Title: INTRODUCTION TO THE CLINICAL LABORATORY
1CHAPTER 15
- INTRODUCTION TO THE CLINICAL LABORATORY
2PRETEST
True or False
- When the body is in homeostasis, an imbalance
exists in the body. - A routine test is performed to assist in the
early detection of disease. - The laboratory request form provides the outside
laboratory with information needed to test the
specimen. - The clinical diagnosis is indicated on a
laboratory request to correlate laboratory data
with the needs of the physician. - The purpose of a laboratory report is to indicate
the patient's diagnosis.
3PRETEST, CONT.
True or False
- A patient who is fasting in preparation for a
laboratory test is permitted to drink diet soda. - A small sample taken from the body to represent
the nature of the whole is known as a specimen. - A laboratory report marked QNS means that the
patient did not prepare properly. - Fecal occult blood testing is an example of a
CLIA-waived test. - The purpose of quality control is to prevent
accidents in the laboratory.
4Content Outline
Introduction to Clinical Laboratory
- Laboratory tests
- Used along with the health history and physical
examination to diagnose patient's condition - Laboratory tests Provide objective and
quantitative information regarding status of body
conditions and functions
5Introduction to Clinical Laboratory
- 2. Homeostasis state in which body systems are
functioning normally - Internal environment of the body is in
equilibrium - Body is in a healthy state
- Normal or reference range An established range
within which laboratory test results of a normal
person are expected to fall
6Introduction to Clinical Laboratory, cont.
- 4. Body in homeostasis
- Physical and chemical characteristics of body
substances fall within normal range - Body substances include
- Fluids
- Secretions
- Excretions
7Introduction to Clinical Laboratory, cont.
- 5. Pathologic condition
- Alters the normal functioning of the body
- Results in imbalance in the body
- Causes patient to experience symptoms of that
particular pathologic condition (e.g.,
iron-deficiency anemia)
8Introduction to Clinical Laboratory, cont.
- May cause alteration in body substances
- Chemical content of blood or urine
- Antibody level
- Cell counts
- Cellular morphology
- May result in abnormal values laboratory test
results - Certain pathologic conditions cause abnormal
values for specific laboratory tests
9Introduction to Clinical Laboratory, cont.
- 6. Abnormal value for a particular test may be
seen with more than one pathologic condition - Example Decrease in hemoglobin levels seen
with - Iron-deficiency anemia
- Hyperthyroidism
- Cirrhosis of the liver
10Introduction to Clinical Laboratory, cont.
- Physician cannot rely solely on laboratory tests
to make a final diagnosis - Must use a combination of data from
- Health history
- Physical examination
- Laboratory/diagnostic test results
11Laboratory Tests
- Number of tests ordered depends on physician's
clinical findings (health history and physical
examination) - May only need to order one test (e.g., urine
culture for a urinary tract infection) - May need to order a series of tests to diagnose a
condition - Many diseases have more than one alteration in
- Physical and chemical characteristics of body
substances
12Laboratory Tests, cont.
- Not all pathologic conditions require use of
laboratory tests to arrive at a final diagnosis - Diagnosis can be made from patient's symptoms and
physical examination (e.g., otitis media) - MA should have knowledge of laboratory tests
performed most often - Purpose of tests
- Normal value or range
13Laboratory Tests, cont.
- Advance patient preparation or special
instructions - Any substances that might interfere with accurate
test results - Food
- Medication
- Make sure physician is alerted to abnormal
results on laboratory tests as soon as possible
14Purpose of Laboratory Testing
- Assist in diagnosis of pathologic conditions
most frequent use of laboratory tests - Confirm clinical diagnosis
- Clinical diagnosis A tentative diagnosis of a
patient's condition obtained through evaluation
of the - Health history
- Physical examination
- Patient's symptoms may provide strong clinical
diagnosis (e.g., diabetes) - Laboratory tests are used to confirm that
diagnosis (glucose tolerance test)
15Purpose of Laboratory Testing, cont.
- Assist in differential diagnosis
- Two or more diseases may have similar symptoms
- Laboratory tests ordered to determine which
disease is present
16Purpose of Laboratory Testing, cont.
