Orderingand Interpreting Diagnostic Testing
Orderingand Interpreting Diagnostic Testing
Duringthe second week of my practicum, a 68-year woman visited the hospitalcomplaining of hunger and fatigue, urinating more often and beingthirstier, blurred vision, dry mouth and itchy skin, as well as painand sometimes numbness in her feet. These are some of the signs andsymptoms of diabetes. Therefore, I ordered glycated hemoglobin (A1C)test.
Evidence-BasedRationale for Ordering the Diagnostic Tests
Asindicated in the above section, the main reason as to why I orderedthe glycated hemoglobin (A1C) test is that the patient exhibitedseveral signs and symptoms of diabetes. Another major reason forordering the diagnostic test for diabetes is that after examination,the client had a body mass index of more than 25. Moreover, I orderedthe diabetic diagnostic test because the patient’s family historyindicated that her mother died at the age of 50 from diabetes.
Estimatesof the Cost of Each Diagnostic Test
Theaverage cost for glycated hemoglobin (A1C) test at the hospital is$28.00.
Interpretationsof the Finding of the Diagnostic Tests
Theglycated hemoglobin (A1C) test results indicated an HbA1c level of 6percent. From this value, it was apparent that the patient haddiabetes. The reason attributed to this interpretation is that theA1C level of a normal person should be below 5.7 percent.
Notificationof the Patient of the Results of the Diagnostic Test
Iused ‘direct result reporting` method to notify the client of theresults of the diagnostic test. In particular, I notified the patientdirectly via a mailed letter. I used the direct result reportingmethod because the system has been associated with severaladvantages. For instance, according to Selby,Crowley, Fluck, McIntyre, Monaghan, Lawson, & Kolhe (2012),directresult reporting does not only cause a more timely patientnotification but also enhances client’s satisfaction. On the samenote, patients usually like test results to be reported to themdirectly this method enhances access to their test results (McShane& Hayes, 2012).The other reason for utilizing the direct result reporting method forthe notification of the client of her test outcomes is that thehospital has comprehensive computerized health information systems.In other terms, the currently available technology in the health carefacility assisted in the task such that it facilitated theimplementation of the direct result reporting system.
Follow-upfor Further Care of the Patient
Inthe article titled “Standardsof Medical Care for Patients with Diabetes Mellitus,” AmericanDiabetes Association (2013) states that every time a clinician ordersa diagnostic test, he or she should ensure that a follow-up isperformed. The reason that the author attributes to this assertion isthat a follow-up enables the clinician that ordered a diagnostic testto make a referral or a recommendation for the required treatment,which reduces the adverse effects of the disease in question(American Diabetes Association, 2013). Aftermailing the test results to the client, I called her and explainedwhat the outcomes meant. Also, during the call, I made therecommendations and the period for the action. I also invited thepatient to return to the hospital after three days for a face-to-facemeeting. I then documented the client`s names, telephone number,results of the diagnostic test, date performed, and the follow-upneeded on the electronic tickler system. On the fourth day, I checkedthe tickler file to determine whether the follow-up had occurred ornot. I realized that the patient had not returned. Therefore, Imailed a letter informing the client that I had informed her bytelephone that the diagnostic test results indicated that she haddiabetes and that I had informed her to return to the hospital todiscuss the matter. In the letter, I urged the patient to visit thehospital within the next two days since the risks of the failure tofollow-up could result in complications and early death. I placed acopy of the letter in the patient`s file. The client showed up thefollowing day, and I advised her to begin diabetes medication.
Cost-Benefitof a Diagnostic Test
Cost-benefitof a diagnostic test is defined as the relationship between thecharges and gains of a specific diagnostic test. In light of this,the cost of any diagnostic test depends on its benefits. When thegains of a diagnostic test are many, then the cost of that particularinvestigative test is usually higher. It should be noted that thecost-benefit of any diagnostic test depends on its accuracy. TA(2014) asserts,hemoglobin A1C test is one of the diagnostic tests with a highcost-benefit ratio. According to this author, hemoglobin A1Cdiagnostic test has a high cost-benefit ratio because it is accurateand provides information about the average level of the blood glucoseof an individual for over the past three months. Another reason whythe test has a high cost-benefit ratio is that blood can be drawn forthe test at any time of the day since it does not require fasting(TA,2014).
AmericanDiabetes Association. (2013). Standards of medical care for patientswith diabetes mellitus. PuertoRico Health Sciences Journal, 20(2).
McShane,L. M., & Hayes, D. F. (2012). Publication of tumor markerresearch results: the necessity for complete and transparentreporting.Journalof Clinical Oncology, 30(34),4223-4232.
Selby,N. M., Crowley, L., Fluck, R. J., McIntyre, C. W., Monaghan, J.,Lawson, N., & Kolhe, N. V. (2012). Use of electronic resultsreporting to diagnose and monitor AKI in hospitalizedpatients. ClinicalJournal of the American Society of Nephrology, 7(4),533-540.
TA,S. (2014). Diagnosis and classification of diabetesmellitus. Diabetescare, 37,S81.