Intro to CLS Flashcards
Accessioning
The process where specimens are logged in, labeled, and assigned identification codes
Accreditation
Voluntary process in which a private, independent agency grants recognition to institution or programs that meet exceed established standards of quality.
AABB
American Association of Blood Banks:
International association that sets blood bank standards, accredits blood banks, and promotes high standards of performance in the practice of transfusion medicine.
Bacteriology
Study of bacteria
blood bank
Clinical laboratory department (immunohematology department) where blood components are tested and stores until needed for transfusion.
CDC
Centers for Disease Control and Prevention:
Central laboratory for the national public health system and provides services to state public labs and physicians, along with materials and guidelines
CMS
Centers for Medicare and Medicaid Services
(HCFA-HealthCare Financing Administration)
Agency within the Department of Health and Human Services (DHHS) responsible for implementing CLIA ‘88. Responsible for providing coverage and availability to citizens of the US.
CLSI
Clinical and Laboratory Standards Institute
(NCCLS-National Committee for Clinical Laboratory Standards)
An international, nonprofit organization that establishes standards of best current practices for clinical laboratories
Clinical Chemistry
Laboratory section that uses chemical principles to analyze blood and other body fluids.
Ex: Blood glucose, cholesteerol, assays of heart and liver enzymes, electrolytes (potassium , sodium, chloride, bicarbonate).
-Can have subdivisions like special chemistry (electrophoresis) or toxicology (Blood or urine analysis to determine drug presence).
CLIA ‘88
Clinical Laboratory Improved Amendments of 1988
-Federal act that minimizes performance standards for clinical laboratories.
-Ensure quality of laboratory work.
Coagulation
The process of forming a fibrin clot; the laboratory department that performs hemostasis testing (stopping of bleeding from a vessel).
Tests are used to diagonose patients who have defects in their blood-clotting mechanism.
CAP
College of American Pathologists
Agency that offers accreditation to clinical laboratories and certification to clinical laboratory personnel.
COLA
Commission on Office Laboratory Accreditation
Agency that offers accreditation to physician office laboratories.
DHHS
Department of Health and Human Services
Governmental agency that oversees public health care matters
FDA
Food and Drug Administration
the division of the DHHS responsible for protecting public health by assuring the safety of foods, drugs, biological products, medical devices, and cosmetics.
Epidemiology
CDC important area-the study of factors that cause disease and determine disease frequency and distribution.
-Data is gathered concerning the origin, distribution, and occurrence of diseases, especially outbreaks.
HIPAA
Health Insurance Portability and Accountability Act of 1996
Immunohematology
The study of human blood groups or blood banking
Immunology
Branch of medicine encompassing the study of immune processes and immunity.
JC
Join Commission
(JCAHO-Join Commission on Accreditation of Healthcare Organizations)
Independent agency that accredits hospitals and large health care facilities
LRN
Laboratory Response Network
-Nationwide network of laboratories coordinated by the CDC with the ability for rapid response to threats to public health
-Ensure that state and private laboratories were able to respond to threats in health.
Microbiology
Branch of biology dealing with microbes.
-Bacteriology procedures make up a lot of the work.
-Viruses as well
Mycology
Study of Fungi
Parasitology
Study of parasites
Pathologist
Physician specially trained in the nature and cause of disease.
AKA director of the hospital laboratory.
Phlebotomist
health care worker trained in blood collection
POL
Physician office laboratory
Small medical laboratory located within a physician office, group practice, or clinic.
-In 2006, 54% laboratories were classified as POLs.
-Can test hemoglobin, hematocrit, urine, pregnancy, blood glucose, occult blood.
Plasma
Liquid portion of blood in which the blood cells are suspended; the straw-colored liquid remaining after blood cells are removed from anti-coagulated blood.
POCT
Point of care testing
Testing outside traditional laboratory setting that is also called beside testing, offsite testing, or alternate-site testing.
PT
Proficiency testing
Program in which a laboratory’s accuracy in performing analyses is evaluated at regular intervals and compared to performance of similar laboratories.