- Obtain information regarding patient's condition
- May not be enough evidence to support a clinical
diagnosis - Patient may be exhibiting vague symptoms
- Example Nonspecific abdominal pain
- Series of laboratory and diagnostic tests ordered
to pinpoint cause of patient's problems
17Purpose of Laboratory Testing, cont.
- Evaluate patient's progress and to regulate
treatment after making the final diagnosis - Based on laboratory results therapy may need to
be adjusted or further treatment prescribed - Examples
- Complete blood count on patient with
iron-deficiency anemia to assess response to iron
therapy - Adjusting Coumadin therapy based on results on
physical therapy (PT) test
18Purpose of Laboratory Testing, cont.
- Establish patient's baseline
- Age, gender, race, geographic location cause
individuals to have different normal levels
within established normal range - Laboratory tests establish each patient's
baseline against which future results can be
compared
19Purpose of Laboratory Testing, cont.
- Prevent or reduce the severity of disease by
early detection of abnormal findings (e.g.,
hyperlipidemia, anemia, diabetes) - Known as a routine test a test performed on a
routine basis on apparently healthy patients to
assist in the early detection of disease - Easy to perform
- Usually part of general physical examination
20Purpose of Laboratory Testing, cont.
- Common routine tests
- Urinalysis
- Complete blood count (CBC)
- Cholesterol
- Routine blood chemistries
21Purpose of Laboratory Testing, cont.
- Requirement by state law
- Example Statutes of most states require
gonorrhea and syphilis tests be performed on
pregnant women - Purpose to protect mother and fetus from harm
22Types of Clinical Laboratories
- Medical office may use outside laboratory or have
its own laboratory (physician's office
laboratory) - Most offices use a combination of both
- Physician's Office Laboratory (POL)
- For tests that are convenient to perform and
commonly required (e.g., glucose, urinalysis) - Time-consuming and expensive to perform complex
tests in the office
23Outside Laboratories
- MA works closely with outside laboratory
- Outside laboratories include
- Hospital laboratories
- Privately owned commercial laboratories
- Laboratory provides office with supplies and
forms to collect and prepare specimens for
transport - MA responsible for checking and reordering
supplies
24Laboratory Directory
- Reference source for proper collection and
handling of specimens - Provided to office by outside laboratory
25Laboratory Directory, cont.
- Information included
- Names of tests performed by laboratory
- Normal range for each test
- Instructions on completion of forms (e.g.,
laboratory request) - Patient preparation required for each test
26Laboratory Directory, cont.
- Supplies required for collection of each specimen
- Amount and type of specimen required for each
test - Techniques for collection of specimen
- Proper handling and storage of specimen
- Instructions for transporting specimen
- If MA has any questions Call laboratory
27Laboratory Directory
28Collection and Testing Categories
- Categories
- Specimen collected and tested at office
- Specimen collected at office and transferred to
outside laboratory - Patient given laboratory request to have specimen
collected and tested at outside laboratory - Responsibilities of MA depend on which method is
used
29Laboratory Requests
Purpose
- Laboratory request Printed form containing a
list of most frequently ordered laboratory tests - a. Can be completed manually
- MA writes in all required information
- b. Can be completed on a computer
- screen
- MA enters information on a keyboard
30Laboratory Requests, cont.
- 2. Required when a specimen is
- Collected at office and sent to outside
laboratory for testing - Collected and tested at an outside laboratory
- Request given to patient at office to take to
laboratory
31Laboratory Requests, cont.
- Provides laboratory with information for
- Accurate testing
- Reporting of results
- Billing
- Format of laboratory requests varies depending on
laboratory
32Laboratory Request Form
33Parts of a Laboratory Request Form
- Physician's name and address
- Facilitates reporting of results to physician
- May be preprinted on form
34Parts of a Laboratory Request Form, cont.
- Patient's name and address
- Needed for
- Identifying report
- Billing purposes
35Parts of a Laboratory Request Form, cont.
- Patient's age and gender
- Normal ranges for some tests vary based on age
and gender - Example Hemoglobin
- Female 12 to 16 g/dL
- Male 14 to 18 g/dL
36Parts of a Laboratory Request Form, cont.
