routine venipuncture:

• Detail patient preparation for venipuncture that shows sensitivity to the

patient’s rights and feelings. • Describe and name the veins that may be used for blood collection. • List in order the steps of a routine venipuncture. • Perform a venipuncture using the evacuated tube method.

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10. Do the following related to problems associated with venipuncture and specimen re-collection:

• Discuss various problems associated with venipuncture. • Discuss possible solutions to venipuncture complications. • Discuss why a specimen may have to be re-collected. • Describe the major causes of hemolysis during collection.

11. Do the following related to capillary puncture:

• Explain why a winged infusion set (butterfly needle) would be chosen over vacuum tube or syringe needle.

• Perform a venipuncture using a winged infusion set. • List situations in which capillary puncture would be preferred over

venipuncture. • Discuss proper dermal puncture sites. • Describe containers that may be used to collect capillary blood. • Explain why the first drop of blood is wiped away when a capillary

puncture is performed. • Perform a capillary puncture.

12. Discuss pediatric phlebotomy, including typical childhood behavior and parental involvement during phlebotomy and general guidelines for pediatric venipuncture. 13. Describe handling and transport methods for blood after collection. 14. Explain chain of custody procedures when blood samples are drawn. 15. Discuss patient education, in addition to legal and ethical issues, related to assisting in blood collection.

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COMPETENCIES: Psychomotor Skills:

I.P2. Perform: b. venipuncture c. capillary puncture

I.P8. Instruct and prepare a patient for a procedure or a treatment Affective Behavior:

I.A2. Incorporate critical thinking skills when performing patient care PROCEDURES: 46-1 Collect a Venous Blood Sample Using the Vacuum Tube Method 46-2 Collect a Venous Blood Sample Using the Syringe Method 46-3 Obtain a Venous Sample with a Safety Winged Butterfly Needle 46-4 Obtain a Capillary Blood Specimen by Fingertip Puncture

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CHAPTER 47 Assisting in the Analysis of Blood PREPARATION: Read Chapter 47 in The Medical Assistant Complete Chapter 47 in the Study Guide CONTENT: This chapter instructs the medical assisting student in the various types of blood cells and the diagnostic purposes of examination of blood. LEARNING OBJECTIVES:

1. Define, spell, and pronounce the terms listed in the vocabulary.

2. Name the main functions of blood. 3. Describe the appearance and function of erythrocytes. 4. Describe the appearance and function of granular and agranular leukocytes. 5. Differentiate between T cells and B cells. 6. Describe the appearance and function of thrombocytes, explain the process

of clot formation, and discuss plasma.

7. Do the following related to hematology in the POL:

• Identify the anticoagulant of choice for hematology testing. • Explain the purpose of the microhematocrit test. • Perform routine maintenance of a microhematocrit centrifuge. • Obtain a specimen and perform a microhematocrit test.

8. Do the following related to hemoglobin:

• Explain the role of hemoglobin in the body. • Obtain a specimen and perform a hemoglobin test.

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9. Do the following related to the erythrocyte sedimentation rate:

• Cite the reasons for performing on erythrocyte sedimentation rate

(ESR) test. • Describe the sources of error for the erythrocyte sedimentation rate

(ESR) test • Perform an erythrocyte sedimentation rate (ESR) test using a modified

Westergren method.

10. Do the following related to coagulation testing:

• Explain how to determine prothrombin time (PT). • Obtain specimen and perform a CLIA-waived PT/INR test. • Reassure a patient of the accuracy of the test results. • Maintain lab test results using laboratory flow sheets.

11. Identify the tests included in a complete blood count (CBC) and their

reference ranges and differentiate between normal and abnormal test results. 12. Describe the red blood cell (RBC) indices and how they are calculated. 13. Explain the reasons for performing a white blood cell (WBC) count and

differential, and discuss preparation of blood smear for the differential. 14. Discuss the identification of normal blood cells and describe the basic

appearance of the five different types of leukocytes seen in a normal Wright-stained differential.

