Welcome to the training on Specimen Collection provided by the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).
Goal
The goal of this module is to equip Texas Health Steps providers and others to implement requirements and best practices for specimen collection and handling in a clinical office setting.
Target Audience
Texas Health Steps providers and other interested health-care professionals.
Specific Learning Objectives
After completing the activities of this module, you will be able to:
- Apply the requirements of the Texas Health Steps Periodicity Schedule to conduct laboratory testing as part of preventive medical checkups for patients birth through 20 years.
- Distinguish between Texas Health Steps laboratory tests that must be performed by the Texas Department of State Health Services (DSHS) Laboratory and those that may be processed by a laboratory of the provider’s choice.
- Evaluate common errors that may cause specimens to be rejected for testing or may lead to inaccurate results.
- Specify the blood collection devices and techniques that should be employed for various blood tests for children of different ages.
- Interpret the DSHS Laboratory’s specimen submission requirements and reporting protocols.
Please note this module expires on 11/21/2020.
This module was released on 11/21/2017.
Accreditation Statement
Continuing Medical Education
The Texas Department of State Health Services, Continuing Education Service is accredited by the Texas Medical Association to provide continuing medical education for physicians.
The Texas Department of State Health Services, Continuing Education Service designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
The Texas Department of State Health Services, Continuing Education Service is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded 1.00 contact hour(s) of Continuing Nursing Education.
Certificate of Attendance
The Texas Department of State Health Services, Continuing Education Service has designated 1.00 hour(s) for attendance.
Disclosures
One of the requirements of continuing education is disclosure of the following information to the learner:
- Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
- Create a Texas Health Steps account.
- Complete on-line registration process.
- Thoroughly read the content of the module.
- Complete the on-line examination.
- Complete the evaluation.
- Commercial Support.
The THSTEPS Web-based Continuing Education Series has received no commercial support. - Disclosure of Relevant Financial Relationships.
The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose. - Non-Endorsement Statement.
Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center. - Off-Label Use.
Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).
The following are policies and definitions of terms related to continuing education disclosure:
The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.
All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.
Glossary of Terms
Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.
Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.
Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).
Browser Requirements
Texas Health Steps courses are best viewed using a current browser. If you are using an out-of-date browser or a version of Internet Explorer less than 11, lesson progress and interactive features may not function properly.
- Centers for Disease Control and Prevention (CDCO video covering finger stick collection for blood lead specimens.
- Texas Department of State Health Services, Texas Health Steps Provider Information web page.
- Texas Department of State Health Services. Texas Health Steps Periodicity Schedule.
- Texas Department of State Health Services, Laboratory Services.
- Texas Department of State Health Services, Notifiable Conditions web page.
- Texas Department of State Health Services, Disease Reporting web page.
- Texas Department of State Health Services Laboratory, Texas Health Steps: Specimen Collection and Handling.
Texas Department of State Health Services, LabGuides Tutorials:
- Texas Health Steps Fingerstick Blood Specimen Collection.
- Texas Health Steps Venipuncture Blood Specimen Collection.
- Packaging and Shipping Blood Tubes.
- Texas Department of State Health Services, Texas laws requiring the reporting of blood lead levels in children and adults.
- Texas Childhood Blood Lead Screening Guidelines, 2015. The download includes an algorithm for blood lead level screening, maps with targeted areas by ZIP code, and a lead risk questionnaire.
- Texas Childhood Lead Poisoning Prevention Program (TXCLPPP).
- Texas Childhood Lead Poisoning Prevention Program (TXCLPPP) flowchart titled Pb-109: Reference for Blood Lead Retesting and Medical Case Management for determining when follow-up blood lead testing is necessary. The flowchart includes schedules for obtaining a diagnostic venous specimen, for follow-up venous blood lead testing, and for medical case management for children with diagnostic elevated blood lead levels.
- Texas Department of State Health Services, Texas Health Steps a Risk-Based Guidance Tool to assist health-care providers in screening children and adolescents.
- Texas Department of State Health Services, Adolescent Health: A Guide for Providers.
- Texas Department of State Health Services adolescent health care resources web page.
Tips to help children and families understand and tolerate blood draws:
- Dell Children’s Medical Center of Central Texas. (2017). 5 Tips to Make a Blood Draw Easier for a Child.
- The Hospital for Sick Children. (2017). Blood Work: Helping Your Child Get Ready.
- University of Cincinnati Health Laboratory policy SC027.2: Venipuncture, Pediatric.
- Centers for Disease Control and Prevention. (2017). Hand Hygiene in Healthcare Settings
- Centers for Disease Control and Prevention. (2017). Standard Precautions for All Patient Care.
- Centers for Disease Control and Prevention. (2016). CDC Guidelines for Collecting and Handling Blood Lead Samples
- Centers for Disease Control and Prevention. (2014). HAI Prevalence Survey.
- National Institute for Occupational Safety and Health. (n.d.). How to Protect Yourself from Needlestick Injuries.
- National Institute for Occupational Safety and Health. (1999). Alert: Preventing Needlestick Injuries in Health Care Settings.
- Texas Department of State Health Services. (2015). Texas Childhood Blood Lead Screening Guidelines.
- Texas Department of State Health Services. (2016). Newborn Screening Specimen Collection Requirements.
- Texas Department of State Health Services, Laboratory Services Section. (2014). LabGuides Tutorials.
- Texas Department of State Health Services, Laboratory Services Section. (2017). Laboratory Testing Services Manual.
- Texas Department of State Health Services, Laboratory Services Section. (2016). Texas Health Steps: Specimen Collection and Handling.
- The Hospital for Sick Children. (2017). Blood Work: Helping Your Child Get Ready.
- University of Cincinnati Health Laboratory policy SC027.2: Venipuncture, Pediatric.
- U.S. Department of Health and Human Services, Occupational Safety and Health Administration. (2010). Bloodborne Pathogens and Needlestick Prevention, Publication No. 2000-135.
The medical definition in this module was obtained from the Mayo Clinic.