- Date and time of collection of specimen
- Date
- Indicates number of days that have passed since
specimen was collected - Provides information regarding freshness of
specimen - Too long of a time lapse can result in inaccurate
results
37Parts of a Laboratory Request Form, cont.
- Time
- Normal range for some tests vary based on whether
test is an AM or a PM specimen
38Parts of a Laboratory Request Form, cont.
- Laboratory tests desired
- Usually indicated by marking a box adjacent to
tests - Mark box clearly
- Space designated for additional tests is provided
- Use to specify a test not listed on request form
39Parts of a Laboratory Request Form, cont.
- Profile contains many laboratory tests
- Profiles performed by laboratory and tests
included in each listed in laboratory directory - Specific profile all tests relate to specific
organ - Used when physician has a good idea of what organ
is involved in patient's condition - Example Hepatic profile tests assist in
diagnosis of liver conditions
40Parts of a Laboratory Request Form, cont.
- General profile contains routine laboratory
tests - Used for routine health screens or when patient's
symptoms are vague - Example comprehensive metabolic profile
41Laboratory Profiles
42Laboratory Profiles
43Parts of a Laboratory Request Form, cont.
- Source of specimen (e.g., throat, wound, ear,
eye, urine, vagina) - Tells laboratory where specimen came from
- May not be possible to determine by looking at
specimen - Method laboratory uses to test specimen based on
source of specimen
44Parts of a Laboratory Request Form, cont.
- Physician's clinical diagnosis
- Assists the laboratory in correlating clinical
laboratory data with the needs of physician - Further testing may be needed if one test method
proves inconclusive - Alerts laboratory to possibility of presence of a
dangerous pathogen (e.g., hepatitis) - Required for billing
45Parts of a Laboratory Request Form, cont.
- Medications
- Certain medications may interfere with accuracy
and validity of test results - Must be indicated on request to inform laboratory
46Parts of a Laboratory Request Form, cont.
- STAT
- Performed as soon as possible
- Results telephoned or faxed to office
- Place completed request form with specimen for
transport to laboratory - Without request laboratory does not have info
to carry out orders - Results in delay in completing tests and
reporting results
47Laboratory Reports
- Purpose
- Relay laboratory test results to physician
- May be
- a. Preprinted form
- Results are printed on form by computer
- b. Computer report
- Entire report (tests and results) are printed by
the computer -
48Laboratory Report
49Laboratory Reports, cont.
- Includes
- Name, address, and telephone number of laboratory
- Physician's name and address
- Patient's name, age, and gender
- Patient's accession number
- Provides positive identification of each specimen
and access to patient's laboratory records
50Laboratory Reports, cont.
- Date specimen received by laboratory
- Date results reported by laboratory
- Names of tests performed
- Results of tests
51Laboratory Reports, cont.
- Normal range for each test performed
- A single value cannot be used because of
individual differences among general population
(age, gender, race, geographic location) - Normal range varies slightly from one laboratory
to another depending on - Test method used
- Equipment used
- Reagents used
- Important to compare test results with normal
range supplied by laboratory performing the test
52Laboratory Reports, cont.
- Reports are relayed to office
- Hand-delivered
- Sent electronically (by computer)
- Faxed
- Mailed to office
53Laboratory Reports, cont.
- Abnormal results posing a threat to patient's
health or STAT reports - Telephoned as soon as possible
- Written results will follow
- MA responsible for reviewing reports as they are
received - Notify physician of abnormal results
- Most reports flag abnormal results
- If not MA should circle abnormal results with
red pen
54Laboratory Reports, cont.
- Reports reviewed by physician correlates with
info from health history and physical examination - Physician initials laboratory report after
reviewing it - MA files report in patient's chart
55What Would You Do?What Would You Not Do?
56What Would You Do?What Would You Not Do?
57Patient Preparation and Instructions
- Factors may affect results of certain laboratory
tests - Food consumption
- Medication
- Activity
- Time of day
58Patient Preparation and Instructions, cont.