PPMP
Provider performed microscopy procedure
Certificate category under CLIA ‘88
QA
Quality assessment
In the laboratory, a program that monitors the total testing process with the aim of providing the highest-quality patient care; “Quality assurance”
Reference laboratory
-Independent regional laboratory that offers routine and specialized testing services to hospitals and physicians. Large hospitals use them when infrequent or complex tests are requested.
-Usually privately owned, regional laboratories that do high volume testing.
Serum
The liquid obtained from blood that has been allowed to clot
Serology
The study of antigens and antibodies in serum using immunological methods; laboratory testing based on the immunological properties of serum
Virology
Study of Viruses
Numberof private and commercial laboratories in the U.S.
196,000
Small Hospital Labs
-Less than 100 beds
-May perform only routine tests
-Complicated requested tests may be sent to reference laboratories
Medium Hospital Labs
-up to 300 beds
-Routine tests and more complicated test procedures are performed
-Only recently developed tests, infrequently requested tests, and complex tests would be sent to reference labs
Large Hospital Labs
-300+ beds
Can handle large volumes of work and perform complex tests
Under CLIA ‘88, laboratories are classified as performing (3)…
-Waived tests
-Tests of moderate and high complexity
-Provider-performed microscopy procedures (PPMP)
5 CLIA certificates
1) Certificate of Waiver
2) Certificate for PPMP
3) Certificate for Registration
4) Certificate of Compliance
5) Certificate of Accreditation
Waived tests
Lab with certificate of waiver can only perform tests that are so simple and can be determined by CDC and FDA
Unwaived tests of 2004
74,000 labs performed tests that were unwaived out of 180,000 certified laboratories.
Laboratory Director Requirements
-Licensed by the state
-Hold a degree of doctor of medicine, doctor of osteopathy, or earned a doctorate in related clinical field.
-Hold certification from appropriate body
-Have supervisory and clinical lab experience
Clinical/technical consultants
For when hospitals don’t have a full time pathologist. Assist the laboratory director in matters of test appropriateness and interpretation or in technical matters related to test methods.
Hematology
Quantitative: Number of leukocytes, erythrocytes, platelets which can be performed manually or on a cell counter or hematology analyzer.
Qualitative: cell size, shape, maturity. Microscopes normally can help a worker view blood to spot any abnormalities in the blood smear.
Urinalysis
Study of Urine.
-Can be a separate department in a large laboratory in hematology or chemistry.
HIPAA Rules
1) Requires all healthcare facilities to use measures to keep patient info private
2) permits disclosure of information that is needed for patient care
3) Patient must be informed of their privacy rights and patients must give written permission for info to be shared to others.
4) Computers must be password protected
5) Computers should be positioned so visitors, patients, and other personnel cannot view the screen.
6) Use specimen codes instead of names.
AMT
American Medical Technologists
Professional society and credentialing agency for clinical laboratory personnel
AAMA
American Association of Medical Assistants
Professional society and credentialing agency for medical assistants
ASCLS
American Society for Clinical Laboratory Science
Professional society and credentialing agency for clinical laboratory personnel.
ASCP
American Society for Clinical Pathology
Professional society and credentialing agency for clinical laboratory personnel and allied health personnel.
ASPT
American Society of Phlebotomy Technicians
Professional society and credentialing agency for phlebotomists
Clinical Laboratory Science
The health profession concerned with performing laboratory analyses used in diagnosing and treating disease, as well as in maintaining good health; the field of medical laboratory technology.
-Works like a medical detective to diagnose and discover.
