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Clinical Lab Science Lecture > Chapter 2 > Flashcards

Chapter 2 Flashcards

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1
Q

A study of lab errors showed that 98% of the errors in the diagnostic process occur in-

A

The preanalytical phase

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2
Q

Having recognized the role of preanalytical errors, The Joint Commission National Patient Safety Goals has-

A

Several goal areas that have specific applications for clinical labs

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3
Q

2 main areas of patient safety-

A

Communications & mitigating patient risk

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4
Q

3 goal areas by Joint Commission National Patient Safety-

A

-ID patient by using their name & DOB
-improve staff communication to ensure getting important test results to right staff person on time
-prevent infection by using CDC or WHO guidelines

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5
Q

ASCLS Patient Safety Indicators: Preanalytical- (6)

A

-patient identification
-phlebotomy-associated negative events
-specimen integrity
-order entry
-specimen identification
-effective use of the clinical lab

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6
Q

ASCLS Patient Safety Indicators: Analytical-

A

Verification of the accuracy of abnormal results

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7
Q

ASCLS Patient Safety Indicators: Postanalytical- (3)

A

-communication of test results
-effective use of test results
-outcomes of lab testing

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8
Q

The need for clear communication is-

A

Imperative

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9
Q

Avoiding direct communication of an error that harmed a patient is-

A

Unacceptable

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10
Q

Avoidance lowers or removes the urgency for-

A

Quality improvement

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11
Q

Medical euphemisms are commonly used in clinical labs to describe-

A

Medical errors that harm patients

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12
Q

The use of euphemisms is a bad habit thought to be rooted in-

A

The desire to avoid painful, complex quality improvement issues as well as the extra work that improvement strategies create

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13
Q

Taking time to communicate will help-

A

Ensure patient safety

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14
Q

Preparation for information technology outages- (2)

A

-planned outages for updates or upgrades
-unexpectedted failures or impairments with an unknown length of downtime

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15
Q

The initial step toward managing IT downtime is to have a-

A

Clear activation & communications plan with established guidelines for initiating downtime protocols

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16
Q

IT downtime protocols- (5)

A

-share protocols with patient care areas
-a single lab contact creates an organized approach
-focus on reporting critical info
-clear communication throughout is essential
-conduct a critique after the outage

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17
Q

Most lab accidents are preventable by- (3)

A

-exercising good technique
-staying alert
-using common sense

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18
Q

Lab safety includes ___standards & ___ guidelines-

A

-OSHA Standards
-CDC Guidelines

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19
Q

_____ is a safety issue-

A

Ergonomics

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20
Q

Safety Standards & Governing Agencies- (5)

A

-US Department of Labor’s Occupational Safety & Health Administration (OSHA)
-Clinical & Lab Standards Institute (CLSI)
-Center for Disease Control (CDC), part of the US Department of Health & Human Services (DHHS), US Public Health Services
-College of American Pathologists (CAP)
-The Joint Commission

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21
Q

Major changes to the standard in 2012 include:

A

-Hazard Classification
-Labels
-Safety Data Sheet

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22
Q

Hazard Classification provides specific criteria to address-

A

health & physical hazards as well classification of chemical mixtures

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23
Q

Chemical manufacturers & imports must provide a label that includes- (4)

A

-signal word
-pictographs
-hazard statement
-precautionary statement for each hazard class & category

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24
Q

SDS information is mostly the same as the MSDS, except the SDSs are required-

A

To be presented in a consistent, user-friendly, 16-section format

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25
Q

The OSHA-mandated program, Occupational Exposure to Bloodborne Pathogens, requires that labs- (2)

A

-manage & handle medical waste in a safe & effective manner
-develop, implement, & comply with a plan that ensures the protective safety of lab staff to potential infectious bloodborne pathogens

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26
Q

All employees who handle hazardous material & waste, must be-

A

Trained to use & handle these materials

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27
Q

Chemical hazard education sessions must be presented to-

A

New employees & conducted annually for all employees

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28
Q

Each lab is required to evaluate the-

A

Effectiveness of its plan at least annually & to update it as necessary

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29
Q

Biohazards denote-

A

Infectious materials or agents that present a risk or even a potential risk to the health of humans or animals in the lab