- Advance patient preparation may be required to
obtain a quality specimen - Inaccurate results may occur if patient does not
prepare properly - MA responsible for instructing patient in advance
preparation - Explain reason for preparation patient will be
more likely to comply - To ensure accurate test results
- To avoid having to collect specimen again
59Patient Preparation and Instructions, cont.
- Check to make sure patient completely understands
instructions - Written instruction sheet may be provided
- Patient can refer to it at home
60Patient Preparation and Instructions, cont.
- Some tests may require patient to remain at site
for specified period of time (e.g., glucose
tolerance test) - Patient should be told in advance of time
requirement
61Patient Preparation and Instructions, cont.
- Patient may collect specimen at home (e.g.,
first-voided urine specimen) - MA should
- Explain instructions on proper technique for
collection - Provide appropriate specimen container
- Instruct patient on proper handling and storage
of specimen
62Patient Preparation and Instructions, cont.
- Type of preparation depends on test ordered and
method used to run test - Outside laboratory testing preparation required
listed in laboratory directory - POL testing preparation listed in manufacturer's
instructions - Advance preparation usually in form of
- Fasting
- Medication restriction
- Diet modification
63Fasting
- Required for some venous blood specimens
- Composition of blood is altered by consumption of
food - Example Food intake results in falsely high
results for - Fasting blood sugar (FBS)
- Glucose tolerance test (GTT)
- Triglycerides
- Must also fast for any profile including a test
that requires fasting (e.g., lipid profile)
64Fasting, cont.
- Fasting abstaining from food and fluids (except
water) for a specified amount of time (usually 12
to 14 hours) - Specimen collected in the morning
- Food from evening meal completely digested and
absorbed - Least amount of inconvenience to patient
65Fasting, cont.
- MA responsible for relaying instructions to
patient - Make sure patient understands to abstain from
both food and fluid (except water) - Advisable to drink water
- To prevent dehydration can alter certain test
results - In case a urine specimen is required as part of
the test
66Fasting, cont.
- When to start fasting
- Indicate the specific time to start fasting
(e.g., 6 PM) - What time to report for collection of specimen
67Medication Restrictions
- Many medications affect physical and chemical
characteristics of body substances - May lead to inaccurate test results
- Example antibiotic therapy before collection of
throat specimen for strep testing may cause
falsely negative results
68Medication Restrictions, cont.
- Patient told not to take medications before
collection (if does not cause health threat or
serious discomfort to patient) - Medications discontinued
- 48 to 72 hours before urine collection
- 4 to 24 hours before blood collection
- Medications more likely to interfere with urine
results than blood test results
69Medication Restrictions, cont.
- If patient cannot be taken off medications
- Medications being taken should be recorded on
laboratory request - Laboratory may be able to use alternate method of
testing
70Medication Restrictions, cont.
- If test performed in medical office
- MA should consult manufacturer's instructions for
medications that interfere with test - Physician determines what medications to
discontinue - MA ensure patient understands medication
restrictions
71What Would You Do?What Would You Not Do?
72What Would You Do?What Would You Not Do?
73Collecting, Handling, and Transporting Specimens
- Specimen small sample or part taken from the
body to represent the nature of the whole - Majority of laboratory tests performed on
specimens that are easily obtained - Blood
- Urine
- Feces
- Sputum
- Cervical and vaginal scraping of cells
74Collecting a Blood Specimen
75Collecting, Handling, and Transporting Specimens,
cont.
- Sample of secretion or discharge for
microbiologic analysis - Nose
- Throat
- Wound
- Ear and eye
- Vagina
- Urethra
76Collecting, Handling, and Transporting Specimens,
cont.
- Other specimens not as easy to obtain
- Gastric juices
- Cerebrospinal fluid
- Pleural fluid
- Peritoneal fluid
- Synovial fluid
- Tissue specimens for biopsy
77Collecting, Handling, and Transporting Specimens,
cont.
- Source of specimen may not be indicative of
pathologic condition - Example Thyroid tests are performed on blood
serum - MA responsible for collection of majority of
specimens - Most common specimens collected by MA blood and
urine
78Collecting, Handling, and Transporting Specimens,
cont.