CLS
Clinical laboratory Scientist (Medical technologist)
Has…
-Baccalaureate degree from accredited college
-Completed clinical training in an accredited clinical laboratory science program
-has passed a national certifying examination
CLT
Clinical (Medical) Laboratory Technician
Has…
-Completed a minimum of 2 years of specific training in an accredited clinical laboratory technician program
-passed a national certifying examination
CAAHEP
Commission on Accreditation of Allied Health Education Programs (CAHEA)
Agency that accredits educational programs for clinical laboratory personnel
Ethics
System if conduct or behavior; rules of professional conduct
NAACLS
National Accrediting Agency for Clinical Laboratory Sciences
Agency that accredits educational programs for clinical laboratory personnel
NCA
National Credentialing Agency for Laboratory Personnel
Credentialing agency for clinical laboratory personnel
NPA
National Phlebotomy Association
Professional society and credentialing agency for phlebotomist
World War 1 Impact on Labs
It became clear that we needed…
-Educating laboratory workers
-Defining educational requirements
-Identifying adequately trained persons
Autoclave
An instrument that uses pressurized steam for sterilization
-Insulated gloves should be worn when removing hot items
Carcinogen
A substance with the potential to produce cancer in humans or animals
Caustic
A chemical substance having the ability to burn or destroy tissue.
Ex: Potassium hydroxide, sodium hydroxide, sulfuric acid, nitric acid.
-When handling chemicals, apron and gloves should be worn to protect against splashes.
Centrifuge
Instrument with rotor that rotates at high speeds in a closed chamber.
-Has a safety latch that prevents the devices from being turned on unless lid is latched.
Chemical Hygiene Plan
Comprehensive written safety plan detailing the proper use and storage of hazardous chemicals in the workplace.
Fume hood
Device that draws contaminated air out of an area and either cleanses and recirculates it, or discharges it to the outside
NIOSH
National Institute for Occupational Safety and Health
Federal agency responsible for workplace safety research and that makes recommendations for preventing work-related illness and injury
OSH act
Occupational Safety and health act
Congressional act of 1970 created to help reduce on-the-job illnesses, injuries, and deaths, and requires employers to provide safe working conditions.
OSHA
Occupational Safety and Health Administration
the federal agency that creates workplace safety regulations and enforces the OSH act.
-Can arrive unannounced to conduct inspections
PPE
Personal Protective Equipment
Specialized clothing or equipment used by workers to protect from direct exposure to blood or other potentially infectious or hazardous materials.
-Masks, goggles, face shield, protection against inhalation of fumes, and gloves.
Radioisotope
Unstable form of an element that emits radiation and can be incorporated into diagnostic tests, medical therapies, and biomedical research; radioactive isotope.
SOP
Standard Opening Procedures
Required to be posted to ensure safety of laboratories
Electrical Safety
-Minor repairs require instrument to be disconnected before work
-All plugs and cords must be kept away
-Circuits must not be overloaded
MSDS
Material Safety Data Sheet
Information describing the hazard of the chemical, ppe, and body organs that could be affected by experiment. These must be kept where every employee has access to them.
AIDS
Acquired Immunodeficiency Syndrome
Form of severe immunodeficiency caused by infection with the human immunodeficiency virus (HIV)
Aerosol
Liquid in the form of a very fine mist
Alimentary tract
The digestive tube from the mouth to the anus
Antiseptic
A chemical used on living tissues to control the growth of infectious agents
Biohazard
Risk or hazard to health or the environmental from biological agents
BBP
Blood-borne Pathogens
Pathogens that can be present in human blood (and blood-contaminated body fluids) and that cause disease.
BBP Standard
OSHA guidelines for preventing occupational exposure to pathogens present in human blood and body fluids, including, but not limited to, human immunodeficiency virus (HIV) and hepatitis B virus (HBV); final OSHA standard of December 6, 1991, effective March 6, 1992.
Disinfectant
Chemical used on inanimate objects to kill or inactivate microbes
Engineering control
Use of available technology and equipment to protect the worker from hazards
Exposure control plan
Plan identifying employees at risk of exposure to blood-borne pathogens and providing training in methods to prevent exposure.
Exposure incident
An accident, such as needle stick, in which an individual is exposed to possible infection through contact with body substances from another individual.
HBV
Hepatitis B virus
The virus that causes hepatitis B infection and is transmitted by contact with infected blood or other body fluids.
