On Tuesday June 2nd the third week of the summer semester I started learning the lab posting process. After the patients have received testing at the clinic it takes a few days for the lab to find out the results. The lab results are then sent in paper form up to the front of the clinic to the medical records department. The results have to first be seen an approved by the patients doctor. Once the doctor signs off on the lab results they are then handed over to the nurses. The nurses have to notify the patients and set up follow up appointments if needed. Once the patient has been notified and the nurse has signed off on the lab results they are then ready to be posted in the medical records.
The lab results are then put into the filing folder in alphabetical order. This allows you to pull the files much easier and a lot quicker. Once you have found all the patients files that have lab results you can begin posting them in the records on the lab results chart. You write out each of the test, the date it was collected and the results that were found. This allows the doctor to be able to look back at the patient’s record to see if there is any history of a problem with the patient. The paper form of the lab results that was signed off by both the doctor and the nurse is also kept in the medical record incase there are any mistakes made on the lab results chart. Then you have to check to see if the patient had anymore lab testing done. If the patient only had the one test and you posted the results to that test then their record can be refilled. However most of the patients have more than one lab test done and many times they don’t get all the results all at the same time.
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