Vaccines & Other Services Providers will order vaccines, EKGs, ear lavages & other services for patients. Sometimes patients will come in for an MA appointment without seeing a provider. It is important to properly document these accurately in the patient's chart & in your daily Vaccine Log. Here’s a guide of common services & how to document them. Vaccines: ● The provider will clip the requested vaccine card to exam room door ● Before administering a vaccine, double check the patient’s chart (PMH and ‘Immunization’ tab) to make sure they haven’t already received it ● Make sure the correct vaccine has been circled on the superbill ● After the vaccine is administered, document the patient name, DOB, vaccine name, LOT #/EXP date, and injection site on your Vaccine Log ● Document the vaccine given and today’s date in the PMH > Preventive Care section ● Also document the vaccine details in the Immunizations tab Paps: ● Performed by provider, you must document in Vaccine Log ● Make sure the patient’s name, DOB, & the DOS is written on the specimen bottle. Lab order should be test order #: “199305 - IGP, Aptima HPV, rfx 16/18, 45”. Please double check all labels to make sure everything is correct. Lab will not accept mislabelled specimens! UA Dip Test: ● Set up test supplies on top of the fridge in the restroom. You will need: urine collection cup with patient’s initials, sanitary swipe ● After patient leaves specimen, take to lab & perform dip test. Record findings on the UA form ● Record in Vaccine Log & present to provider. Use urine straw to transfer specimen into UA & culture tubes. Confirm lab order & specimen tubes are properly labeled EKGs: ● The provider will clip the requested vaccine card to exam room door Vaccines & Other Services ● Check with the patient before entering the room with the EKG table. Make sure they are properly dressed for the procedure - they should have undressed from the waist up and put on a gown with the opening in the front ● Bring in the EKG table & use alcohol swabs to wipe down the areas where you will be placing the tab electrodes. If a patient has lotion or oily skin the tabs will not properly stick. (See placement guide for where to place tabs) ● Attach corresponding electrodes to limbs - RL, LL then RA LA, then V1 through V6 ● Patient should be fully relaxed with arms flat by their sides. Plug in the machine allow & a couple of seconds to boot up ● Make sure that the screen reflects the patient’s sex. No need to change the age. Press “start” & the machine will print out the report ● DO NOT INTERPRET RESULTS TO PATIENT. Tell the patient that you will have the provider check. In the meantime, they can get dressed and wait for the results ● Mount the report paper & write the patient's name, DOB & your initials. Make a copy of the report - sometimes these can go missing! Save the copy at your desk just in case ● Provider will review & sign. You can inform the patient if normal, usually if abnormal the provider will discuss. File the report for scanning & document in Vaccine Log & if needed for pre-op clearance: ○ Attach report along with chart notes, lab results, and pre-op paperwork if possible ○ Fax to surgeon's office with cover sheet - include patient’s name, DOB, surgeon’s name or group ○ Create an “Orders Only” encounter to document that you have faxed the paperwork and you’re done! Ear Lavages: ● Check ears for wax. If ordered by provider, they will usually specify which ear needs washing ● Fill bottle with warm water, check with your pinky to make sure it’s not too hot. It’s important that the water is warm that way it loosens the wax. ● Have the patient hold the water basin with their opposite hand. Make sure to have paper towels handy. Perform ear lavage Vaccines & Other Services ● Document in the patient’s chart & in Vaccine Log. You can copy/paste this template for the chart and change as needed: # BILATERAL IMPACTED CERUMEN -- EAR LAVAGE PERFORMED: - LARGE AMOUNT OF CERUMEN RETURNED FROM L EAR CANAL - SMALL AMOUNT OF CERUMEN RETURNED FROM R EAR CANAL - BILATERAL EAR CANALS CLEAR POST LAVAGE ● If unsuccessful, recommend the patient use Debrox earwax to loosen better. They can return after a few days for another lavage if needed TB/PPD Test: ● This is usually an appointment with the MA’s only. Usually needed for clearance for a job or school ● Patient can only schedule TB test on Monday, Tuesday, or Wednesday as they will need to return in 2 days for reading ● Create a “Nurse visit” encounter, “Medical Assistant Visit” note type & document. Prep paperwork for patient. You can find it in the Drive if needed ● Patient will return in 2 days for reading. Complete paperwork, make a copy & file for scanning, give patient original & complete encounter note ● Pssst ;) patients can also get TB clearance as a lab! Order blood work LabCorp test#: 182879 - QuantiFERON-TB Gold Plus