- Certain specimens must be collected by the
physician - Examples
- Vaginal discharge
- Urethral discharge
- Tissue specimen
- MA assists with collection
79Collecting a Tissue Specimen
80Collecting, Handling, and Transporting Specimens,
cont.
- Handle specimen properly to maintain in vivo
characteristics - In vivo Occurring in the living body
- If handled improperly may cause inaccurate test
results - May interfere with accurate diagnosis and
treatment
81Guidelines for Specimen Collection
- Review and follow OSHA Bloodborne Pathogens
Standard - Review requirements for collection and handling
of the specimen - Collection materials required
- Type of specimen required (e.g., serum, plasma,
whole blood, urine) - Amount of specimen required
- Procedure for collecting specimen
- Proper handling and storage of specimen
82Guidelines for Specimen Collection, cont.
- Assemble equipment and supplies
- Use only appropriate specimen containers
- Substituting containers may affect test results
- Container should be sterile
- To prevent contamination of specimen may affect
accuracy of test results
83Guidelines for Specimen Collection, cont.
- MA should check each container before using to
make sure it is not broken, chipped, cracked, or
otherwise damaged - Discard damaged containers
84Guidelines for Specimen Collection, cont.
- Label each tube and container
- Patient's name
- Date
- MA initials
- Any other information required by laboratory
85Guidelines for Specimen Collection, cont.
- Identify the patient by full name and date of
birth - Avoids collecting from wrong patient
- Could lead to invalid test results
- May affect patient's diagnosis and treatment
- Explaining procedure helps relax and reassure
patient - Gains patient's confidence and cooperation
86Identify the Patient
87Guidelines for Specimen Collection, cont.
- Determine if pt has prepared properly
- Improper preparation may lead to inaccurate test
results - Example FBS If patient does not fast, results
will be falsely high - Inform physician if patient failed to prepare
- Physician may want patient to prepare properly
and return - Physician may have MA collect specimen anyway
- Alert laboratory to situation on request form
- Example Nonfasting specimen
88Guidelines for Specimen Collection, cont.
- Explain the procedure
- a. Helps relax and reassure patient
- b. Gains patients confidence and
cooperation
89Guidelines for Specimen Collection, cont.
- 7. Collection of the specimen
- Involves medical and surgical asepsis
- Collect specimen using proper technique
90Guidelines for Specimen Collection, cont.
- Collect proper type of specimen
- Collect proper amount of specimen
- Refer to appropriate reference material
- If specimen transported to outside laboratory
refer to laboratory directory - If specimen tested in office refer to
manufacturer's instructions
91Guidelines for Specimen Collection, cont.
- If proper amount not collected laboratory unable
to perform test - Laboratory request will be returned marked QNS
(quantity not sufficient) - Patient must be called back for another
collection
92Guidelines for Specimen Collection, cont.
- Once collected, MA records in chart
- Date and time of collection
- Laboratory tests ordered
- Type of specimen
- Source of specimen
- If transferred to outside laboratory date
specimen was collected should be recorded (if
different from date of collection)
93Recording Specimen Collection
94Guidelines for Specimen Collection, cont.
- 8. Properly handle and store the specimen to
preserve in vivo qualities
- Best to perform laboratory tests on fresh
specimens (within 1 hour after collection) - Yield most reliable test results
95Guidelines for Specimen Collection, cont.
- If specimen awaiting laboratory pick-up properly
preserve specimen to maintain in vivo physical
and chemical characteristics
96What Would You Do?What Would You Not Do?
97What Would You Do?What Would You Not Do?
98Clinical Laboratory Improvement Amendments (CLIA)
Purpose of CLIA 1988
- To improve the quality of laboratory testing in
the United States - Consists of federal regulations governing all
facilities that perform laboratory tests for
means of - Health assessment
- Diagnosis, prevention, or treatment of disease
- Health Care Financing Administration (HCF)
(division of Department of Health and Human
Services) responsible for monitoring compliance
with CLIA regulations
99Categories of Laboratory Testing
Categories of laboratory testing based on
complexity of testing methods
- Waived tests
- Simple procedures including procedures that are
easy to perform - Include procedures that patients can perform at
home - b. Laboratories must apply for certificate of
waiver from HCFA - Exempts laboratory from many CLIA requirements
- Must still adhere to good laboratory practices
- Includes following manufacturer's instructions
for each product or testing kit
100Categories of Laboratory Testing, cont.