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30
Q

Risk is defined as-

A

The probability that a health effect will occur after an individual has been exposed to a specific amount of hazard

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31
Q

Bioterrorism agents are divided into categories- (3)

A

-A
-B
-C

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32
Q

Biosafety is divided into levels- (4)

A

-1
-2
-3
-4

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33
Q

Risk assessment is an important part of-

A

Biosafety

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34
Q

Labs should perform a risk assessment to determine-

A

If there are certain procedures or specimens that may require higher levels of biocontainment

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35
Q

Most frequent routes of lab-acquired infections & accidental inoculation are- (4)

A

-Inhalation
-percutaneous inoculation
-contact between mucous membranes & contaminated material
-ingestion

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36
Q

An occupational exposure is- (6)

A

-percutaneous injury
-contact by mucous membranes or non intact skin with blood
-tissues
-blood-stained body fluids
-body fluids to which Standard Precautions apply
-concentrated virus

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37
Q

The likelihood of infection after exposure to blood affected with HBV or HIV depends on- (4)

A

-the concentration of HBV or HIV virus; viral concentration is higher for HBV than for HIV
-the duration of contact
-the presence of skin lesions or abrasions on the hands or exposed skin of the healthcare worker
-the immune status of the healthcare worker for HBV

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38
Q

Most exposures do not result in-

A

Infection

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39
Q

Personal protective equipment- (3)

A

-selection & use of gloves
-facial barrier protection & occlusive bandages
-lab coats or gowns as barrier protection

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40
Q

Disinfection describes a process that-

A

Eliminates many or all pathogenic microorganisms, except bacterial spores, or inanimate objects

41
Q

In healthcare settings, objects usually are disinfected by-

A

Liquid chemicals or wet pasturization, including hypochlorites

42
Q

Disinfecting procudure is used on-

A

Nondisposable equipment

43
Q

Disposable labware or supplies that have come in contact with blood should be-

A

Autoclaved or incinerated

44
Q

general infection control safety practices- (4)

A

-pipetting safeguards: automatic devices
-safety manual
-sharps safety & needlestick prevention
-transport & handling of diagnostic specimens

45
Q

use of the sharps container permits- (2)

A

-quick disposal of a needle without recapping
-safe disposal of other sharp devices that may be contaminated with blood

46
Q

specimens should be transported to the lab in-

A

plastic leakproof bags

47
Q

protective gloves should always be worn when handling-

A

any type of biological specimen

48
Q

zika-

A

within the US as category B biological substances

49
Q

all devices in contact with blood & capable of transmitting infection to the donor/recipient must be-

A

sterile & nonreusable

50
Q

proper handling of blood & body fluids is critical to-

A

the accuracy of lab test results

51
Q

the safety of all individuals who come in contact with specimens must be-

A

guaranteed

52
Q

if blood specimen is to be transported, the shipping container must-

A

meet OSHA requirements for shipping clinical specimens

53
Q

shipping containers must meet the packaging requirements of- (2)

A

-major couriers
-US department of transportation hazardous materials regulations

54
Q

prevention of disease transmission required immunizations- (6)

A

-Hep B
-influenza
-measles
-mumps
-rubella
-varicella

55
Q

prevention of disease transmission optional immunizations- (8)

A

-hep A
-meningococcal disease
-pertussis
-typhoid
-vaccinia
-diptheria
-pneumococcal disease
-tetanus

56
Q

prevention of disease transmission screening tests- (3)

A

-tuberculosis: purified protein derivative (PPD Mantoux) skin test
-rubella
-hep B surface antigen

57
Q

prophylaxis, medical follow up, & records of accidental exposure- (3)

A

-Hep B
-Hep C
-HIV

58
Q

prevention of disease transmission for tuberculosis control-

A

respirators or masks

59
Q

prevention of disease transmission for protection from aerosols- (2)

A

-biosafety cabinets
-negative-pressure isolation rooms

60
Q

specific hazardous chemicals- (9)

A

-sulfuric acid
-nitric acid
-acetic acid
-hydrochloric acid
-sodium hydroxide
-phenol
-carbon tetrachloride
-trichloroacetic acid
-ethers

