This document provides an overview and instructions for performing fecal occult blood testing. It discusses that a positive test requires follow up testing such as colonoscopy and CBC. It outlines the procedural steps for applying stool samples to test slides, developing the slides, and interpreting the results within 30-60 seconds. It emphasizes that an internal control test using developer solution must be performed with each test and yield a positive (blue) result within 30 seconds for the test to be considered valid.

1. For Medical Clinical Staff NORTHWEST COMMUNITY HEALTH CARE Click here to move on

2. Fecal Occult Blood Testing: General Overview of Testing As with any fecal occult blood test, results are not to be considered conclusive evidence for the presence or absence of any gastrointestinal pathology. The test is not a substitute for other diagnostic procedures such as endoscopy or colonoscopy, barium enema or other studies. The fecal occult blood test will be considered a screening test at Northwest. Positive results must be followed with diagnostic procedures to confirm and when indicated, negative results should be followed with recommended testing. Since bleeding from gastrointestinal lesions may be intermittent, fecal samples for testing should be collected from three consecutive bowel movements or three bowel movements closely spaced in time. To further increase the probability of detecting occult blood, separate samples should be taken from two different sections of each fecal specimen. Foods which contain peroxides may leave residues in the feces that may interfere with the test. The expected/normal result is a sample that is negative for fecal occult blood. Click here to move on Click here to go back

3. A positive fecal occult blood test: Should be repeated for validation Requires follow up testing such as colonoscopy and CBC Can be ignored if the patient has not followed dietary restrictions Is almost always related to hemorrhoids Click here to go back Click here to select this answer Click here to select this answer Click here to select this answer Click here to select this answer

4. The correct answer is Requires follow up testing such as colonoscopy and CBC Since bleeding from the intestinal tract may be intermittent (come and go), even one slightly positive test should not be ignored Click here to move on Click here to go back

5. Fecal Occult Blood Testing: Storage and Stability Test slides: Store slides at room temperature (15-30ºC), protected from light, heat, and UV radiation Slides are stable until expiration date unless general integrity is interrupted. Developer Solution: Store developer at room temperature (15-30ºC) If properly stored, developer will remain stable until expiration date on bottle. Click here to move on Click here to go back

6. Fecal Occult Blood Testing: Storage and Stability Prior to testing a slide, be sure to check that the slide and developer solution have not expired Click here to move on Click here to go back

7. Each stool card is imprinted with an expiration date on the back of the card that can be difficult to see without close inspection- marking over the area with ink will help you to see the date Click here to go back Click here to move on

8. Fecal Occult Blood Testing: Procedural Steps Open the front flap of the slide and apply a very thin layer of stool smear to one window and apply a very thin smear of stool to the other window then close front flap of slide. Click here to move on Click here to go back

9. For accurate fecal occult blood testing, the fecal smear should be: thinly spread on window applied thickly on window applied to both sides of the card applied with a cotton swab Click here to go back Click here to select this answer Click here to select this answer Click here to select this answer Click here to select this answer

10. The correct answer is: thinly spread on window applied thickly on window (this will interfere with reading results) applied to both sides of the card (the front flap is for the test specimen and the back flap is for test and control interpretation) applied with a cotton swab (the specimen should be applied with a gloved finger or wooden spatula ) Click here to move on Click here to go back Click here to select this answer Click here to select this answer Click here to select this answer Click here to select this answer

11. Fecal Occult Blood Testing: Procedural Steps Open perforated cover on back of slide. Apply 2 drops of developer solution to each smear in specimen test area and read at 30-60 seconds. A positive result is indicated by the appearance of any blue color in the testing window. A lack of blue color indicates a negative result. Click here to go back Click here to move on

12. When performing fecal occult blood testing, ____ drops of solution are to be applied to each of the test areas on the back of the card. Click here to select this answer Click here to select this answer Click here to select this answer Click here to go back One Two Three

13. The correct answer is Click here to go back Click here to move on

14. The fecal occult blood test result should be read at __________: 2 minutes 5 minutes 5-10 seconds 30-60 seconds Click here to go back Click here to select this answer Click here to select this answer Click here to select this answer Click here to select this answer

15. The correct answer is Click here to move on Click here to go back

16. A positive test result is indicated by the appearance of: any black color any yellow color any blue color any white color Click here to go back Click here to select this answer Click here to select this answer Click here to select this answer Click here to select this answer

17. The correct answer is any blue color Click here to move on Click here to go back

18. Fecal Occult Blood Testing: Procedural Steps Develop the performance control for each slide (only after specimen tests have been completed and interpreted) by applying 1 drop of developer solution to the performance Control line. A blue color should appear within 30 seconds (indicating a valid test slide). Remove and dispose of gloves in regular trash; perform hand hygiene. Document results in the patient record (verbally alert provider of any positive results) and mark on the encounter form. Click here to move on Click here to go back

19. Fecal Occult Blood Testing: More On Control Testing The internal control must be performed with each test done (Rationale: Based on manufacturer instructions) by applying 1 drop of developer solution to the performance control line only after the interpretation of the actual test results. A blue color should appear within 30 seconds. A positive control test lets us know that both the slide and solution are likely to give accurate results. A negative control tells us that there is a problem with either the test slide or solution and the test results are not valid. If the control is negative, disregard the testing results and perform control testing on another slide from the same lot. If the control is positive, repeat testing using another slide and interpret test and control results accordingly. If the control remains negative, immediately notify the COO or designee. Action to taken includes the determination of the source of the problem (ie. developer verses test slides). Use a different developer solution from same lot if possible on same lot of test slides-if control is now positive, discard the original developer solution bottle. If control remains negative, test the same lot of test slides using a developer solution from a different lot. If control is now positive, segregate and return all developer solution bottles of this lot number. If control remains negative, run the control on a test slide from a different lot of stool cards. If control is now positive, segregate and return to manufacturer all test slides of the affected lot number. Click here to move on Click here to go back

20. Internal control testing must be performed: with the opening of each new box with the opening of a new solution with each test performed never; there is no control Click here to go back Click here to select this answer Click here to select this answer Click here to select this answer Click here to select this answer

21. The correct answer is….. With each test performed. Click here to move on Click here to go back

22. Control testing must be performed: Prior to interpreting the “test’ results” Only after interpreting the “test” results Click here to go back Click here to select this answer Click here to select this answer

23. The correct answer is….. Only after interpreting the “test” results Click here to go back Click here to move on

24. To perform control testing, use ______ drop/s of solution; a blue color must appear in _______ to be counted as a valid test One, 30-60 seconds Two, 30-60 seconds One, 30 seconds Click here to select this answer Click here to select this answer Click here to select this answer Click here to go back

25. The correct answer is…….. One (drop of solution) with a blue coloring appearing within 30 seconds Click here to go back Click here to move on

26. If the control on the fecal occult blood card is negative: the test is positive the test is negative the test is not valid the test is sensitive Click here to go back Click here to select this answer Click here to select this answer Click here to select this answer Click here to select this answer

27. The correct answer is….. The test is NOT VALID- The results MUST NOT BE INTERPRETED Click here to move on Click here to go back

28. You have reached the end of this program….. Once you are confident that you are comfortable with all the materials presented, proceed to the Fecal Occult Blood Testing post-test at http://www.classmarker.com/ Your username is the first initial of your first name followed by your full last name. Your password is= nwhealth Click here to go back and review previous slide Start Over Exit