Principle of Medical Laboratory Science, Lecture notes of Laboratory Practices and Management

Download Principle of Medical Laboratory Science and more Lecture notes Laboratory Practices and Management in PDF only on Docsity! LESSON 1 Phlebotomy “venesection” Phlebos - vein Temnein - to cut act of opening a vein by using incision or puncture methods to draw blood for analysis or as part of therapeutic or diagnostic measures under the physician's request simple bloodletting to fundamental diagnostic tool. Main Goals . Diagnosis and treatment using blood samples . Transfusion, to remove blood at the donor center . Removal of blood for polycythemia or therapeutic purposes Methods CAPPILARY PUNCTURE Done by puncturing the skin VENIPUNCTURE Method of blood collection using a needle inserted in a vein Evolution STONE AGE used crude tools to cut vessels and drain blood from the body. ANCIENT EGYPTIANS (1400 B.C.) form of "Bloodletting" person’s health dependent on the Lala nann Af foie bee nen - Earth (blood & brain) - Air (phlegm & lungs) - Fire (black bile & spleen) - Water (yellow bile & gall bladder) Removing excess humor through bloodletting (balance) MIDDLE AGES Bloodletting as part of treatment for some illness 17" and 18" CENTURY treated as major therapy CUPPING alternative medicine application of special heated suction cups on the patient's skin incision using fleam (lancet) - wiped with rag LEECHING Understanding Phlebotomy HIPPOCRATES (460-377 B.C.) “Hirudotherapy” use leaches for bloodletting used for microsurgical replantation Process - drop milk or blood patient’s skin - put hirudo medicinalis (medicinal leech) to the site Leeches - Inject local anesthetic, (anticoagulant) vasolidator, and hirudin Role of Phlebotomist Collect blood samples for laboratory testing or transfusion. Properly label collected blood samples. Deliver or transport collected samples within appropriate prescribed time limits. Process collected blood samples such as centrifuging and aliquoting samples laboratory testing. ready for = Assist in collecting other specimens such as urine and other non-blood samples from patients. » Main players in _ bloodletting activities such as drawing of blood units from donors for transfusion to a patient requiring whole blood or blood components. Phlebotomist Traits Good manual dexterity Special communication skills Good organizational skills Through knowledge of laboratory specimen requirements Training in phlebotomy © skills coupled with standard practice eee < Credentials ¥ CERTIFICATION - certified complete training ¥ LICENSE - passed licensure examination ¥ CONTINUING EDUCATION - attend trainings and seminars Patient-Client Interaction PHLEBOTOMISTS should be: ** ¢ Reassuring and pleasant ¢ Able to communicate well ¢ Maintain positive customer relations ¢ Understand the diversity of the patients and be able to adjust accordingly Qualities of Professionalism ae ¢ Professional appearance Self-confidence Integrity Compassion Self-motivation Dependability Ethical Behavior Communication in UAsnlthnnvrn ¢ VERBAL COMMUNICATION ** ¢ NON-VERBAL COMMUNICATION ¢ ACTIVE LISTENING Elements in Healthcare Empathy Control Respect Confirmation Trust eeee<e Verbal Communication Loop (Book) The Healthcare Setting CATEGORIES: 1. INPATIENT (Non-ambulatory) - Patients stay in the hospital for at least one night to be serviced by tertiary care practitioners. 2. OUTPATIENT - Patients served by secondary care specialists on the same day. Levels of Healthcare WILLIAMS TUNGPALAN: 1, PRIMARY LEVEL = health units in the rural areas and sub-units which are operated by the Department of Health. ¢ put the sanitizer on hands, rub the hands together for about 20 seconds or until it feels dry Centers for Disease Control and Prevention (CDC) Guidelines for Hand Hygiene in Health Settings recommends the following: ¥ When washing hands with soap and water, wet hands with water, apply soap and rub hands vigorously making sure that all the surfaces are covered for at least 15 seconds. ¥ Rinse the hands with water (do not use hot water because it will cause dryness in the skin) and use disposable towel to dry hands. ¥ Use disposable towel to turn off Hh fa.nnt Handwashing Steps 1) Stand a few inches from the sink to avoid contamination. 2) Turn on the faucet and place hands under the running water. 3) Use soap and work up lather to ensure that hand surfaces are reached. 4) Scrub for at least 15 seconds is necessary. Make sure to scrub all surfaces especially between the fingers and the knuckles. 5) Apply a little friction and rub hands together for at least 15 seconds. 6) Rinse the hands from the wrist to fingertips using a downward motion. 7) Dry hands using a clean paper towel. 