When a serum separation tube (SST) is collected, which of the following actions should the phlebotomist take to ensure optimal test results?

Choice A reason:
While maintaining compliance with Clinical Laboratory Improvement Amendments (CLIA) standards is important, it is not the primary reason for explaining the venipuncture procedure to the patient. CLIA standards primarily deal with laboratory testing and do not specifically require the explanation of procedures to patients.

Choice B reason:
Evaluating the patient's understanding is a beneficial practice as it ensures that the patient is informed and can participate in their own care. However, it is not the primary legal or ethical requirement for explaining the procedure.

Choice C reason:
Maintaining compliance with Occupational Safety and Health Administration (OSHA) standards is crucial for ensuring the safety of both the healthcare provider and the patient. OSHA standards require that certain safety protocols be followed, but they do not specifically mandate that the procedure be explained to the patient for the purpose of obtaining consent.

Choice D reason:
Obtaining the patient's consent is the primary reason a phlebotomist should explain the procedure prior to venipuncture. Informed consent is a fundamental ethical and legal principle in healthcare. It involves informing the patient about the procedure, its risks, benefits, and alternatives, and ensuring that the patient understands this information before agreeing to proceed. This process respects the patient's autonomy and right to make decisions about their own healthcare.

Choice A Reason:
The age of the newborn is important for certain metabolic screenings, as some metabolites may not be present or at measurable levels immediately after birth. However, the requirement for the newborn to be at least 3 days old is not a standard for all blood spot collections for inborn errors of metabolism (IEM). Some screenings are performed within 24 to 48 hours after birth.

Choice B Reason:
While it is important that the circles on the filter paper are adequately filled to ensure there is enough blood for the test, the requirement for them to be at least half filled is not specified in the guidelines. The focus is usually on ensuring the blood spot is of the right size and properly saturated through the filter paper.

Choice C Reason:
The inclusion of the first drop of blood is not typically a requirement. In fact, the first drop is often wiped away to avoid contamination with tissue fluids that could affect the test results. Subsequent drops are used to fill the circles on the filter paper.

Choice D Reason:
The specimen must be completely dried before the test can be processed to prevent degradation or hemolysis of the blood sample. This is a critical step in the preparation of the sample for accurate testing of IEM. The drying process helps preserve the integrity of the metabolites to be analyzed.