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Name:
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Date: |
Emp
ID:
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Clinic / Unit:
TSM
Name: |
Preceptor(s): |
CERT EXPIRES:
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POC
Test: NicCheck I Cotinine |
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AFTER
TAKING ONLINE TEST AND READING THE POLICY,
EMPLOYEE PERFORMS A TEST AND MARKS RESULTS BELOW.
THE PRECEPTOR OR TSM GRADES RESULTS FOR ACCURACY. |
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1. Reads entire
Policy/Procedure
2. Completes and passes
written test (Passing criteria is 100%)
3. Return demonstration |
TEST SCORE:
0
Test taken on:
6/18/2013 |
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CRITICAL
POINTS
FROM POLICY AND PROCEDURE
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OPERATOR
INITIALS |
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a.
Specimen:
Acceptable specimen for the
NicCheck I Cotinine test is 0.5 ml urine.
Specimens should be tested within 1
hour of
collection.
If specimen cannot be tested within 1
hour, it may be refrigerated for up to 24 hours.
If the sample cannot be tested within 24 hours, it must
be frozen.
Unacceptable specimens:
Specimens taken from other sites i.e. saliva, sputum,
urine. Preserved samples.
Samples which have been frozen and thawed more than 3
times. |
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b. Patient Testing:
1. Obtain a urine specimen
2. Label sample with the patients
information and prior to testing ensure that the sample
to be tested is the correct one using two patient
identifiers.3. With a
pipette transfer no more than 1.0 ml and no less than
0.5 ml to a 13x100 mm test tube
4. Remove
a NicCheck I test strip from the canister handling the
strip only at the arrow end.
5. Place
the strip directly into the urine specimen with the
arrow pointing downward into the specimen.
6. Observe results in 15 minutes
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c. Interpretation of Results:Positive Result:
At 15 minutes Pale to Dark Pink or
Orange to Reddish Pink
Negative Result:
At 15 minutes no color develops.
The intensity of color on the strip differentiates
between low vs. high nicotine consumption. Less
intense pink color when compared to the color chart is a
low positive where a more intense pink color compared to
the chart is a high positive. |
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c.
Quality Control:
NicCheck I Human Urine Positive
and Negative controls should be run once on the day of
testing. |
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d. Reagent Storage:
Test strips and controls should be
stored at 2-8°C. |
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Sample: _________________
Result: ________________
Pass: _____Yes _____No |
VALIDATOR:___________ |