8) Use the paper towel to close the faucet except when it is foot or motion activated. Personal Protective DCAniinmant = Includes gloves, gowns, lab coats, mask, face shield, goggles, and respirators. DONING AND DOFFING OF PPE =» Kept clean and worn to protect the healthcare worker from splashes of blood and specimen during the patient-care activities. DONNING OF PPE 1) Gown should be put on first. Make sure that it is fastened, and the belt is tied. 2) Mask should cover both the nose and mouth. 3) Gloves should be pulled over the gown cuff. DOFFING PPE 1) Gloves are removed first. Do not touch contaminated areas with ungloved hands. 2) Gown should be pulled from the shoulders towards the hand, so it is turned inside out. 3) Mask should be removed by only touching the string NOTE: Wash hands immediately after removal of PPE. Gloves =» Worn during blood collection and specimen handling = Prevent contamination of hands =» Reduce chances of transmission of microorganism = Worn over the cuffs of the lab gown to ensure protection Wearing of gloves 1) The wrist of one hand is grasped by the opposite hand. 2) The glove is pulled inside out and off the hand. 3) Place the recently removed glove in the gloved hand. The fingers of the non-gloved hand are slipped under the wrist of the remaining glove but make sure not to touch the exterior surfaces. 4) The second glove is pulled inside out. 5) Drop the gloves in the proper receptacle. Nursey and Neonatal ICU Infection Control Technique NEWBORNS - most susceptible because of undeveloped immune system. 1) Do the proper hand washing procedure before putting on the PPE. 2) The phlebotomist should only bring items necessary for the specimen collection. 3) Blood collection tray should be left outside the nursery, preferably the anteroom. 4) Remove gloves, wash hands, and use a new pair of gloves between patients. Standard and Transmission-Based Precaution for Blood-Borne Pathogen BLOOD BORNE PATHOGENS =» Microorganisms in the human blood. = Infectious = From needle stick or other injuries caused by sharp objects. =» Most common pathogens include: - Hepatitis B (HBV) - Hepatitis C (HCV) - Human Virus (HIV) Immunodeficiency DEFENSE, HAZARDS, AND SYMPTOMS OF BLOOD-BORNE PATHOGEN TABLE ** Exposure Control Plan EXPOSURE OCCURS WHEN FOLLOWING HAPPENS: ¢ A contaminated needle or sharp object pierces the skin of the health worker. ¢ Body fluid or blood splashes in the eyes, nose, or mouth. ¢ Cut, scratch or abrasion has made contact with blood or body fluid of infected patient. ¢ Human bite cuts the skin WHAT TO DO: A. BBP Exposure cause by Needle Stick or Any sharp object: 1) Carefully remove the shards or foreign object. 2) Wash the site thoroughly with soap and water for at least 30 seconds. B. BBP Exposure through Mucous Membrane: 1) Flush with water or saline for at least 10 minutes. 2) For the eyes, use eyewash station for flushing if available. Remember to remove the contact lenses (if there are any) and make sure to disinfect them. Report the incident to the immediate supervisor and the provider so that evaluation, treatment, and counseling can be provided. 3 SURFACE DECONTAMINATION: 1) Use 1:10 bleach solution or other disinfectants for specimen collection and processing areas. 2) Wear gloves and use an absorbent material when cleaning the area to avoid spreading the spills over a wider area. 3) All non-reusable items contaminated by blood or other body fluids should be placed in biohazard waste containers. Biohazard BIOHAZARD = any material that could be harmful to health. BIOSAFETY = used to prevent and_ protect clinical laboratories from harmful incidents caused by laboratory specimen that are _ potentially biohazard. Biohazard Exposure Routes = Exposed to biohazard 1) AIRBORNE - from splashes and aerosols during centrifuge and aliquot; patients with airborne diseases a. Proper handling practices b. Wearing PPE properly c. Use safety shield and guards 2) INGESTION - Hands are not sanitized before handling food a. Wash hands frequently. b. Avoid hand-to-mouth activities. c. Avoid placing items in the mouth. 3) NON-INTACT SKIN - contamination through breaks or cuts in the skin a. Cover with non-permeable bandages 4) PERCUTANEOUS - exposure through the skin due to injuries from needlesticks and other sharps objects. a. Use needle safety devices b. Wear heavy-duty — utility gloves when cleaning broken glass c. Never handle broken glass with bare hands. 5) PERMUCOSAL - infection through mucous membranes of the mouth and nose and the conjunctiva of the eyes. a. Observe proper handling to avoid aerosols and splashes. b. Avoid rubbing and touching the eyes, nose, and mouth. Electric Shock = potential hazard in the workplace when dealing with — electrical equipment. ACTIONS SHOULD BE TAKEN: 1) remove the source of electricity using non-conductive object or simply turn off the source of electricity 2) Ask for medical assistance 3) Start Cardiopulmonary Resuscitation (CPR) if necessary 4) Keep the victim warm. Fire