61
Q

carcinogens are any substance that causes-

A

the development of cancerous growths in living tissue

62
Q

when a potentially hazardous solution or chemical is being used, protective equipment for- (5)

A

-eyes
-face
-head
-extremities
-protective clothing or barriers

63
Q

volatile or fuming solutions should be used under-

A

a fume hood

64
Q

quick action is essential in case of-

A

accidental contact with a contaminated substance

65
Q

shock or fire can result from-

A

electrical apparatus

66
Q

OSHA regulations stipulate for grounding electrical equipment-

A

published in the National Fire Protection Association’s National Electrical Code must be met

67
Q

all electrical equipment must be-

A

underwriters labs approve

68
Q

regular inspection of electrical equipment decreases-

A

the likelihood of electrical accidents

69
Q

grounding of all electrical equipment is-

A

essentially

70
Q

any equipment used in an area where organic solvents are present must be equipped with-

A

explosion-free fittings

71
Q

for fire safety, personnel need to be trained in-

A

the use of safety equipment & procedures

72
Q

acronym for the use of a fire extinguisher-

A

PASS: Pull, Aim, Squeeze, Sweep

73
Q

fire classifications- (5)

A

-A
-B
-C
-D
-E

74
Q

fire classification A-

A

ordinary combustules

75
Q

fire classification B-

A

flammable liquids & gasses

76
Q

fire classification C-

A

electrical equipment

77
Q

fire classification D-

A

powdered metal (combustible) material

78
Q

fire classification E-

A

cannot be extinguished

79
Q

any broken/cracked labware should be discarded in-

A

special container for broken glass

80
Q

proper storage of labware-

A

heavy pieces on lower shelves & tall pieces placed behind smaller pieces

81
Q

OSHA regulations apply to- (3)

A

-human blood
-human infectious waste
-human pathologic waste

81
Q

body fluid specimens must be placed in-

A

well constructed biohazard containers with secure lids to prevent leakage during transport & future disposal

82
Q

plastic bags are appropriate for disposal of-

A

most infectious waste materials

83
Q

rigid, impermeable containers should be used for disposal of-

A

sharps & broken labware

84
Q

most labs generate at least 3 major types of waste streams-

A

-nonregulated waste
-regulated medical waste
-chemical waste

85
Q

regulated medical waste is divided into 2 groups-

A

-biohazard waste
-biohazard sharps

86
Q

control of infectious. chemical, & radioactive waste is regulated by- (2)

A

-OSHA
-US FDA

87
Q

infectious waste being discarded in proper biohazard containers should be conspicuously marked-

A

“biohazard” & bear the universal biohazard symbol

88
Q

infectious waste being discarded in proper biohazard containers should display the universal color- (3)

A

-orange
-orange & black
-red

89
Q

infectious waste being discarded in proper biohazard containers should be used for- (3)

A

-blood
-certain body fluids
-disposable materials contaminated with blood & fluids

90
Q

who regulated radioactive waste disposal?

A

The Nuclear Regulatory Commission

91
Q

eyewash stations & safety shower equipment need to be within-

A

100 feet or no more than a 10 second walk from hazardous chemicals

92
Q

the first priority in basic first aid procedures-

A

removal of accident victim from further injury, followed by definitive action or first aid to victim

93
Q

because many injuries may be extreme & because immediate care is critical with such injuries, all lab personnel must thoroughly understand the application of-

A

the proper first-aid procedure

94
Q

safety audit incase of heat burns- (3)

A

-apply cold running water (or ice water) to relieve pain & stop further tissue damage
-use a wet dressing of 2 tablespoons of sodium bicarbonate in 1 quart of warm water
-apply a bandage securely but not tightly

95
Q

safety audit incase of third degree burns-

A

consult a physician immediately

96
Q

safety audit incase of serious cuts-(2)

A

-apply direct pressure to the wound area to control bleeding, using the hand over a clean compress covering the wound
-call for a physician immediately

97
Q

safety audit incase of minor cuts- (3)

A

-wash the wound carefully & thoroughly with soap & water
-remove all foreign material that projects from the wound by careful washing, but do not gouge for embedded material
-apply a clean bandage if necessary

Clinical Lab Science Lecture (10 decks)

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