- Examples of Waived Tests
- Dipstick or tablet reagent urinalysis
- Fecal occult blood testing
- Ovulation testing
- Urine pregnancy testing
- Erythrocyte sedimentation rate (nonautomated)
101Categories of Laboratory Testing, cont.
- Hemoglobin using a CLIA-waived analyzer
- Spun microhematocrit
- Blood glucose determination (using an
FDA-approved blood glucose monitor) - Rapid strep testing
102Categories of Laboratory Testing, cont.
- Moderate-complexity tests
- Account for 75 of estimated 10,000 laboratory
tests performed in United States - Examples
- Hematology and blood chemistry tests performed on
automated blood analyzer (that are not
CLIA-waived) - Microscopic analysis of urine sediment
103Categories of Laboratory Testing, cont.
- High-complexity tests
- Include
- Cytogenetics
- Histopathology
- Histocompatibility
- Cytology (e.g., Pap test)
104Requirements for Moderate- and High-Complexity
Testing
- Must meet CLIA regulations
- Subject to unannounced inspections every 2 years
by HCFA - Patient test management
- System to maintain optimal integrity and
identification of specimens - System to ensure accurate reporting of results
105Requirements for Moderate- and High-Complexity
Testing, cont.
- Quality control to ensure accurate and reliable
test results - Each laboratory must establish and follow written
procedures - That monitor and evaluate quality of each testing
process
106Requirements for Moderate- and High-Complexity
Testing, cont.
- Includes
- Developing laboratory procedure manual
- Following manufacturer's instructions
- Performing calibration procedure every 6 months
and documenting results - Performing two levels of controls daily and
documenting results - Performing and documenting actions taken when
problems or errors occur - Documenting all quality control activities
107Requirements for Moderate- and High-Complexity
Testing, cont.
- Quality assurance
- Must establish and follow written policies and
procedures - To monitor and evaluate the overall quality of
the total testing process
108Requirements for Moderate- and High-Complexity
Testing, cont.
- Proficiency testing (PT)
- Form of external quality control
- Laboratory specimens prepared by an approved PT
agency - Unknown specimens shipped to POL
- POL tests specimens and reports results to PT
agency for evaluation - Done 3 times per year
109Requirements for Moderate- and High-Complexity
Testing, cont.
- Personnel requirements
- CLIA specifies education and training
qualifications and responsibilities for - Laboratory directors
- Technical consultants
- Clinical consultants
- Testing personnel
110The Physician's Office Laboratory
- MA may be responsible for performing laboratory
tests and recording results - Laboratory tests can be classified into
categories - Hematology Examination of blood for the
detection of abnormalities - Includes
- Blood cell counts
- Cellular morphology
- Clotting ability of blood
- Identification of cell types
111The Physician's Office Laboratory, cont.
- Clinical chemistry Determining the amount of
chemical substances present in body fluids,
excreta, and tissues - Largest area in clinical chemistry blood
chemistry - Serology and blood banking Studying
antigen-antibody reactions to assess the presence
of a substance and/or to determine the presence
of disease - Urinalysis Physical, chemical, and microscopic
analysis of urine
112The Physician's Office Laboratory, cont.
- Microbiology Identification of pathogens present
in specimens taken from the body - Examples of specimens
- -Urine - Wound
- -Blood -Urethra
- -Throat -Vagina
- -Sputum -Cerebrospinal fluid
113The Physician's Office Laboratory, cont.
- Parasitology Detection of the presence of
disease-producing human parasites or eggs present
in specimens taken from the body - Examples of specimens
- Stool
- Vaginal
- Blood
114The Physician's Office Laboratory, cont.
- Cytology Detection of the presence of abnormal
cells - Histology Detection of diseased tissue
115Categories of Laboratory Tests
116Categories of Laboratory Tests, cont.
117The Physician's Office Laboratory, cont.