HCV
Hepatitis C virus
The virus that causes hepatitis C infection and is transmitted by contact with infected blood or other body fluids
HIV
Human immunodeficiency virus
The retrovirus that has been identified as the cause of AIDS
Isolation
The practice of limiting the movement and social contact of a patient who is potentially infectious or who must be protected from exposure to infectious agents; quarentine.
Nosocomial
Hospital acquired disease; acquired as a result of being hospitalized or institutionalized
OPIM
Other Potentially Infectious Materials
Any and all body fluids, tissues, organs, or other specimens from a human source
Parenteral
Any route other than by the alimentary canal; intravenous, subcutaneous, intramuscular, or mucousal
Pathogenic
Capable of causing damage or injury to the host
Standard Precautions
Set of comprehensive safety guidelines designed to protect patients and healthcare workers by requiring that all patients and all body fluids, body substances, organs, and unfixed tissues be regarded as potentially infectious.
Sterlization
The act of eliminating all living microorganisms from an article or area
Transmission-Based Precautions
Specific safety practices used in addition to Standard Precautions when treating patients known to be or suspected of being infected with pathogens that can be spread by air, droplet, or contact
Universal Precautions
Method of infection control in which human blood and other body fluids containing visible blood are treated as if infectious
Work practice controls
Methods of performing tasks that reduce the worker’s exposure to blood and other potentially harzardous materials.
Accuracy
Measure of how close a determined value is to the true value
Average
The sum of a set of values divided by the number of values; the mean
Blind sample
An assayed sample that is sent as an unknown to laboratories for PT programs
Calibtration
The process of checking, standardizing, or adjusting a method or instrument so that it yields accurate result
Coefficient of variation
Calculated value that compares the relative variability between different sets of data. (Standard Deviation divided by mean multiplied by 100 as a percentage)
Controls
solutions usually made from human serum, and with a known concentration of the same constituents at those being measured in the patient sample.
Gaussian curve
Graph plotting the distribution of values around the mean; normal frequency curve
Levey Jennings chart
Quality control chard used to record daily quality control values
Mean
The sum of a set of values divided by the number of values; the average
Popoulation
Entire group of items or individuals from which the samples under consideration are presumed to have come
Precision
Reproducibility of results; the closeness of obtained values to each other
QC
Quality Control
system that verifies the reliability of analytical test results through the use of standards, controls, and statistical analysis
QS
Quality Systems
in an institution, comprehensive program in which all areas of operation are monitored to ensure quality with the aim of providing the highest quality patient care
Random error
Error whose source cannot be definitely identified
Sample
a subgroup of population
Shift
An abrupt change from t he established mean indicated by the occurrence of all control values on one sided of the mean
Standard
Chemical solution of a known concentration that can be used as a reference or calibration substance
Statistics
Branch of mathematics that deals with collection, classification, analysis, and interpretation of numerical data; collection of quantitative data
Systematic Error
Variation that can influence results to be consistently higher or lower than the real value
Trend
Indication of error in analysis, detected by increasing or decreasing values in the control sample
Varience
The square of the standard deviation; mean square deviation
Westgard’s rules
Set of rules used to determine when a method is out of control.
Beaker
Wide-mouthed, straight-sided container with a pouring spout formed from the rim and used to make estimated measurements
Borosilicate glass
Nonreactive glass with high thermal resistance and commonly used to make high-quality labware
Critical measurements
measurements made when the accuracy of the concentration of a solution is important using glassware manufactured to strict standards.
