Patient Preparation and Safety
Patient Preparation and Safety
The Patient Preparation and Safety domain tests whether you can get the patient ready for collection and protect both patient and staff. Questions cover fasting and timing instructions, medication and history screening, identification, consent, positioning, syncope prevention, hand hygiene, PPE, and sharps safety.
Core rules
- Give preparation instructions in plain language and confirm understanding. Most fasting tests require 8-12 hours without food; water is allowed and encouraged.
- Ask about anticoagulants, antiplatelets, biotin, caffeine, alcohol, and recent transfusions because these can alter results or increase bleeding risk.
- Verify identity with two identifiers and match them to the requisition before drawing.
- Explain the procedure, obtain consent, and position the patient seated with an armrest or supine if they have a history of fainting.
- Perform hand hygiene before and after patient contact and wear gloves for all collections.
- Use a safety-engineered needle and activate the safety device immediately after use. Never recap by hand.
- Dispose of sharps at the point of use in a puncture-resistant container; report needlesticks immediately.
Worked example
A patient arrives for a lipid panel and fasting glucose and says she had coffee with cream and sugar two hours ago. The correct action is to reschedule the draw. Cream adds fat and sugar adds glucose, so the results would not reflect fasting status. Coffee without additives and water do not break a fast for most lipid panels, but the cream and sugar do. Document the instruction given and the new appointment. Do not draw and label the specimen as fasting.
Traps
- Telling a patient "NPO" without clarifying that water is allowed: dehydration makes veins fragile and can alter results.
- Drawing above an IV line: dilution and contamination by infusing fluid.
- Applying a tourniquet over a rash, fistula, or mastectomy side: increased infection and lymphedema risk.
- Failing to ask about fainting history: syncope and injury during the draw.
- Recapping a needle because the sharps container is full: needlestick injury.