Introduction to Lab Medicine

Question 1

Understand the concept of National Patient Safety Goals and how they relate to Laboratory Medicine.

Answer 1

NPSGs were established in 2002 to help accredited organizations address specific areas of concern in regards to patient safety.Goal 1: improve the accuracy of patient identification
* We must now use at least two patient identifiers: name, DOB, Phleb initial/date, MR#
* Want to use a bar-coding system: Vantage System
Goal 2: improve the effectiveness of communication among caregivers
* Report critical values (so abnormal that require immediate Tx or the patient could have serious consequences) of tests and diagnostic procedures on a timely basis

Question 2

Understand the main sources of laboratory errors in pre-analytic, analytic and post-analytic testing phases

Answer 2

Pre analytic: Patient or specimen, error occurs before the analysis (70% of errors)
* Patient related: not fasting, not available
* Phlebotomy: wrong tube, incomplete filling
* Patient ID error
* Transportation: temperature fluctuation, lost, delayed
* Specimen problem: hemolysis, lipemia, wrong time of draw
* Physician/provider related: wrong test ordered, computer order issued
Analytic: Error due to specimen analysisPost analytic: Error during report delivery.

Question 3

Define Point of Care Testing, and know qualifications for performing a waived test

Answer 3

Point of Care Testing:defined as testing done on site where the patient care is being delivered. Are usually simple, waived tests. Examples are:
* ER: stroke patient to expedite triage
* Radiology: creatinine, pre-contrast evaluation
* Hospital floor: glucose
* Physician office: glucose, pregnancy test, strep screen
Waived test: Test is so simple to perform as to render the likelihood of erroneous results negligible. Qualifications are:
* Operator must follow manufacturers instructions
* Usually have built-in, automatic quality control
* Ex: Glucose meters, occult blood, pregnancy test

Question 4

What is the most common source of lab errors?

Answer 4

Pre-analytic errors, these error arise even before the sample is sent to the lab for analysis.70%

Question 5

Understand how Test Utilization Management will affect your practice.

Answer 5

Test utilization management is a strategy for performing appropriate laboratory and pathology testing with the goal of providing high-quality, cost-effective patient care. The goals are:
* Correct tests are ordered for the correct patients
* Best test methodologies are utilized
* Accuracy and quality remain high, ensuring the best medical care
Mayo clinic has algorithms to help with deciding what laboratory tests should be ordered