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Create a Strong Lab Team Through Recruiting
By Milly Keeler, MT(ASCP), CLC(AMT), CCCP, Medical Laboratory Management

No matter how much money is spent on sophisticated laboratory instrumentation, a lack of qualified, well-trained personnel will undermine the laboratory’s success at every turn. In fact, well-trained and skilled laboratory personnel are the single greatest determining factor of operational success. That said, recruiting and retaining new laboratorians can be difficult, time consuming, and expensive.

Managing risk is more important than ever in this litigious age and as experienced laboratory staff members are retiring faster than new employees are able to fill those positions, many laboratories are experiencing significant increases in workload and work-related stress. These circumstances are a breeding ground for potential mistakes, increased costs due to overtime and temporary workers, and for the cessation or abandonment of improvement projects. Therefore, a concerted effort should be invested in how the laboratory is bringing new staff on board. Read more >

Top 10 Health Technology Hazards for 2019

Health Data Management, October 2018

 

Health technology—ranging from simple devices to complex information systems—poses unanticipated risks for healthcare organizations. It’s important to identify these risks, understand them and try and correct them.

 

Each year, the ECRI Institute’s Health Devices Group produces a list of the top 10 health technology hazards, identifying potential sources of danger that warrant the most attention for the coming year. “All the items on our list represent problems that can be avoided or risks that can be minimized through the careful management of technologies,” ECRI reports.

Read more >

The Evolution of Group A Streptococcus Pharyngitis Testing

By Dithi Banerjee, PhD, and Rangaraj Selvarangan, BVSc, PhD, D(ABMM), FIDSA Sept 2018, Clinical Laboratory News
 

Molecular assays may soon eliminate the need for supplemental testing, but patient selection and appropriate test methods remain key

 

Acute pharyngitis, an inflammation of the pharynx and/or tonsils, is a common illness caused by many microorganisms. Although viruses are the main etiological agents, Streptococcus pyogenes, commonly known as group A streptococcus (GAS), is the primary bacterial cause, accounting for pharyngitis in 5%–15% of adults and 20%–30% of children worldwide (1).

GAS pharyngitis mainly affects children 3–15 years of age and can lead to suppurative and non-suppurative complications, the latter being more common in developing countries. Suppurative complications include oral or peritonsillar abscesses, cervical lymphadenitis, and rarely, septicemia. Read more >

POC in the Lab: A Regional Experience in Urinalysis and Pregnancy Testing
MLO, Yu Chen, Susan McDonald, and Jason Weshler

Horizon Health Network operates 12 hospitals and more than 100 medical facilities, clinics and offices in the province of New Brunswick in Canada. Providing services ranging from acute care to community-based health services, Horizon Health Network has more than 12,400 employees, including 1,000 physicians, and has 5,700 volunteers, auxiliary workers, and alumni. The network consists of four areas with core lab services provided only in the four regional hubs. As part of the provincial laboratory standards, all sites performing point-of-care testing (POCT) must be accredited by the Institute for Quality Management in Healthcare IQMH (former Ontario Laboratory Accreditation 2013). Findings from a 2013 audit identified minor non-conformances specific to ISO 22870 in urinalysis POCT, which remained unresolved during a subsequent audit in 2015 and were escalated to major non-conformances.

Point-of-care (POC) urinalysis testing has been widely evaluated in the literature; studies have demonstrated both the safety and efficacy of both urine test strips and urine hCG testing using semi-automated platforms. The utilization of POC middleware further facilitates the management of POC testing by providing enhanced traceability of both operators and results—including elements of training, testing patterns, certification, and quality control. Read more >

A Novel Point-of-Care Approach for Improving Acute Bleeding Management
MLO, By Todd Allen and Francesco Viola

Whole blood viscoelastic testing (VET) for perioperative bleeding management is systematically increasing in clinical use and is approaching the level of standard of care for many clinical settings such as cardiovascular surgery, liver transplantation, trauma, and obstetric hemorrhage. Conventional coagulation testing has proven to be inadequate for directing therapeutic intervention in these critical settings.

Physicians managing acute bleeding events require faster turnaround times for test results and prefer assays that more accurately reflect the whole blood or cell-based hemostatic process described by Hoffman and Monroe. The benefits of VET have been well-documented. There exists an abundance of publications and systematic reviews in a variety of clinical settings, including review articles in this area published in previous issues of MLO. Several medical societies have given strong recommendations for the use of VET in conjunction with goal-directed treatment algorithms guided by VET for managing acute bleeding in the perioperative setting. To date, two technologies have emerged at the forefront of whole blood VET: thromboelastography and rotational thromboelastometry. Read more >

One and Done?
Prospective trial suggests that a single blood test may be sufficient to diagnose diabetes.

