2.1. Clinical Laboratory Part 2

Question 1

Laboratory Requisition

Answer 1

• Form used by a physician to document the tests to be performed on the patients
• Have to test the patient first so that the doctor will be able to make his diagnosis
• Doctor will decide what test must be taken by the patient so that the doctor knows what to do
• ‘Pag walang clinical impression, reject agad

Question 2

Laboratory Requisition Contains:

Answer 2

• Patient’s demographic data
  (1) Maintain the privacy of the person
• Name, data, address, birthday
• Gender
• Date and time of collection
• Room no. (inpatient and outpatient)
  (1) Should have complete information
• Test selection
  (1) Should be updated
• Requisition form should be from the laboratory
• If requisition is received, follow date and time must be collected
• Identification of the person who performed the collection
• Name and sign of ordering physician
  (1) Name should be written
• Source of specimen
• Physician’s clinical diagnosis
  (1) Basis on what is the case of the patient
  (2) If no clinical, reject request
• Additional comments

Question 3

Laboratory Directory

Answer 3

• Internal test number / “Coding”
• Acronyms or abbreviations of the test
• Type of specimen required
• Specimen volume and the minimum acceptable volume
  (1) Usually these kind of lab directory is already given
  (2) Can be found in the pre-analytical phase
  (3) Needs to be exact
  (4) Verify with test number
• Collection notes
• Storage instruction of specimen
• Stability of the specimen
• Reference ranges
• Clinical significance
• Test schedule or testing interval/frequency
  (1) Schedule is already written so that one will know and be aware
• Method

Question 4

Laboratory Reports

Answer 4

• Transmit test results
  (1) Requires proper documentation
  (2) Have log book
  (3) Indicate date and time + person
  (4) Should be properly defined
• Reference ranges
• Date and time of the specimen collection
• Name, address of the laboratory
• Name and identification of patient
  (1) Coded
• Source of specimen
• Date and time the report was generated

Question 5

Three Phases of Laboratory Testing

Answer 5

Pre-Analytical Phase
Analytical Phase
Post-Analytical Phase

Question 6

Pre-Analytical Phase

Answer 6

• Occurs first in the laboratory process
• Specimen processing
• Patient preparation
  (1) If you have mistakenly recorded the patient’s info/mixed up the specimen, throughout the process is an error up to the post-analytical phase
• Paperwork and data entry
  (1) Need to be quiet and careful
  (2) Encode the information properly
• Look at the test if there is a corresponding code
• When assigning a lab code, there shouldn’t be a duplicate
• Specimen collection, processing, storage and transportation
• Responsible personnel: Phlebotomist, laboratory technician

Question 7

Analytical Phase

Answer 7

• Actual laboratory testing by using specific procedures
• Make sure to look at the specimen being tested QUALITY CONTROL
• Ensure accuracy, precision, reliability of test procedure
  (1) Precision testing, reliability testing
• Validates test reagents/kits, testing process, training of the lab personnel performing the tests

Question 8

Post-Analytical Phase

Answer 8

• Review and analysis of results
• Make sure that it is properly reviewed
• Recording and reporting of test results
  (1) Make sure that It is properly handled
  (2) Either patient or physician will receive
• Storage and disposal
• Releasing of results

Question 9

Laboratory Policies: Laboratory Hours and Emergency Work

Answer 9

• Definite working hours

- Outside regular working hours, organize a system for testing urgent specimen

Question 10

Laboratory Policies: Range of Tests to be Performed and Those to be Referred to Higher Level

Answer 10

• Number of staff available
• Availability of material resources
• Types of health institutions (hospital or health center)

Question 11

Laboratory Policies: Referral of Specimens When Necessary

Answer 11

Example specimens for HIV detection and water samples for bacteriological analysis

Question 12

Laboratory Policies: Collection of Laboratory Specimen

Answer 12

• Clearly labelled specimen

- Urine sample tray

Question 13

Laboratory Policies: Workload Capacity of Laboratory

Answer 13

• Should match to the number of staff
  (1) Training should be employed
  (2) Their level of training
  (3) Size of the laboratory
  (4) Availability of laboratory facilities