- Specimens can be analyzed by either manual or
automated method - Steps for testing specimen
- Specific amount of specimen required measured
from specimen sample - Chemical reagents are combined with specimen
118The Physician's Office Laboratory, cont.
- Specimen/reagents may require further processing
(e.g., centrifuging, incubation) - Substance is manually or automatically measured
or identified - Results obtained from direct readout or by
mathematic calculation
119The Physician's Office Laboratory, cont.
- Results are recorded on laboratory report form or
in patient's chart - Patient's name (not needed if recording in chart)
- Date
- Time
- Name of laboratory test(s)
- Results of laboratory test(s)
- Name of individual performing test(s)
120Recording Laboratory Test Results
121Manual Method
- Involves performing a series of steps by hand
- Testing kits available to speed up process
- a. Examples of testing kits
- -Urinalysis
- -Strep testing
- -Mono testing
- -Urine pregnancy testing
-
122Manual Method, cont.
- Requires a thorough knowledge of testing
procedure - Must be careful to avoid errors
123Automated Analyzers
- Automated analyzers designed for use in medical
office - Permit processing of specimens in a short period
of time - Provide greater precision than manual method
124Automated Analyzers, cont.
- Tests results by direct readout (digital or
printed) - Must be able to recognize signs that indicate
analyzer is malfunctioning - May lead to inaccurate test results
125Automated Analyzers, cont.
- Numerous automated systems available
- Operating manual with each that includes
information needed to - Collect specimen
- Handle specimen
- Perform quality control procedures
- Test specimen
126Automated Analyzers, cont.
- Personnel available for on-site training and
service - Examples of automated analyzers
- QBC hematology analyzer
- Reflotron blood chemistry analyzer
- Clinitek urine analyzer
127Quality Control
- Must make sure laboratory test is accurately
measuring what it is supposed to measure - Encompasses every aspect of
- Patient preparation
- Specimen collection
- Handling
- Transport
- Testing
128Quality Control, cont.
- Quality control the application of methods and
means to ensure that test results are reliable
and valid and that errors that may interfere with
obtaining accurate test results are detected and
eliminated - Quality control methods
- Use standards and controls
- To check the precision and accuracy of laboratory
equipment - To detect errors in technique
129Quality Control, cont.
- Discard outdated reagents
- Follow the procedure exactly to test specimen
- Perform tests in duplicate
- Periodically check the accuracy of test results
with reference laboratory - Maintain equipment by having it checked
periodically
130Laboratory Safety
- Carefully handle and store glassware
- Arrange in storage cabinets to prevent breakage
- Carefully remove from storage cabinets
- If breakage occurs dispose in puncture-resistant
container
131Laboratory Safety, cont.
- Handle chemical reagents carefully
- Reagent container should be clearly labeled
- If label becomes loose, reattach
- Recap container immediately after using
132Laboratory Safety, cont.
- Laboratory specimens should be handled carefully
- Follow OSHA Bloodborne Pathogens Standard
- Wash hands immediately if accidentally touch
specimen - c. Avoid hand-to-mouth contact
- d. Immediately clean up any spill
133Laboratory Safety, cont.
- Properly dispose of all contaminated materials
- Cover any break in the skin
- Make sure specimen containers are tightly capped
- Handle all laboratory equipment and supplies
properly
134POSTTEST
True or False
- Laboratory tests are most frequently ordered by
the physician to assist in the diagnosis of
pathologic conditions. - A laboratory directory indicates the patient
preparation required for laboratory tests. - Laboratory tests termed profiles contain a number
of different tests. - A lipid profile includes a test for glucose.
- The purpose of patient preparation for a
laboratory test is to ensure the test results
fall within normal range.
135POSTTEST, CONT.
True or False
- A comprehensive metabolic profile requires that
the patient fast. - Antibiotics taken by the patient prior to the
collection of a throat specimen for culture may
result in a false-positive result. - The purpose of CLIA is to prevent exposure of
employees to bloodborne pathogens. - If a POL is performing moderate-complexity tests,
CLIA requires that two levels of controls be run
daily. - The study of blood and blood-forming tissues is
known as serology.