15. Discuss red blood cell morphology. 16. Differentiate between the ABO blood groupings and the Rh blood groupings. 17. Describe the medical assistant’s responsibility for legally preparing a patient

for a blood transfusion.

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18. Do the following related to blood chemistry testing:

• Explain the reasons for testing blood glucose, hemoglobin A1c,

cholesterol, liver enzymes, and thyroid hormones. • Obtain a specimen and perform a blood glucose, hemoglobin A1c and

cholesterol test using CLIA-waived test methods approved by the U.S. Food and Drug Administration (FDA).

19. Summarize typical chemistry panels, the reason for performing each panel,

and the individual tests performed in those panels. 20. Discuss patient education and professionalism related to assisting in the

analysis of blood.

COMPETENCIES: Psychomotor Skills:

I.P11. Obtain specimens and perform: a. CLIA waived hematology test

I.P11 Obtain specimens and perform: b. CLIA waived chemistry test

II.P3. Maintain lab test results using flow sheets VI.P8. Perform routine maintenance of clinical equipment

PROCEDURES: 47-1 Perform Preventive Maintenance for the Microhematocrit Centrifuge 47-2 Perform a Microhematocrit Test 47-3 Perform a Hemoglobin Test 47-4 Determine the Erythrocyte Sedimentation Rate Using a Modified Westergren

Method 47-5 Obtain Specimen and Perform a CLIA-Waived Protime/INR Test 47-6 Determine the Cholesterol Level or Lipid Profile Using a Cholesterol Analyzer

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CHAPTER 48 Assisting in Microbiology and Immunology PREPARATION: Read Chapter 48 in The Medical Assistant Complete Chapter 48 in the Study Guide CONTENT: This chapter examines the infection process, viruses and bacteria. The student will learn methods of prevention and spread of disease and how to provide patient education in this area. LEARNING OBJECTIVES:

1. Define, spell, and pronounce the terms list in the vocabulary.

2. Describe the naming of microorganism. 3. Describe various bacterial staining characteristics, shapes, oxygen

requirements, and physical structures; also explain the characteristics of common diseases caused by bacteria.

4. Describe the unusual characteristics of Chlamydia, Mycoplasma, and

Rickettsia organisms. 5. Do the following related to fungi, protozoa, and parasites:

• Compare bacteria with fungi, parasites, and protozoa. • Identify the characteristics of common diseases caused by fungi,

protozoa, and parasites. • Perform patient education on the collection of a stool specimen for ova

and parasites testing. 6. Compare bacteria with viruses, and describe the characteristics of common

viral diseases.

7. Cite the protocols for the collection, transport, and processing of specimens. 8. List the different growth media used for culturing.

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9. Describe and Perform CLIA-waived microbiology test.

• Describe three CLIA-waived microbiology tests that use a rapid identification technique.

• Obtain a specimen and perform the CLIA-waived rapid Streptococcus test.

10. Do the following related to CLIA-waived immunology testing:

• Discuss the purpose of indirect immunology testing. • Describe three CLIA-waived immunology tests that could be done in

the physician office laboratory. • Obtain a specimen and perform the CLIA-waived mononucleosis strep

test.

11. Detail the equipment needed in a microbiology reference laboratory, and discuss identification of pathogens in the microbiology laboratory by

describing various staining techniques. 12. Describe the reference laboratory assessment of a throat culture and a urine culture. 13. Explain the method used for culture and sensitivity testing. 14. Discuss patient education, in addition to legal and ethical issues, involved in laboratory testing. COMPETENCIES: Cognitive Knowledge:

III.C1. List major types of infectious agents Psychomotor Skills: I.P11. Obtain specimens and perform: e. CLIA waived microbiology test

I.P11. Obtain specimens and perform: d. CLIA waived immunology test

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PROCEDURES: 48-1 Instruct Patients in the Collection of Fecal Specimens to Be Tested for Ova and

Parasites 48-2 Perform a Rapid Strep Test 48-3 Perform the QuickVue+ Infectious Mononucleosis Test Revised 7/2016sb