Flask
Container with an enlarged body and a narrow neck
Flint glass
inexpensive glass with low resistance to heat and chemicals
Graduated cylinder
upright container with a flared base and volume scale
Labware
Articles or containers intended for laboratory use
Meniscus
The curved upper surface of a liquid in container
Micropipet
pipet that measures or holds one milliliter or less
Micropetter
Mechanical pipetter than can measure or deliver very small volumes, usually less than 1.0 mL
Noncritical measurements
Estimated measurements made in containers that estimate volume
Pipet
Slender tube used in laboratory for measuring and transferring liquids
Polyethylene
Plastic polymer of ethylene used for containers
polypropylene
Lightweight plastic polymer of propylene that resists moisture and solvents and is heat sterilizer
Polystyrene
Clear, colorless polymer of styrene used for labware
Quartz glass
expensive glass with excellent light transmission; used for curvettes; silica glass
Reagent
Substance or solution used in laboratory analyses; substance involved in a chemical reaction
Solute
the substance dissolved in a given solution
Solvent
Dissolving agent, usually a liquid
TC
To Contain
TD
To Deliver
Deionized water
Water that has had most of the mineral ions removed
Microfuge
A centrifuge that spins micro centrifuge tubes at high rates of speed
pH
measurement of the hydrogen ion concentration expressing the degree of acidity or alkalinity of a solution
Reverse osmosis
Purification of water by forcing water through a semi-permeable membrane
Rotor
Part of centrifuge that holds the tubes and rotates
Serlogical centrifuge
Centrifuge that spins small tubes such as those used in blood banking
Binocular
Having two oculars
Coarse adjustment
Control that adjusts position of microscope objectives and is used to initially bring objects into focus
electron microscope
Microscope that uses an electron beam to create images from a specimen and that is capable of much greater magnification and resolving power than a light microscope
Eyepiece
occular
Field diaphragm
adjustable aperture attached to microscope base
Fine adjustment
Control that adjusts position of objectives and is used to sharpen focus
Iris diaphragm
Device that regulates the amount of light striking the specimen being viewed through the microscope
Kohler illumination
Alignment of illuminating light for microscopy; double diaphragm illumination
lens
curved transparent material that spreads/focuses light
lens paper
special nonabrasive material used to clean lenses
microscope arm
the portion of the microscope that connects the lenses to the base
microscope base
the portion of the microscope that connects the lenses to the base
monocular
having one ocular or eyepiece
objective
magnifying lens closest to the object being viewed with microscope
ocular
eyepiece of microscope that contains magnifying lens
parfocal
having objectives that can be interchanged without varying the instrument’s focus
resolving power
the ability of microscope to produce separate images of two closely-spaced objects
stage
platform that holds object
working distance
distance between microscope objective and the microscope slide when the object is in sharp focus.
diluent
liquid added to a solution to make it less concentrated
dilution
solution made less concentrated by adding diluent
formula weight
weight of entity represented by chemical formula; molecular weight
lyophilize
remove water from frozen solution; freeze-dry
molar solution
solution containing one mole of solute per liter of solution
mole
formula weight of substance expressed with grams
present solution
solution made by adding units of solute per 100 units of solution
proportion
relationship in number to compare one portion or to the whole
ratio
relationship in number or degree of two things
solute
substance dissolved in a given solution
solution
homogeneous mixture of two or more substances
solvent
dissolving agent
titer
the reciprocal of highest dilution that gives the desired reaction
capillary
minute blood vessel that connects small arteries to small veins ans serves as oxygen exchange vessel
capillary action
action by which fluid enters a tube because of attraction between fluid and tube
capillary tube
slender glass or plastic tube used for lab procedures
heparin
anticoagulant used in certain procedures and in treatment for thrombosis
lancet
sterile, sharp blade used to perform a capillary procedure
lateral
toward the side
basilic vein
large vein on inner side of arm
caphalic vein
superficial vein of arm commonly used for venipuncture
guage
measure of diameter of needle
hematoma
swelling of tissue around vessel due to leakage of blood into tissue
hemoconcentration
increase in concentration of cellular elements in blood
hemolysis
rupture or destruction of RBC resulting in release of hemoglobin
hypodermic needle
hollow needle used for injections or for obtaining fluid specimens
lumen
the open space within a tubular organ or tissue
median cubital vein
superficial vein located in the bend of the elbow that connects the cephalic vein to the baslic vein
palpate
to examine by touch
phlebotomy
venipuncture; entry of vein with needle
