Which of the following is caused by excessive shaking of a tube?

Choice A Reason:
A multipart requisition involves multiple copies of a paper form, which can be prone to errors due to manual entry, misplacement, or illegible handwriting. While it provides physical copies for various departments, it is not the most accurate method compared to digital solutions.

Choice B Reason:
A manual requisition is similar to a multipart requisition but typically consists of a single form. It carries the same risks of human error and does not offer the benefits of automated tracking and data entry that come with electronic systems.

Choice C Reason:
An automated requisition is considered the most accurate method for receiving orders for specimen collection. It reduces the risk of human error associated with manual data entry and allows for better tracking and integration with laboratory information systems. Automated systems can also provide immediate feedback if there is an issue with the order, such as a missing patient identifier or a test code.

Choice D Reason:
A verbal requisition is the least reliable method as it depends on the memory and communication skills of the individuals involved. It lacks the documentation and verification steps present in written or automated methods, making it susceptible to misunderstandings and errors.

Choice A reason:
Reporting the exposure to the supervisor is the immediate and required action after experiencing a needlestick injury. The supervisor will then guide the phlebotomist through the institution's post-exposure protocol, which includes immediate care of the wound, evaluation of the exposure, and initiation of post-exposure prophylaxis (PEP) if necessary. This step is crucial to ensure that the risk of HIV transmission is minimized and that the phlebotomist receives appropriate medical attention and follow-up.

Choice B reason:
Reporting the exposure to the Centers for Disease Control and Prevention (CDC) is not the immediate action required. The CDC provides guidelines and recommendations for handling such incidents, but the initial report and response are managed at the healthcare facility level. The CDC may be involved in the tracking of such incidents on a larger scale or providing statistical data, but they are not the first point of contact.

Choice C reason:
Sending the patient for further sexually transmitted infection (STI) testing is not an immediate action required following a needlestick injury. The patient's HIV status is already known, and the focus should be on the treatment and protection of the healthcare worker who experienced the needlestick. Any additional testing of the patient would be unrelated to the immediate management of the injury.

Choice D reason:
Saving the collection device for future evaluation is not a standard procedure. While the device may be retained as part of the incident investigation to determine how the injury occurred and to improve safety measures, the immediate concern is the treatment of the injured healthcare worker. The device itself does not play a role in the post-exposure management of the worker.