Clinical Laboratory News, July 2018

Multiple blood tests have been the clinical mainstay for confirming type 2 diabetes. However, a study that tracked individuals over several decades for incident diabetes and other conditions found that measuring elevated fasting glucose and HbA1c levels from a single blood sample may suffice for an accurate diagnosis. Investigators published the results of their prospective cohort study in the Annals of Internal Medicine.

Clinicians under current guidelines rely on two glucose tests to confirm a diabetes diagnosis. “Whether 2 different tests from a single blood sample provide adequate confirmation is uncertain,” wrote the study’s investigators, who launched a prospective study known as the Atherosclerosis Risk in Communities (ARIC) trial to see if this approach was possible.

 

Read more...

The FDA reviews guidelines for capillary glucose testing in critically ill patients
By Jeffrey A. DuBois, MLO, June 21, 2018
 

Capillary whole blood testing with point-of-care (POC) glucose meters in hospitalized patients and, particularly, in critically ill patients, remains a topic of interest in the medical and regulatory communities. However, determining the requirements for effective clinical use has proved challenging.

 

An FDA panel convenes

This past March, the U.S. Food and Drug Administration (FDA) convened its Clinical Chemistry and Clinical Toxicology Devices Advisory Panel, seeking guidance and recommendations on the acceptability of capillary specimens in critically ill patients based on benefits and risks, and whether capillary specimen testing in this patient population meets the criteria for waived status under the Clinical Laboratory Improvements Amendments (CLIA) regulations. The FDA began by summarizing the history of POC glucose testing for the panel and emphasized the need for manufacturers to submit data supporting their glucose meters’ acceptability for use with critically ill patients. The FDA reviewed the data submitted for a glucose meter cleared for use with these patients using arterial and venous specimens, and related that no manufacturer had submitted data for capillary whole blood. Read more >

Keeping the lab environment clean and safe

By Daniel J. Scungio, MLO, June 21, 2018

 

The clinical laboratory is an inherently dangerous place. Laboratorians face a variety of dangers working in an environment that contains biohazards. Utilizing standard precautions and correctly employing Personal Protective Equipment (PPE) are essential keys to ensure laboratorians’ safety. Maintaining a clean and orderly environment and employing good disinfection practices are vital as well. A cluttered workspace and an area contaminated with biohazards threaten the safety of both employees and visitors.

 

General disinfection tips

Lab directors should conduct audits of their department’s physical environment to identify safety hazards specific to their lab. Such audits typically do not need to interfere with the day-to-day lab processes, and they should be performed on a regular basis, at least monthly. Many changes can occur in a laboratory at any time, such as the movement of instruments, the placement of new equipment, or even the movement and stocking of lab supplies, and the implications of such changes for safety should be recognized. Read more >

New guidelines and studies suggest improved approaches to C. difficile testing
By Sherry A. Dunbar, MLO, June 21, 2018
 

Clostridium difficile represents a significant health threat around the world. In the United States, infections caused by C. difficile are now the most common type of healthcare-associated infection. Nearly half a million infections occur in the U.S. annually, with an estimated 29,000 deaths within 30 days of the initial diagnosis.

Consequently, much effort is ongoing toward the development of better testing and treatments for C. difficile. This year, new clinical guidelines were released that included significant changes to how healthcare teams respond to C. difficile infections. In addition, scientists and clinicians are conducting a number of studies and generating useful information that could guide new expectations or policies about testing and treatment.

For example, studies have shown that molecular tests targeting a marker specific to a single C. difficile strain are less useful now, as other strains of the pathogen have become more prevalent.3-5 These findings could help clinical labs fine-tune their C. difficile testing procedures to ensure the most reliable results. Also, several recent studies have demonstrated that... Read more >

Christiane Nooney from Duke Hospital
Named 2018 POCC of the Year by AACC


The AACC Critical and Point of Care Testing (CPOCT) Division has announced that Christiane “Chris” Nooney, MBA/MHA, MT(AMT), DUH POC Supervisor, Duke Hospital, DukeHealth has been award the 2018 Point of care Coordinator of the Year.

Chris was unanimously selected as the 19th recipient of this auspicious award given annually to recognize outstanding achievements in the POCT field by persons who are primarily responsible for a given institution’s POCT program. It is based on the extent of the nominee’s responsibilities and accomplishments, particularly the impact this person has made in improving the quality of the POCT program at their facility. The award also includes a cash award and funds to support attendance at the AACC Annual Meeting as well as an elegant trophy. Read more >

 

Other AACC Award Winners Announced include:

 

 

Outstanding Contributions to POCT

Best Annual Meeting Abstract for Outstanding Research in CPOCT

2018 Penny Jones Travel Award

Jeff Dubois, PhD

Nova Biomedical

Comparison of the Time Required for Manual and Semi-Automated Urinalysis and Pregnancy Testing with Associated EMR Manual Entry Errors

John R. Petersen and Peggy Mann

UTMB | Read more

JoAnn Crain, MS, CLS, UMass Memorial Medical Center, Worcester, MA

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